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COUGH – WHEN TO SEE THE DOCTOR WITH YOUR CHILD

12 May

Cough is the commonest reason for preschool children to see a GP. Isolated coughing has been reported by parents in almost a third of children at any one time; the symptom can have an impact on sleep, school and activities for the child and can be anxiety provoking for parents.

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An average preschool and primary school child has 3-8 coughs or colds per year. Sometimes several coughs or colds occur one after the other. A child who lives with smokers has an increased risk of developing coughs and colds.

A cough is a reflex action to clear your airways of mucus and irritants such as dust or smoke.
Coughs may be dry or chesty and most coughs clear up within three weeks.

Cough may be broadly split in to three categories:

Acute cough = < 3 weeks

Prolonged acute cough = 3-8 weeks, slowly resolving, e.g. post-viral pertussis

Chronic cough   = Variably defined from 3-12+ weeks

Needless to say that constantly hearing your child cough especially at night is bound to cause concern. Even if the mother is happy her child is otherwise well someone else will make a comment. It may be a well meaning grandparent, a dad returning from work or a teacher who will ask whether the child has seen a doctor. I have to say when I see a child  with a cough I examine the child step by step explaining as I go along what symptoms and signs which would cause me as a doctor to be concerned. This not only makes me rule out significant causes of cough but it also reassures and educates the mother as to what important signs she should be looking for.

  • has the child lost their appetite?

  • are they playing or responding as normal?

These symptoms are most important when you are deciding if your child is unwell in that if the child is showing both of the above symptoms you must  keep a closer eye on your child so that if they go on to develop any signs listed below you can visit your GP  On many occasions I have seen a child in surgery racing around, playing happily and having eaten a good breakfast.  Be reassured a child with a cough in this situation is not needing to see a doctor.

However, If you notice any of the following associated with a cough you must bring the child to the doctor

  • has trouble breathing or is working hard to breathe

  • is breathing faster than usual

  • has a blue or dusky colour to the lips, face, or tongue

  • has a high fever (especially if your child is coughing but does NOT have a runny or stuffy nose)

  • has any fever and is younger than 3 months old

  • is an infant (3 months old or younger) who has been coughing for more than a few hours

  • makes a “whooping” sound when breathing in after coughing

  • is coughing up blood

  • has stridor (a noisy or musical sound) when breathing in

  • has wheezing when breathing out (unless your doctor already gave you an asthma action plan)

  • is weak, wingy, or irritable

  • is dehydrated; signs include dizziness, drowsiness, a dry or sticky mouth, sunken eyes, crying with little or no tears, or passing urine less often (or having fewer wet nappies)

Because most coughs are caused by viruses, doctors usually do not give antibiotics for a cough. A cough caused by a virus just needs to run its course. A viral infection can last for as long as 2 weeks. We very rarely send a child for a chest X-ray. 

Unless a cough won’t let your child sleep, cough medicines are not needed. They might help a child stop coughing, but do not treat the cause of the cough. If you do choose to use an over-the-counter (OTC) cough medicine, discuss with the pharmacist to be sure of the correct dose and to make sure it’s safe for your child.

Do not use OTC combination medicines  they have more than one medicine in them, and children can have more side effects than adults and are more likely to get an overdose of the medicine. Some cough medicines have the effect of making a child hyperactive which most parents would agree is not a desired side effect!

Cough medicines are not recommended for children under 6 years old. Meanwhile, you may want to try this homemade remedy my mother gave to us as children and remains a good remedy.

HOMEMADE COUGH MEDICINE 

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Honey, lemon and glycerine (a liquid I use in Christmas cake Royal icing to make the icing softer) is a homemade remedy for coughs provided the person  is not allergic to any of the ingredients. It is not adviseable to give to a child < 12 months. Honey is a natural antibiotic and lemon is full of cold-fighting vitamin C and glycerine is good for soothing sore throats.

It can also be bought ready mixed over the counter.

Store in the refrigerator for up to a year. For sore throats and chest congestion take one teaspoonful every few hours. (If it starts to taste so good you want to pour it over ice cream – you are probably getting better and don’t need it any more.)

¼ cup (60ml) freshly squeezed lemon juice
¼ cup (60ml) liquid honey
¼ cup (60ml) food grade glycerine

Strain the lemon juice through a fine meshed strainer. Whisk together with the honey and glycerine and pour into a glass bottle with a tight-fitting lid.

Store in the refrigerator for up to a year. For sore throats and chest congestion take one teaspoonful every few hours.

Remember to train your child to cover their cough in order to help protect  those who are vulnerable from catching an infection. 

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