Cough (Viral Brochitis)
- The cough reflex expels air from the lungs with a sudden explosive noise.
- A coughing spasm is more than 5 minutes of continuous coughing.
Cause
Most coughs are due to a viral infection of the trachea (windpipe) and bronchi (larger air passages). These infections are called tracheitis and bronchitis, respectively. Most children get this infection a couple of times every year as part of a cold. Keep in mind that coughing clears the lungs and protects them from pneumonia. Bronchitis isn’t serious. The role of milk in thickening the secretions is doubtful.
Expected Course
Usually bronchitis gives a dry tickly cough that lasts for 2 to 3 weeks. Sometimes it becomes loose (wet) for a few days and your child coughs up a lot of phlegm (mucus). This is usually a sign that the end of the illness is near.
Home Care
Medicines to Loosen the Cough and Thin Secretions
Cough drops: Most coughs in children over 4 years of age can be controlled by sucking on cough drops freely. Any brand will do.
Homemade cough syrup: For children under age 4 years, use 1⁄2 to 1 teaspoon of honey or corn syrup instead of cough drops. Honey and corn syrup can thin the secretions and loosen the cough.
Warm liquids for coughing spasms: Warm liquids usually relax the airway and loosen the mucus. Start with warm lemonade, warm apple juice, or warm herbal tea if your child is over 4 months old. Avoid adding any alcohol because inhaling the alcohol fumes stimulates additional coughing and also because there is a risk of intoxication from unintentional over dosage. Children over 4 years old can suck on butterscotch hard candy or cough drops. (Reason: to coat the irritated throat.)
Cough Suppressants. Cough suppressants reduce the cough reflex, which protects the lungs. They are only indicated for dry coughs that interfere with sleep, school attendance, or work. They also help children who have chest pain from coughing spasms. They should not be given to young children under 24 months of age or for wet coughs.
A nonprescription cough suppressant is dextromethorphan (DM). Ask your pharmacist for help in choosing a brand that contains DM without any other active ingredients. Dosage is on the bottle and should not be used in children under 2
Often honey or corn syrup or cough drops can be given during the day and DM given at bedtime and during the night. DM is also available as a cough lozenge for easy carrying and as a long-acting (12-hour) liquid. BE AWARE: cough medicines do not STOP the cough they only quiet the cough minimally.
Humidifiers in the Treatment of Cough. Dry air tends to make coughs worse. Dry coughs can be loosened by encouraging a good fluid intake and using a humidifier in your child’s bedroom. Ultrasonic humidifiers are very quiet, and they kill molds and most bacteria found in the water. Don’t add medication to the water in the humidifier because it irritates the cough in some children.
Active and Passive Smoking. Teenagers will find that physical education classes and exercise trigger coughing spasms when they have bronchitis. If so, such physical activity should be avoided temporarily. Don’t let anyone smoke around your coughing child. Remind the teenager who smokes that his cough may last weeks longer than it normally would without smoking.
Common Mistakes in Treating Cough. Antihistamines, decongestants, and antipyretics are found in many cough syrups. These ingredients are of unproven value, and the antihistamines carry the risk of sedation. Expectorants are of unproven value but harmless. Stay with the simple remedies mentioned above or use dextromethorphan. Milk does not need to be eliminated from the diet, since restricting it only improves the cough if your child is allergic to milk. Also, never stop breast feeding because of a cough.
CALL OUR OFFICE IMMEDIATELY if:
- Breathing becomes difficult and is not better after you clear the nose.
- Your child starts acting very sick.
During regular hours if:
- A fever lasts more than 3 days.
- The cough lasts more than 3 weeks.
- You have other concerns or questions.