Coughs

The content in this article is only a guide. It is strongly recommended that your child’s condition should be assessed by a suitably, qualified health professional, especially if the patient is suffering from any other medical condition and/or is taking other medicines. This articles is not to be used, in any capacity, as a means of self-diagnosing or self-prescribing. Your local pharmacist is accessible without the need of an appointment. Always read the instructions of any medicines you use.

What is a cough?

Cough is a reflex which is stimulated by irritation of the respiratory mucosa in the lungs, trachea (windpipe) or the pharynx (throat region). The cough reflex is infact a protective mechanism. It is an attempt by the body to clear the airways of contaminants. Therefore, if this is the case, do we really want to stop the cough mechanism? The answer is both yes and no.

Generally cough falls under two categories; productive or non-productive commonly described as dry or chesty respectively. Identifying which type of cough your child have, is important in deciding whether we want the cough to stop or not. This directly impacts on the type of medication your child will need.

Dry Coughs (Non-Productive)

As its name implies a dry cough produces no sputum. It is often described as “irritating” or, as mentioned earlier, “dry”. In most cases the cause of this type of cough is not due to an infection, although this must be considered along with other symptoms. In some cases the patient may claim that the cough is dry but that they can feel phlegm on there chest. If this is the case then it is best to regard this as a chesty (productive) cough.

Generally dry coughs are irritating to the child and those who surround them. Its causes can be due to many reasons such as change in temperature, a dry atmosphere, air pollution and passive smoking. In some cases it can be due to drug reactions but this is more applicable in adults. Sometimes a dry cough can be attributed to asthma especially if it is troublesome at night time but this is not always the case. If you are concerned, book an appointment with your local doctor to check this out.

Treatment

Your local pharmacist will be able to advice you as to what medicines would be appropriate if any. Also they may decide that the child would need to see a doctor. They will ask you a few questions to determine the outcome. Generally, if there is no cause for concern, the pharmacist may prescribe a cough suppressant or a linctus. Nowadays there are many cough medicines to choose from, but always ask your pharmacist which one is the most suitable if any. Many of them have more than one combination, such as the addition of an antihistamine, which not only helps in suppressing the cough but can also sedate the child allowing them a good nights sleep. Cough medicines with antihistamines may also be useful if there are any associated nasal secretions, since this will dry it up and prevent it from causing post nasal drip (mucus dripping from the back of the nose into the throat) which in itself can initiate a cough.

Chesty Coughs (Productive)

Chesty coughs in general produce sputum or phlegm. By identifying the colour of this phlegm the pharmacist may be able to decide whether a referral is necessary or not. Unless produced in copious amounts, clear or white sputum can be considered generally as being of little significance. Due to the presence of phlegm, medicinal treatment is different to that of dry coughs. As you can imagine, if a cough suppressant were to be given in this case, then phlegm would not shift. In this case it is desirable for the cough to continue to allow the child to remove the phlegm. I hear you say “but it just goes back in because he/she swallows it!” The fact is that when the child coughs up the phlegm it is removed from the airways and is swallowed down into the stomach via the food pipe.

Treatment

Again your local pharmacist is conveniently accessible without an appointment to advice you of any treatment, referral or just advice. Sometimes the child may need antibiotics if it is due to an infection, but this is not always the case. Unfortunately, many of us believe that antibiotics is the solution for most of our children’s illnesses. This is not the case and can infact be harmful to the wider community. When antibiotics are used unnecessarily or not correctly, the bacteria can build up an immunity against the antibiotic. This is beginning to cause problems in that bacteria are becoming, well you can say, stronger! The pharmacist or your doctor will let you know if antibiotics may be needed.

So what do we do when our child has a chesty cough? Well if there are no causes for concern then an expectorant may be of some use. These apparently help by breaking up the bonds in the phlegm thus easing its expulsion by the cough reflex. As is the case with many cough remedies, there are many combinations. Some expectorants again contain antihistamines. This may at first seem desirable since it will help the child to sleep, but the antihistamine may have some cough suppressive activity which may contribute in keeping some of the phlegm down. Also it can dry up the phlegm a little making it more difficult to cough up.

Give them plenty of fluids to drink and the use of something like Karvol may be useful.

Conclusion

It is important to identify the type of cough your child has. Always ask your pharmacist for advice before purchasing anything since in some cases referral may be required. There are many conditions to referral so I have not included them in this article and have left them for your local pharmacist to decide. Remember, that antibiotics is not always the solution and may cause unnecessary problems. Recently, pharmacists are now part of a “Minor Ailment Scheme”. Ask your local pharmacist if they participate in this scheme. It involves the pharmacist assessing the condition of your child and, if appropriate, can prescribe medicines for your child for free, or refer to the doctor, whatever the case may be.

Just to reinforce! Always ask a qualified health profession if the medicines you are purchasing are suitable. In most cases the treatment is symptomatic which means only the symptoms can be treated while the illness takes its natural course.