Hacking Up a Lung: What is the Best Cough Medicine for Kids?

Coughing children are a big problem.  They can’t sleep.  They keep their parents awake.  They sound dreadful.  They cough so hard they barf (ick).  

 

Every parent, at some time, comes to me desperately seeking a cure for their child’s cough.  The children are usually desperate too, though after his mom told me that he had coughed for a month, one patient of mine seemed quite gleeful, exclaiming “And I have snot rockets!”

 

What can a sleep-deprived parent do to help the hacking little one?  Isn’t there a medicine to stop that cough?

 

The marketers of cough and cold medications would like you to think so.  Take a tour of the cough and cold aisle in your local drugstore and you will see some very seductive terms: cough syrups are marketed as “mucolytics” (break down that disgusting thick sludge in your lungs!), “expectorants” (out, out, damn goo), and “suppressants” (STOP that painful, hacking cough.)  True, “seductive” may be a strange descriptor when discussing snot, but these terms can be very tantalizing to a frantic parent whose kid is hacking up a lung.   

 

A sure fire cough remedy, however, is not as easy to find as these product descriptions would suggest.  

 

Though I would love to have a cure for cough, several widely cited studies have concluded that no cough syrup, whether over-the-counter (OTC) or prescription, actually works. They don’t help kids get better faster. They don’t help kids feel better. They don’t help kids (or parents) sleep through the night.  Furthermore, a variety of rare but serious health problems have been associated with use of these medications in children, including death, convulsions, rapid heart rates and decreased levels of consciousness. The American Academy of Pediatric’s Committee on Drugs recommends “that parents be informed about the lack of proven effects and potential risks of cough preparations.”  In other words, we should tell our patients that cough medicines don’t work and may be harmful.  The American College of Chest Physicians agrees.  

 

I once gave a mom that news that there was no immediate cure for her child’s cough.  “Our family,” she said, quite irate, “cannot afford another night without sleep!”  Her point was well taken:  colds can cause a great deal of stress in families’ lives.  So what is a desperate parent to do?  Is there any remedy that will help their hacking child?

 

Though I can’t immediately cure most coughs, there are some helpful treatments that are safe to use for children of all ages.   

 

• Taking a steamy shower once or twice a day can loosen the thick mucous in the nose and upper airway.  Carefully holding your child’s head over a steamy pot or a vaporizer can also loosen the phlegm.
• Nasal saline drops or saline rinses can be extremely helpful.  Babies will hate having water in their nose but it will loosen their mucous and after some spluttering and coughing, they will appreciate your efforts in clearing their breathing passages.  
• For children over 1-year-old, honey is a delicious and effective remedy for cough:  see my previous post on honey as a cough remedy for further details.  
• And as with any illness, staying well hydrated will help the immune system fight the infection and can also keep the mucous loose and flowing.

In the end, it is love and time that will cure most coughs, which are usually caused by cold or flu viruses.  As usual, please seek medical advice from a physician and not the internet if you have any serious concerns, especially for children who have difficulty breathing, have a persistent cough for more than two or three weeks, or who seem very sick. 

 

Tips for Parents:  

 

• Tried-and-true home remedies can be very helpful for relieving symptoms of colds and the flu:  try honey for children over 1 year old.
• OTC cough and cold medicines do not cure children or adults when they have nasal congestion and cough.  They may be helpful for short term symptom relief.  And they are rarely harmful (except to the wallet) for older children and adults.  But if you try them and they’re not helping, there is no need to continue to use them.
• OTC cough and cold medicines should be avoided in young children (<2 years old.).\
• Read medicine bottles closely and use the measuring devices that come with them when giving children any medicine.

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