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Child's Cough: Is No Medicine the Best Medicine?

cough medicine, children, age, guidelines, otc, safe, effective

When your child has a bad cough, it's natural to want to do something, anything, to soothe the sore throat, stop the painful cough, and generally make your kid feel better again.

There are plenty of over-the-counter cough suppressants out there, but is medicine the best antidote?

"Probably not," says pediatrician Dr. Pamela Phillips. "Cough is the body's way of keeping bacteria out of the lungs, so it's not a good idea to suppress a cough."

"We don't generally recommend over-the-counter cough medications for children because side effects such as sedation, irritability, and behavioral changes tend to outweigh any potential benefits."

In fact, the American Academy of Pediatrics recommends against giving children younger than 4 over-the-counter cold and cough medications. Instead, the advice is to let the illness run its course and wait it out.

Getting through a cough without medication

Most school-age kids get 5 or 6 colds a year and each one can last 2-3 weeks. So it may feel like your child is constantly battling a cold or cough, especially from October through March. 

"We don't generally recommend over-the-counter cough medications for children because side effects such as sedation, irritability, and behavioral changes tend to outweigh any potential benefits," explains Dr. Phillips. 

What should I use instead of medication?

In the absence of medication, most pediatricians suggest supportive care to help kids weather coughs and other cold symptoms. 

Because cough and sore throat result from postnasal drip, clearing out your child's sinuses is the first step. Top remedies include: 

  • Steamy showers: One way to loosen up phlegm is to stand in a steamy shower for 10 minutes. If your child has a barking, croup-like cough, have them step into cold air after the steam. "For whatever reason, that 1-2 punch of steam followed by cold air tends to quiet down the cough," Dr. Phillips says.
  • Saline nasal drops or sprays: Saline helps flush the nasal cavity of the icky stuff that causes cough. It also helps moisturize the nasal passages, which can ease sore throats. 
  • Nasal aspirators: For children who can't blow their own noses, nasal aspirators can help you clear out their nasal passages so they can breathe a little easier. The process eliminates excess mucus from stuffy nasal passages and helps eliminate cough irritants in the process.  
  • Humidifiers: Cool-mist humidifiers disperse moisture into the air, which can help loosen mucus and relieve swollen throats. Choose cool mist instead of hot water or steam to prevent a child from getting burned. 
  • Prop your child's head up: When kids lie flat, mucus can build up in the sinuses, where it can clog nasal passages and interfere with restful slumber. You can help relieve the pressure by propping up your child's head with a pillow to decrease blood flow to the nose. 

And the sore throat that comes with a cough?

Sucking on a popsicle can help relieve a scratchy throat. Older children can try low-sugar cough drops.

When to see a pediatrician

The majority of kids' coughs go away without treatment. But there are cases where you have to be more vigilant. 

"Viruses can wear down the body's ability to keep bacteria out of the lungs where it doesn't belong," says Dr. Phillips. 

"So if a cough or cold gets worse instead of better, particularly with a fever that comes on later in the course of the illness, the child should be seen by a doctor to make sure they're not developing a bacterial infection." 

Other signs that warrant a visit to the pediatrician: 

  • Persistent cough: Children who have a cough that lasts for more than 3 weeks should see a pediatrician. 
  • Difficulty breathing: If your child has labored breathing, or if they're using their belly to breathe, call a doctor right away. 
  • A seal-like barking cough: This signature sound can indicate a specific virus called croup, which can be especially dangerous for young children. 
  • Stridor breathing: Stridor is noisy breathing that is high-pitched or creaky. If a child has stridor at rest, they may need steroid treatment to weather the illness. 
  • Wheezing: Wheezing is especially common in young babies and it often sounds like a whistle on the exhale. 
  • Severe malaise: A child who is not interacting with you, or who is lethargic and has no appetite, should see a physician. 

The best medicine

When it comes to cold and cough, prevention is the best medicine. Encourage your child to get plenty of rest, eat a mix of fruits and vegetables to boost the immune system, and practice good hand-washing hygiene.

A solid hand-washing routine should take 20-30 seconds, about the time it takes to sing "Happy Birthday." No soap or water? Use hand sanitizer until your kid can get to a sink.