It’s that season again, and I think the bad stuff has started earlier this go ‘round. Of course, I’m referring to cold and flu season. We know that our kids are going to get colds and we do our best to treat the symptoms, but what should we do when they get a really horrible cough? You know, the kind of cough that makes them cry in pain or gasp for breath or throw up or not be able to sleep or get sent home from school.
Well, here’s how your doctor thinks about a cough. Most of the time a cough is one of those mixed blessings, like fever or even pain. A cough is a life-saving reflex that clears our airways when we’re sick and can save our lives when we’re choking, but we also realize it can make us miserable and feel like we’re never going to get better.
Early in an illness, doctors only get concerned about a cough if it has a unique sound (like the high-pitched cough with croup), if it’s consistently productive of phlegm, if it’s worse than expected (as with an asthmatic), if it’s associated with persistent shortness of breath (sustained rapid breathing), or if a patient is also feeling and acting seriously ill. Apart from these situations, we would recommend home remedies (like honey), homeopathic remedies (like Zarbee’s), or traditional over-the-counter cough medicines (like Robitussin DM or Delsym). Most of the time, we should save any cough syrup for use at night before bed only.
Later on in the course of an upper respiratory infection, we’ll often remind our patients that the cough is usually the last symptom to go away. This may take at least 2-3 weeks and should not be a reason for concern as long as your child is feeling well and the other symptoms are mostly gone. Beyond this time frame, even if we decide to treat the cough with an antibiotic for bronchitis or atypical pneumonia, there is no guarantee that the antibiotic will make much of a difference. And this is also assuming that your child hasn’t gotten sick with another cold virus just as they were getting better from the last one. This happens a lot in the older infants and toddlers, so be warned.
For otherwise healthy children, most of the time a cough can be taken care of at home. If you’re just not sure or something seems worrisome about your child’s cough or illness, then that is the time to contact your doctor.