Cough (Viral Bronchitis)

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(270) 769-0110

Immediately if

• Breathing becomes difficult and is not better after you clear the nose

• Your child begins running a high temperature, becomes lethargic (lifeless) or appears very sick

During Regular Hours if

• A fever lasts for more than 3 days
• The cough lasts for more than 3 weeks
• You have other concerns or questions

Description

A cough is a sudden, often repetitive, spasmodic contraction of the thoracic cavity, resulting in violent release of air from the lungs, and usually accompanied by a distinctive sound. A cough is usually initiated to clear a buildup of phlegm in the trachea. More than 5 minutes of continuous coughing is referred to as a coughing spasm.

Possible Causes

Most coughs are due to a viral infection of the trachea (windpipe) and bronchi (larger air passages). These infections are called tracheitis and bronchitis, respectively. Most children get this infection a couple of times every year as part of a cold. Keep in mind that coughing clears the lungs and protects them from pneumonia. Bronchitis isn’t serious. The role of milk and thickening the secretions is doubtful.

Expected Outcomes

Usually bronchitis gives a dry tickly cough that lasts for two to three weeks. Sometimes it becomes loose (wet) for a few days and your child coughs up a lot of phlegm (mucus). This is usually a sign that the end of the illness is near.

Home Treatment

Medicines to Loosen the Cough and Thin the Secretions.
• Cough drops: Most coughs in children over four years of age can be controlled by sucking on cough drops freely. Any brand will do.
• Homemade cough syrup: For children under age 4 years, use ½ to 1 teaspoon of corn syrup instead of cough drops. Corn syrup can thin the secretions and loosen the cough.
• Warm liquids for coughing spasms: Warm liquids usually relax the airway and loosen the mucus. Start with warm lemonade, warm apple juice, or warm herbal tea if your child is over 4 months old. Avoid adding any alcohol because inhaling the alcohol fumes stimulates additional coughing and also because there is a risk of intoxication from unintentional over dosage. Children over 4 years old can suck on butterscotch hard candy or cough drops to coat the irritated throat.

Cough Suppressants. Cough suppressants reduce the cough reflex, which protects the lungs. They are only indicated for dry coughs that interfere with sleep, school or work. They also help children who have chest pain from coughing spasms. They should not be given to infants under 12 months of age or for wet coughs.

A nonprescription cough suppressant is dextromethorphan (DM). Ask your pharmacist for help in choosing a brand that contains DM without any other active ingredients. Dosage is 0.25 mg/lb every 4-6 hours as needed. It usually comes as a liquid in the strength of 15mg per teaspoon. The following table shows the dosages of DM that you can give a child according to weight or age.

Often corn syrup or cough drops can be given during the day and DM given at bedtime and during the night. DM is also available as a cough lozenge for easy carrying and as a long-acting (12 hour) liquid.

Humidifiers. Dry air tends to make coughs worse. Dry coughs can be loosened by encouraging a good fluid intake and using a humidifier in your child’s bedroom.

The new ultrasonic humidifiers are very quite and they kill molds and most bacteria found in the water. Do not add medication to the water in the humidifier because it irritates the cough in some children.

Physical Activity. Physical activity such as vigorous play or physical education classes should be avoided if suffering from a persistent cough. These activities worsen symptoms and trigger coughing spasms.

Active and Passive (Second Hand) Smoke. Exposing a child with a cough to second hand smoke will cause the cough to last weeks longer than it would normally last. Do not allow anyone to smoke in the same house or building as your child.

Common Mistakes in Treating Cough. Antihistamines, decongestants, and antipyretics are found in many cough syrups. These ingredients are of unproven value, and the antihistamines carry the risk of sedation. Expectorants are of unproven value but harmless. Stay with the simple remedies mentioned above or use dextromethorphan. Milk does not need to be eliminated from the diet, since restricting it only improves the cough if your child is allergic to milk. Also, never stop breast-feeding because of a cough.