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Doctor at the Desk

Calming that

By: Lourdes Nena A. Cabison-Carlos, MD article_3

Coughs are one of the most common reasons for a visit to the doctor. A tiny body can produce a very loud and scary cough, which can alarm parents. But really, cough is an important reflex that helps protect the lungs by clearing secretions and foreign matter which somehow found their way inside the airways either by aspiration, inhalation, inflammation/ infection or postnasal drip. However, excessive coughing can not only be troublesome but also potentially harmful to the airway mucosa.

Most upper and lower respiratory tract diseases would manifest as a cough. Why is a cough alarming nowadays? According to recent reports, cases of a whooping cough, which is a vaccine preventable disease, has been increasing in the recent years. Researchers attribute this to waning immunity because the vaccine provides a shorter term of protection than originally thought. That being said, cough in children can cause significant anxiety to parents and caregivers. And because advertisements on cough medications abound, the use of inappropriate or unnecessary medications for a cough is a normal practice.

Causes of A cough

To be able to successfully treat a nasty cough, one should always look for the cause. In children, cough is usually caused by the following:

Infection: Viruses and bacteria abound in our environment. Because the immune system of a child is still developing, they are particularly prone to diseases. In the Philippines, where most of the population live in crowded environments, viruses and bacteria can pass from one person to another as fast as the daily gossip. This is primarily the reason why prevention through hand washing, proper hygiene and immunization is very important.

Asthma: a lot of parents will go to the clinic claiming that their child has “asthma”. In truth, diagnosing asthma can be a challenge. The presence of wheezing, the timing of a cough and trigger factors are among the many considerations when dealing with a child with asthma. Hence, it is better to seek a consult with your pediatrician before accepting that nebulizer your friendly neighbor is offering to lend.

Acid reflux: this is usually diagnosed through a careful history and physical examination. Symptoms would include vomiting or spit up and for children old enough to verbalize ouchies, a bad taste in the mouth and heartburn.

Allergies: sometimes, a lingering cough can be due to irritants and allergens commonly found in your home. Examples of “triggers” are cigarette smoke, animal hair, dust, and mites.

Foreign body: children love putting things in their mouth and they can easily choke on small objects. A sudden, forceful cough that has your child turning blue should always receive medical attention.

A psychogenic cough: in adults and older children, anxiety is a known risk factor for a chronic cough. However, that habitual “ehem ehem” is difficult to diagnose, so give your child the benefit of doubt and rule out all other causes before you suspect your child with it.

How to help your child

Over-the-counter medicines for a cough are little or of no help. Cough medicines given to children under age 4 should always be upon the advice of your doctor because most of these medicines are not approved for young children. Candies that relieve a sore throat and itchiness are also not recommended for young children for the obvious choking hazard. However, some simple home remedies can help children cope with a cough.

  • Remove irritants from your home. Clean the carpet, dust the shelf and change your beddings as these might harbor allergens which trigger your child’s cough.
  • Cool-mist humidifiers can help your child especially if they are having trouble sleeping at night. Using hot steam is not advisable because of children, being the curious little critters that they are, run a high risk of burning themselves.
  • Clear soups and plenty of fluids not only will help soothe that itchy throat but also keep your child hydrated.
  • Some studies have shown that honey can help your child better than cough syrups, but check with your doctor first as giving honey to infants can cause botulism.
  • Giving herbal remedies or chest rubs on children have not been thoroughly studied so give these only when given a “go” signal by your doctor.

When to see your doctor

Because it is very common in children, some parents are very laid back when a child coughs. The presence of any of the following, however, warrants a visit to the doctor (or the ER).

  • Breathing faster than usual or is working hard to breathe (for babies and young children, you may observe widening of the nostrils, noisy breathing, refusing to suck or drink milk)
  • Bluish or dusky tinge of the lips, tongue or fingernail
  • A cough with a fever
  • Coughs and makes a “whooping” sound after
  • Coughs out blood or vomits after coughing
  • Increased sleeping time, weakness, irritability, or appears dehydrated
  • Babies who cough and are younger than 3 months should always be seen by a doctor right away

Easy methods for prevention

Infection is easily spread by coughing, sneezing or unclean hands.  We can stop the spread of germs by the following:

  • Avoiding close contact with sick people
  • Concurrently, when we are sick, we should also prevent infecting others by staying at home (please, please avoid going to the mall when you’re sick!)
  • Wash your hands with soap and water, or use an alcohol-based hand rub. Truly, handwashing is the most effective component in preventing the spread of infection!
  • Avoid touching your eyes, mouth, nose and body fluids
  • Cover your mouth and nose (please!) with a tissue when coughing or sneezing and throw away the tissue after use and then wash your hands. When tissue is not available, you can cough on your sleeve or inside your shirt.

So there you go! Hopefully, by following these tips, we can all have a cough-free, fun-filled summer! 


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Keywords: cough, children, phlegm, wheezing, psychogenic, Acid reflux, Asthma, Infection, irritants   
  
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