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Dr Shapiro completed his undergraduate education at UC San Diego earning a B S in Biochemistry and Cell Biology and a B A in Political Science He furthered his education at UCLA where he earned a Masters Degree in Public…
FAST FACTS
After the winter of illness I am witnessing on a daily basis, I thought it might be helpful to shed some light on probably the most common symptom out there these days...the dreaded cough. And so what I'd like to do is share some of the reasons why your child may cough, other symptoms to monitor for, and what can be done. But first, it is important to acknowledge the one very important reason why your child may cough...it acts as an important reflex to protect your child's airway, plain and simple. No irritant...whether it be infectious or non-infectious, environmental or internal...no cough.
Now some of the more common reasons your child may cough include the signature seal bark-like cough of croup, the whistling type of cough of wheezing, or just the typical cough you might hear with the common cold. But other explanations, both infectious and non-infectious, include: allergies, allergic rhinitis-where the cough develops from post-nasal drip, gastroesophageal reflux disease (GERD)-somewhat of an insidious presentation as there may not be any other presenting symptoms, sinus infections-colds that linger for at least 2 weeks (if not longer) and often worsen as the nasal cavity becomes filled with mucous, and even pertussis (whooping cough)-where your child will have coughing spells that end with the classic "whoop"...often having its greatest impact on infants. But fortunately, we have a pertussis vaccine that begins at 2 months of age as part of the DTaP (which also includes diphtheria and tetanus). In fact, there now exists a pertussis booster vaccine for both adolescents and adults.
Most coughs worsen during the night, particularly related to the horizontal position your child sleeps in, but other coughs may be worse during the day as the climate or physical activity your child encounters may have a negative impact (e.g cold air or exercise-induced asthma or wheezing). And while some coughs do not require immediate attention, when any of the following symptoms accompany your child's cough, please seek immediate medical attention:
- Difficulty breathing or working harder than normal to breath.
- Any shortness of breath or stridor ("harmonical" breath sound upon inspiration).
- The cough is associated with a high fever.
- Any change in color (typically blue) around the mouth.
- Any blood noticed with the cough.
- If wheezing is noted and no asthma care plan already exists with your physician.
- The classic "whoop" of pertussis is noted.
- Any infant who has been coughing for a prolonged period.
And what can you do at home to help your child's cough?
- If your child has asthma, initiate the care plan as previously discussed with your pediatrician (e.g., inhaled corticosteroids, bronchodilators). If no plan is in place, please be seen for an immediate evaluation.
- As far as croup, if the seal bark-like cough begins, bring your child into the bathroom after the steam from a hot shower encases the room. The steam will help your child relax. If no improvement is seen, have your child be seen for an immediate evaluation.
- Purchase a cool-mist humidifier for your child's room. The moisture can often be very helpful.
- Keep your child well hydrated and maintain good rest.
- Use saline nasal sprays to deal with some of the nasal congestion.
- And as there is some research supporting the use of honey prior to bedtime in children 2 years and older, a trial of 2 teaspoons of honey with the caveat of never giving honey to children less than 1 year of age secondary to the risk of infantile botulism.
And, as I've discussed before (http://dailystrength.org/blog/280-otc-cold-medicines-and-children), don't forget the most recent recommendations regarding over-the-counter (OTC) cough and cold medications that state they should not be used for children less than 4 years of age secondary to no real data supporting its effectiveness and the concern of over-dosing.
Be well.
Dr. Jeremy
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when I took her to the dr., they did xrays & everything came out fine. they gave me a rx for anitboitics, and it seemed to clear up for a while, but she was eating ice cream & dairy products & the cough caMe back worse as ever. she has had trouble breathing & wheezing..but she doesn't have asthma.
What do you think might be wrong?