When a child has a cough it can be very concerning to a parent. Not only is it difficult to listen to your child cough all day, but it may even keep them up at night. Most parents want to make the coughing stop, not realizing that the best treatment may be to let the child cough -- or that the underlying cause needs to be treated, not the cough itself.
Over-the-counter cough suppressants are generally ineffective in children, especially those younger than 6. An FDA advisory committee has recommended that children under 6 should not get any cough or cold medications because they are ineffective and may have bad side effects. While so far the FDA has only advised that children under 2 not receive any cough or cold medications, the same may be advised for children under 6 at some point in the future.
When it comes to prescription cough suppressants, these can actually be much more dangerous for young children. If a child is coughing so frequently and so hard that he or she is unable to sleep, there is likely more going on than a cold, and the underlying cause needs to treated. Suppressing the cough with a prescription cough medication could potentially make things worse.
These medications are also dangerous for children because they contain narcotics. Hydrocodone, or codeine, is a narcotic which can actually slow down a child’s respiratory rate. If too much is given or there are other complications, it can depress the respiratory system so much that the child stops breathing. It is definitely a very serious medication, and it is the position of the FDA that it should never be given to a child under 6 years old for a cough because of these risks. They have received reports of children under 6 dying after taking prescription cough suppressants.
When to be Concerned About a Cough
Most coughs in children are nothing to be worried about, but there are some instances when you should be concerned and contact your health care provider immediately. These include:
- A child with difficulty breathing or who is working harder to breathe
- A child who is breathing faster than normal
- A child who looks blue or gray in the face, lips, chest or inside the mouth (call 911)
- When the cough is accompanied by a high fever (over 102 or any fever in a child under 3 months)
- An infant under 3 months who has been coughing for more than a few hours
- An infant or child who makes a “whooping” noise when he breathes in after coughing
- An infant who is unable to suck/feed
- A child who is coughing up blood
- A child who has stridor (a harsh “whistling” noise) when inhaling
- A child who wheezes (a high-pitched whistling noise) when exhaling
- A child who is listless or cranky
- A child who coughs constantly or cannot sleep due to the cough
If your child has an occasional cough that is not interfering with their sleep, it is best to just let them cough. The cough is the body’s way of expelling things from the lungs that shouldn’t be there.
If your child’s cough is just occasional, these tips may help.
- Run a cool mist humidifier in his room at night. Saline drops and suction or encouraging a child to blow his nose often will help with congestion and may help minimize a cough because it will decrease the amount of postnasal drip.
- If your child has asthma, you should follow the asthma management plan your child’s doctor has prepared. If you are unsure or you do not have a plan, call the doctor immediately.
- If your child has a “barky” cough, take him into the bathroom with the door closed, turn on the hot water and let the room get steamy. Stay in the steamy room for about 20 minutes and the cough should subside. If it does not improve, call the doctor.
- Cool clear liquids (such as water or juice) may be helpful and soothe a child’s throat. Carbonated beverages and citrus juices should be avoided though because they can irritate raw areas in the throat.
- Do not give over the counter or prescription cough or cold medications to your child (especially those under 2) without contacting your child’s health care provider first.
Of course, if you have a question about your child’s symptoms or their cough, you should contact their health care provider and get advice about what to do. This information is not a substitute for the advice of a doctor.
”Questions and Answers About FDA’s Enforcement Action Regarding Unapproved Hydrocodone Drug Products.” U.S. Food and Drug Administration 01 Oct 07. 21 Mar 08.
”FDA Issues Alert on Tussionex, a Long-Acting Prescription Cough Medicine Containing Hydrocodone.” FDA News Press Release 11 Mar 08. U.S. Food and Drug Administration. 24 Mar 08.
”Your Child’s Cough.”KidsHealth Oct 05. Nemours Foundation. 24 Mar 08.