Cough In Children Could Be Sign Of Chest Infection – Paediatrician

A  Consultant Paediatrician at the University of Ilorin Teaching Hospital, Kwara State, Dr. Rasheedat Ibraheem, has advised parents to avoid self-medication when their children have a cough, instead they should find out about the actual cause of the cough.

She said although cough reflex is a natural protective mechanism of the body, coughing in children could be a sign of chest infection.

Ibraheem said it was wrong for parents to give their children, who are under-five cough and cold medicines whenever they have a cough, warning that they could have adverse effects on their health.

Speaking in an interview with Newsmen, the child health expert said the most important thing to do for children who have a cold is to clear their nostrils and make their airways free.

The paediatrician cautioned against giving a child expectorant and suppressant cough syrups, which she said would not stop the cough, instead, it would weaken the child and worsen his health condition.

She said, “The disadvantage of giving children cough syrup is that when a child is coughing, it could be as a result of chest infection, maybe pneumonia.

“And then if the parents give the child cough suppressants, that means the parents will give the false impression that the child’s condition has improved but that child’s condition has not improved because the infection is still there.

“Now, they will not treat the infection and for the infection to be treated, what the child needs is antibiotics. So, by giving cough suppressants, you are not taking care of the underlying condition; you are worsening that child’s condition.”

Read Also: WHO says one in 10 children may be obese in Africa by 2023

According to her, it is not advisable to give children cough medicine when they are coughing, stressing that children under five cannot expectorate and do not produce sputum when they cough.

“For children under five years of age, when they cough, they do not have the ability to expel sputum. They do not have adequate force to expel sputum.

“Even if they cough and bring something up, most of the time, they end up swallowing it. Under-five children cannot expectorate, they don’t produce sputum.

“When a mother comes and tells me that “my child is three years old and she is bringing out sputum”,  I tell her no, your child cannot bring out sputum.

“No doctor can tell a mother to go and run a sputum test on a four-year-old child because he/she knows that the child does not produce sputum.”

She noted that there are two types of cough syrups mainly in the market, adding, “The first one is what we referred to as expectorant. That means, when you cough, you are going to bring out sputum. The other one is antitussive, a cough suppressant. So, we have cough suppressant syrup that will suppress cough and the expectorant that will expel sputum.”

The US Food and Drug Administration recommend that children under the age of two should never be given over-the-counter cough or cold medications.

FDA noted that parents need to be aware that many OTC cough and cold products contain multiple ingredients which can lead to accidental overdosing

In her recommendations, the paediatrician said the most important thing for children who have a cold is for their mothers to clear their nostrils.

According to her, mothers can use the mouth-to-nose method and suck out mucus blocking the nostrils.

She also encouraged mothers to breastfeed their babies more whenever they have a cold and also have a thermometer at home to monitor their temperature regularly.

In a 2021 article published in the American College of Emergency Physicians titled, “Use of antitussive medications in acute cough in young children”, the authors said OTC antitussive medications should not be routinely used in children under two years of age.

The authors said, “As a protective reflex, cough facilitates mucociliary function, helping to clear excessive secretions and debris from the airways.

“The respiratory tract has cough receptors from the larynx to the segmental bronchi.  With mechanical stimulation, cough can be elicited in 10 per cent of 27‐week gestational-age preterm infants and up to 90 per cent of full‐term infants.

“As many as 50 per cent of school‐age children continue to cough up to 10 days after the onset of a common cold, and 10 per cent of preschool children cough for up to 25 days after a respiratory tract infection.”