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Cough (Children)

 


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Condition
Cough (Children)
Class
Respiratory system
Description
A cough is a protective mechanism that the body uses to clear the airways of an obstruction such as a foreign object, dust, smoke, irritants or mucus. A cough may also be due to inflammation of the upper airway caused by a viral infection such as a cold or influenza, or a symptom of other diseases that affect the lungs such as asthma, bronchitis or whooping cough.
Causes
Coughing occurs when the body wants to clear something from the airways. Foreign objects, dust, smoke, irritants, mucus or particles of food stimulate receptors in the airways that send signals to the brain that start the coughing reflex. When a child has a viral infection such as cold, it is the inflammation of the airways and the presence of mucus running down the back of the nose onto the throat, which causes the cough. When the airways are inflamed, they become swollen and make breathing more difficult. The receptors in the airways react as if there is an obstruction, signalling a cough reflex. In rare cases, a cough may be a symptom of more serious diseases such as tuberculosis or pneumonia.
Symptoms
There are three types of cough - productive cough, congested non-productive cough and a dry cough.

A productive cough, sometimes called a chesty cough makes a person feel that they want to clear mucus or phlegm that has been produced as a result of a chest infection. The mucus is thin and clear and is removed by coughing.

A congested non-productive cough also makes a person feel that there is mucus in the airways that needs to be cleared, but because the mucus is thick and clinging it is difficult to be dislodged by coughing.

A dry cough, sometimes called a non-productive cough, is called dry as there is no mucus to clear. The dry cough is produced by a persistent tickling in the throat or chest that is often worse at night.
Treatment
The treatment of cough depends upon the type of cough and the nature of the symptoms.

A productive or chesty cough is useful as it clears mucus from the airways. A productive cough should not be suppressed. If the mucus is not cleared, then it can lodge in the airways making breathing more difficult and increasing the chances of causing a secondary bacterial infection. There is usually no need to treat a productive cough with a cough medicine. Inhaling steam from a bowl of hot water with a towel over the head will help loosen the mucus. If necessary, oils such as Olbas Oil or Karvol capsules can be added to the hot water to clear any nasal congestion.

A congested non-productive cough needs to be treated with an expectorant. The expectorant will thin and loosen the thick, sticky mucus allowing it to be cleared from the airways by coughing. There are a number of expectorant cough medicines available that include substances such as guaifenesin, ipecacuanha, ammonium chloride or squill. These substances stimulate the production of a watery mucus in the airways which helps thin the sticky congested mucus. Sometimes, the mucus is so thick that even expectorants will not work. In these circumstances, medicines such as carbocisteine, erdosteine and mecysteine may be used. These medicines are called mucolytics, they break down the mucus into smaller pieces, so helping it to be cleared more easily.

A dry, tickly cough serves no useful purpose and can be very tiring and annoying if it persists for a long time. It is treated by medicines known as cough suppressants or antitussives such as pholcodine and dextromethorphan. Antitussives work by suppressing the cough reflex in the brain. Preparations called demulcents may also be used. These preparations which include glycerin, honey and lemon have a soothing effect, helping to relieve the tickling sensation that is causing the dry cough. They may be taken in the form of a cough medicine or as pastilles.
When to consult your pharmacist
Many of the traditional cough and cold medicines are no longer supplied from supermarkets or other non-pharmacy outlets and are available only from a local pharmacy following a review of the safety of the use of these medicines in children.

Cough and cold remedies containing antihistamines, antitussives, expectorants or decongestants are not suitable for children under 6 years of age. Children under 6 years of age suffering from a cough or a cold may be given paediatric formulations of medicines containing paracetamol or ibuprofen to lower a raised temperature, or if they have a cough may be given soothing cough medicines containing glycerin, honey or lemon.

Cold remedies containing antihistamines, antitussives, expectorants or decongestants can be used in children age 6 to 12 years, but they should only be used after soothing preparations have been tried and they should not be used for more than 5 days. Never give your child more than the recommended dose or other cough and cold medicines containing similar ingredients at the same time.

Preparations containing codeine and dihydrocodeine should not be used to treat coughs and colds as they are not considered appropriate and may cause addiction if taken for more than 3 days.

Always tell your pharmacist your child's age and describe your child's symptoms so the pharmacist may be able to recommend the most suitable product. If your child's cough produces green or yellow coloured mucus, or if your child has had a cough for more than two weeks following a viral infection, these symptoms indicate that your child may have a secondary chest infection requiring an antibiotic, and so you will be advised to see your doctor.
When to consult your doctor
You should see your doctor if your child has a persistent, high temperature, a painful cough, wheezing, shortness of breath or trouble swallowing.
Living with a cough
If your child's cough is caused by a cold or influenza, you can normally expect the cough to go within a week. During this time, give your child plenty of fluids to drink to help soothe a dry cough or to help improve a productive and non-productive cough. Cough medicines, as described above, can also be given if considered necessary.

Try to avoid irritants and allergens that can make your child's cough worse. Examples of irritants include paint fumes, perfumes and air fresheners. Examples of allergens include dust, animal fur, mould, and pollens from trees, grasses, and flowers. A room humidifier or steam vaporiser may help relieve an irritated throat and loosen mucus. Try to keep your child physically active.

Do not smoke or allow other people to smoke in the presence of your child. In addition to the smoke irritating your child's cough, passive smoking increases the risk of your child developing heart and respiratory problems later in life.

If your child suffers from asthma that requires continuous or repeated use of steroids, or has been admitted to hospital because of a previous asthma attack, go to see your doctor at the first signs of a cough. Make sure that your child takes any prescribed antibiotics as directed and ensure that your child has adequate supplies of reliever and preventer inhalers, and has the influenza vaccine each year.
Useful Tips
  • Keep your child in a warm room
  • Do not smoke or allow others to smoke near your child
  • Give your child plenty of fluids


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