Managing Cough Medications For Kids

All of us parents know that children cough, sometimes a lot and knowing how to help our kiddos is important. Knowing which over-the-counter medications are best and when it's time to see the doctor, these are just a few of the questions that Franciscan Physician Network board-certified pediatrician Shivani Parikshak, MD, is helping answer.

What Are The Most Common Causes Of Coughs In Children?

"I would say the most common infectious cause of coughs is viruses," said Dr. Parikshak, who practices at Franciscan Physician Network County Line Pediatrics in Greenwood. "The flu, influenza has been pretty terrible this year. So usually about this time of the year, we should be seeing less of the flu. But that's not really the case this year."

Other viruses such as RSV and COVID-19 are also very common viruses that can cause children to cough and have cold symptoms, she added.

"There are many other viruses that can cause cough and cold symptoms in children," Dr. Parikshak said. "There's rhinovirus, adenovirus and human metapneumovirus, but they're not discussed often or well-known because they're not commonly tested for in the clinic setting, urgent care or even in the emergency room."

Other causes of coughs include allergies or chronic illnesses such as asthma.

When Should I Give A Child Cough Medication?

"If the cough isn't bothering the child, they likely don't need any medication," Dr. Parikshak said, adding that most children with a cough or cold symptoms can be happy, playful and sleeping well.

"I only really recommend treating symptoms if your child's uncomfortable," she said. "So, if they're having trouble sleeping or if the cough is really bothering them and keeping them awake at nighttime, those are the times that you want to do something about that cough."

What Should I Know About Cough Medication Safety?

Whether cough medicine is appropriate often depends on the age of your child.

"Over-the-counter is not really recommend for babies and young children under the age of four," Dr. Parikshak said. "Over the age of six, cough medicines are safer to use."

For children between the ages of four and six, she recommends discussing whether to use over-the-counter cough medicine with your child's pediatrician because it may do more harm than good.

Parents and caregivers also should be aware of:

• Ingredients in the medication. Some cough medications may also include other ingredients, like Tylenol or acetaminophen. Parents need to be aware in those cases not to give separate doses of Tylenol, for example.
• Medication dosage instructions on the label. Always read the medicine label closely to make sure your chid is receiving the right dose of the right medication. "It's important to follow the instructions on the package and the bottle to know the right amount of medication to give," Dr. Parikshak said.
• Giving the appropriate dose amounts. Don't use household spoons to measure the dose, because these can be inaccurate. Use the measuring device that comes with the product or an oral dosing syringe.
• Supervising a child each time they take a medicine, even if it is something they take every day. Stress the importance with your child of asking an adult before taking a medicine.
• Safely storing the medication to avoid your child consuming it. Leaving products on the counter or table between uses will increase the likelihood that a child will get into it.
• Close the lid tightly after use. However, remember that child-resistant packaging is child "resistant," not child "proof."

What's The Difference Between Children's And Adult Cough Medications?

"The difference between adult cough medicines and children cough medicines is the dosing," Dr. Parikshak said. "What I worry about is the child getting more medication than they need and then having side effects. That could be dangerous sometimes."

What Are Potential Side Effects Of Cough Medications?

"Side effects vary," Dr. Parikshak said. "Some side effects are very similar to any other medication such as stomach discomfort, headache, dizziness and drowsiness."

Side effects also can happen if taking too much of a medication at once or taking it more often than advised.

This includes things like:

• Slowed breathing
• Increased heartbeat
• Psychosis
• Hallucinations
• Seizures

"In severe cases such as an accidental overdose, in case where the child is taking a lot more than they should be, this can even result in coma and death," Dr. Parikshak said.

If your child overdoses on cough medication

Call the Poison Control Center at 1-800-222-1222 (available 24/7) if your child overdoses on any cough or cold medication, and keep the medicine bottle handy so you can provide the poison information specialist with the exact ingredients.

What Are Home Remedies For Coughs?

Some of the home remedies that can ease coughs include:

Saline nasal spray or a cold mist vaporizer

"That can also help with making that mucus keep moving and getting rid of that," Dr. Parikshak said.

Honey

A teaspoon or two of honey can help coat the throat and soothe it some, Dr. Parikshak said.

However, honey is only appropriate for children older than one year. Honey can cause infant botulism in children under the age of one.

Chest rubs

For older kids, Dr. Parikshak recommended chest rubs like the Vicks Vapor Rub, which can be applied on top of the chest or the throat area to help reduce the cough so the kid can sleep better.

Rest and fluids

"Like all illnesses I do advise plenty of rest and fluids," said Dr. Parikshak. "If your child is coughing, their throat is likely irritated, so I recommend pushing fluids instead of trying to get them to eat something."

How Do Cough Medications Work?

Two types of medications may be used to treat coughs: antitussives, which help suppress the cough, and expectorants, which help thin the mucus. The two may be used in the same over-the-counter product or in combination with other medications, like Tylenol.

"Antitussive is a cough suppressant, so this means that it works on the central nervous system or the brain, to help suppress the cough," Dr. Parikshak said. "It works on the part of the brain to reduce coughing. On the other hand, the expectorant, works on the respiratory tract, so that helps to thin and loosen up that mucus that's in the respiratory tract."

When Does My Child Need To See A Doctor For A Cough?

"When your kid is sick and they have a cough and cold, it's important to also be patient," Dr. Parikshak said. "The first few days I like to tell parents are usually the worst but then the cough and cold symptoms in children tend to get a a little bit better each day.

There are several situations when your child should see a doctor for a cough.

Difficulty breathing or swallowing

"If your child is having difficulty breathing or swallowing, or the cough's so severe where they're vomiting because of it, I would definitely let your pediatrician know," Dr. Parikshak said.

When coughing lasts for weeks

"I'd also recommend calling the pediatrician if your child's symptoms last a long time and it's not getting much better, or they're getting better and now they're starting to get worse suddenly."

These could be signs that there's a secondary infection on top of whatever virus they already have.

"I do like to let my families know that coughs can linger for two to four weeks after an illness," she said.

Coughing when your child has asthma

Asthma is one of the major causes of coughing in children.

"If your child has asthma, and now they're coughing more, it could mean that the asthma is actually getting worse and it's not necessarily due to an illness," Dr. Parikshak said, adding that it's important to reach out to your child's pediatrician.

When Will My Child's Cough Be Better?

Coughs can last for a couple weeks and sometimes up to four weeks.

"I think it's also important to remind parents that children get sick and they can get as many as like six illnesses in a year, and for kids who attend daycare or go to school, that number might be even higher," Dr. Parikshak said.

Because coughs and colds are caused by viruses, prescription antibiotics usually do not help.

"You just have to unfortunately hang in there a little bit," she said. "I know you're trying to do everything to make your child feel better, but I think it's always best for remind families not to treat your child's cough and cold symptoms with too much medication."