Tell me why an infant's cough will not be treated?

[Dream]

So DD2, 17 months has this cough for about 3 weeks now, its worse in the night, she can hardly sleep, I always apply vicks and put on socks to help her sleep better. Plus I had her bed alleviated. I took her to the pediatrician, no infections so no medicine. This was about 10 days ago. She's still the same, while she's not weezing, you can hear her breathing, her chest is congested. How long we're supposed to go on like this?

I was born and raised in Asia, they wouldn't let a cough/cold go this long. DD2 got sick with similar cough/cold while we were visiting family in April, and we took her to the doctor and was prescribed medicine and in 3-4 days she was back to herself. I'm trying to understand why in the USA, a prolonged cough is not medicated. Clearly the child is suffering, coughing is not easy on a small body. Help me understand!!

[crl]

Not a doctor, but my understanding is that cough suppressants and the like carry significant risks for young chidren and those risks outweigh the benefits. Did your ped give you an idea of when to call or come back of she wasn't better? Mine always gives me a list of things to watch for and a time to call him if my dd isn't better.

Catherine

[brittone2]

I assume they listened to her breathing and are not concerned about pneumonia, etc. It can take a while for a cold to resolve. Treatments come with risks of their own, and many of the things that were done in the past weren't really effective from an evidence-based standpoint anyway. Just because you can RX meds doesn't mean they are appropriate for the situation. In the case where the cough was treated, it may have resolved in that period of time anyway.

It is tough to see them suffer though :hug: I understand.

If you are concerned, have you followed up with her ped to see if they want to see her again based on the symptoms?

[crl]

Here is a link to help explain.

http://www.webmd.com/cold-and-flu/features/cold-cough-home-remedies-children

Catherine

[dogmom]

I guess the question is what medication would have been prescribed? Often an antibiotic is prescribed, but most infections that would cause a "prolonged cough" is not a kind of respiratory infection that needs an antibiotic. It tends to be either viral or a mild viral/bacterial infection that is causing a small amount of post-nasal drip that is triggering a cough. That would be considered an upper respiratory infection, it will go away on it's own. A prescribed antibiotic will not treat a virus or if not picked correctly will not treat a mild bacterial infection appropriately. We know from studies that in general people get better from these mild upper respiratory infections an the same rate with or without antibiotics. The downside of antibiotics is either an allergic reaction (rare) or that the bacteria that normally live in your body and skin will become immune to the antibiotic and promote antibiotic resistant bacteria growth. There is a severe problem in the US with antibiotic resistant bacteria. There is also in other parts of the world that antibiotics and not regulated properly. Some bacteria are or have approached untreatable status since very few antibiotics are left that work against them.

The problem is with a prolonged cough may indicate a lower respiratory infection (pneumonia) that is deeper in the lungs. Usually it happens in a community, as opposed to a hospital, because an upper infection can spread to a lower or another bacteria can set up housekeeping on top after a viral infection leaves the body vulnerable. This is why they ask you to come to the doctor after a prolonged cough. Usually a listen to the lungs, maybe a chest xray, can rule out pneumonia. Just because you do get pneumonia later does not mean that starting antibiotics earlier would have prevented the pneumonia, and it may make it harder to treat. I have patients all the time an major antibiotics, multiple ones, and they can still get pneumonia! It really is best to hold off on antibiotics as until there is clear clinical indication to use.

As far as any medicines to treat the symptoms of cough, most are not proven to be more effective in studies than basic at home treatments (humidity, etc.). So with children it is often best to avoid. Some few meds to thin out mucous or help shrink swollen nasal tissue for post nasal drip can help in specific situations, but only some.

Hope this helps you understand.

[marymoo86]

Have you tried treating naturally? Honey is a great natural medicine for coughs.

[BabyBearsMom]

Our doc gave a prescription for a nebulizer and we just use it with saline (no medication) when the girls get a bad cough. It helps a lot. Maybe ask your doc if you could give that a try.

But cough suppressants are not safe for children.

[Tondi G]

Do you think the cough is caused by a post nasal drip? If she is congested as well you might try giving her some Benedryl at bedtime and see if it will dry up the drip which is often the cause of the coughing at night. Other than that a humidifier could be helpful. You could try Delsym cough syrup to see if that helps at all.

If the cough hasn't improved and she is going on 3 weeks (last seen 10 days ago) you might want to take her back in to be checked again.

[Dream]

Thank you for the info. I guess I understand what you're saying that more harm can come from cough meds than benefits. But hundreds of thousands of children get medicated for coughs in that part of the work and they appear to be pretty healthy and grow up to be regular people. They don't seem to have anything different than the people in the western world as far as their health goes.

I've tried giving her honey with tea but she doesn't like it and refused it. I will give Benadryl a try and if that doesn't work out will take her again. She doesn't have the symptoms they asked me to look out for but the cough is there.

[crl]

Thank you for the info. I guess I understand what you're saying that more harm can come from cough meds than benefits. But hundreds of thousands of children get medicated for coughs in that part of the work and they appear to be pretty healthy and grow up to be regular people. They don't seem to have anything different than the people in the western world as far as their health goes.



Right. But you aren't looking at the whole population. If one out of a thousand (just making numbers up here, I haven't read the studies) dies from a side effect, you aren't likely to know that one child. But that's still a significant risk, IMO. Certainly significant if leaving children untreated simpy means dealing with temporary symptoms that don't involve any risk of death. I am not a doctor, so if you want real numbers, I suggest checking the link posted above.

I would check with your doctor about another appointment.

Catherine

[lilycat88]

As others have said, try treating the nasal drainage. Just because you can hear the breathing doesn't mean it's chest congestion. I've been fooled many times when DD has had a cough that I am SURE is from her chest but it's really just junky drainage.

[dhano923]

DD develops a cough when her allergies are acting up. I give her children's Claritin and it clears it right up. Make sure there aren't any irritants in her room that coud cause her to have an allergy. DDs triggers tend to be dust and pollen, so we've removed all the stuffed animals from her room, which helped quite a bit.

[tmahanes]

I've tried giving her honey with tea but she doesn't like it and refused it. I will give Benadryl a try and if that doesn't work out will take her again. She doesn't have the symptoms they asked me to look out for but the cough is there.

Try just giving straight honey. This is what we use and it works well! We also found buckwheat honey to work the best. It is very dark honey.

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[truly scrumptious]

Try to figure out whether the cough is from post nasal drip - is her nose running during the day? If so then the things suggested for that might help.
The reason honey helps us that it coats the throat like a cough suppressant does and reduces the tickle and urge to cough.

If it is NOT post nasal drip, I'd recommend looking into the nebulizer as a PP recommended. It helped enormously with our DS, whenever he had a cough where he couldn't break up the mucous. Unfortunately vicks tends to dry out the mucus, which then makes it harder to break up. If you find Vicks helps at night, be sure to keep her well hydrated and try a nebulizer or humidifier so she coughs it out as much as possible when she's awake. If her cough sounds junky and phlegmy that usually means its moving which is a good thing.

But as other said, if it's not getting any better and it's been that long, it's a good idea to go see the doc again.

[TwinFoxes]

I've tried giving her honey with tea but she doesn't like it and refused it. I will give Benadryl a try and if that doesn't work out will take her again. She doesn't have the symptoms they asked me to look out for but the cough is there.

We just gave them a big teaspoon of honey. It really helped. Do you you have a humidifier? That helps too. We have one of the Crane animal ones, we have the elephant, it's very cute. Also, the whole put Vicks on their feet seems to be an old wives tale (I think that's what you meant?) Put it on her chest, the vapors can get to her nose that way. If you put it on her feet, and put socks on on top of that, I'd think the vapors wouldn't get to her very well.

Also, is it OK to give Benadryl to a 17 month old?

[brittone2]

One thing that often helps my kids is to get the bathroom steamy (with your little one safely out of the way of hot water), with the bathroom fan off. I've found this often gets their nose running and loosens things up. If we do that before bed, sometimes they get a little longer period of sleep because they've cleared out some of the drippy gunk for a while. During really bad colds, I've sometimes done that more than once a day because it seemed to help a good bit.

[dogmom]

Thank you for the info. I guess I understand what you're saying that more harm can come from cough meds than benefits. But hundreds of thousands of children get medicated for coughs in that part of the work and they appear to be pretty healthy and grow up to be regular people. They don't seem to have anything different than the people in the western world as far as their health goes.

I've tried giving her honey with tea but she doesn't like it and refused it. I will give Benadryl a try and if that doesn't work out will take her again. She doesn't have the symptoms they asked me to look out for but the cough is there.

Actually South Asia is a place that many antibiotic resistant bacteria start. So it is more of a risk to effect the whole bacteria ecosystem than a particular bacteria.I'm not trying to throw stones at any area of the world, just relay some information.

I'm still interested in what medications are given to the children with a persistent cough that you are used to. Is it a cough suppressant? And antibiotic? I think many of the cough and cold remedies for children have little effect and more of a placebo influence. Several medical organizations said cough and cough over the counter medication was not to be used in under age six here because it had minimal benefit in studies and there many cases of children winding up in the hospital or a few deaths because parents accidentally overdosed there children.

Although I do feel you pain. I often feel like the whole "just give them honey and some humidity" advice is not helpful when you are the parent going on week 3, the kid isn't sleeping, you haven't slept, and everyone is miserable. It isn't a good answer. I used to get cough syrup with codeine as a kid, I bet they don't give that out anymore to kids. I had it a couple years ago for a multi week illness I had, and I have to say if I was objective I don't think it really helped except made me feel like I was doing something.

I do think that some kids get reactive airway disease with infection, sort of like a short term asthma, that is under-treated because doctors/parents are reluctant to put that label on it. But I've moved to an inhaler twice in my life after long, lingering infections and it helped both times.

[Momit]

I believe I read somewhere that many cough suppressants actually target the brain and stifle the reflex that prompts the cough. I can see how that would be considered risky for a small child, and actually it has made me less likely to take cough medicine myself.

When we lived in Germany we had friends whose daughters had terrible coughs all winter long. They were not usually medicated other than with the saline/nebulizer treatment and with something called Bronchipret (thyme extract). The mom was a naturopath and felt comfortable giving her girls that.

Here's a quote from WebMD about cough medicine:
A 2010 review of studies found that there is no evidence to support using common over-the-counter drugs for cough. This includes cough suppressants, such as dextromethorphan, or expectorants such as guaifenesin, which are supposed to loosen up mucus in the airways.
In 2006, the American College of Chest Physicians surveyed a number of cough medicine studies from the last few decades. It found no evidence that these medicines help people with common coughs caused by viruses.

It's important to understand that these studies have not proven that cough medicines don’t work. Rather, they’ve just found no proof that they do. It’s always possible that further studies could show that they help.

Because of a lack of good evidence that cold and cough medicines help -- and a very small risk of serious side effects -- the FDA stated in 2008 that toddlers and babies should not use cold and cough medicines. Drug makers voluntarily changed the labeling of OTC cough and cold products, recommending them only for children aged 4 and older.

The American Academy of Pediatrics went further, saying that there's no reason that parents should use them in children under age 6.

I know it's so hard to watch your little one suffer and not be able to help. I hope your DC feels better soon!

[Pyrodjm]

We give teaspoons raw honey for coughs. Its super thick and my girls will gladly eat it off of a spoon. my then 19 month old had a cough that lasted for a month. I know it hurts to watch them suffer.