It seems that at this time of year not many families escape
the coughs and colds that rip through the community and particularly
seem to bother the younger folk. Coughs are one of the most
frequent symptoms of childhood illness, and although they
can sound awful at times, they usually are not a symptom of
anything dangerous. Actually, coughing is a healthy reflex
that helps clear the airways in the throat and chest. Occasionally,
though, coughs can be cause for us to feel we have to medicate.
Experts now however are saying that we may be doing the wrong
thing.
Lung Experts: No Evidence Over-the-Counter Cough Medicines
Work; May Be Harmful in Kids
Over-the-counter cough medicines may be a waste of time and
money, says a panel of America’s top lung specialists.
Consumers spend billions each year on nonprescription cough
syrups, drops, and so-called cough and cold medications. But
an expert panel concluded that these products rarely help
a cough.
“There is no clinical evidence that over-the-counter
cough expectorants or suppressant actually relieve cough,”
says panel chairman and pulmonary specialist Richard D. Irwin,
MD. The updated cough treatment guidelines were issued by
the American College of Chest Physicians and are published
in the January issue of its journal Chest. They are endorsed
by the American Thoracic Society and the Canadian Thoracic
Society.
No Drowsy No Good
So what should you do instead to relieve that irritating cough?
The panel recommends the use of older antihistamines with
a decongestant for the treatment of coughs due to colds, allergies,
and sinuses in adults. They specifically suggest the antihistamine
brompheniramine and the decongestant pseudoephedrine, both
found in many over-the-counter cold remedies. The anti-inflammatory
pain reliever naproxen (Aleve, Naprosyn) has also been shown
to be effective for cold-related coughs, the report states.
Newer antihistamines, which are nonsedating, are not effective
for treating coughs, Irwin tells WebMD. “If you take
an [antihistamine] medication that says ‘nonsedating’
or ‘nondrowsy’ on the label, it isn’t going
to do anything for your cough,” he says.
Coughers Everywhere
Each year in the United States, roughly 30 million Americans
see their doctors because of coughs.
“Cough is the No. 1 reason why patients seek medical
attention,” Irwin says. “Although an occasional
cough is normal, excessive coughing or coughing that produces
blood or thick, discolored mucus is abnormal.”
ACCP President W. Michael Alberts, MD, tells WebMD the guidelines
were updated to reflect new research on the treatment of coughs.
Kids and Cough Medicine
While the revised ACCP guidelines stop short of saying that
adults should not take over-the-counter cough medications,
this was the group’s recommendation for children under
the age of 15.
“Cough and cold medicines are not useful in children
and can actually be harmful. In most cases, a cough that is
unrelated to chronic lung conditions, environmental influences,
or other specific factors, will resolve on its own.”
”says Irwin, who is chief of the division of pulmonary,
allergy, and critical care medicine at the University of Massachusetts
Medical School.
But pediatric lung specialist William Brendle Glomb, MD, who
helped write the new guidelines, tells WebMD that he frequently
treats children with products such as Robitussin and will
continue to do so.
“I have discussed this with every pediatric pulmonologist
that I know, and we all use it,” he says. “It
works wonderfully to clear the mucus out.” The problem,
he says, is that there have been very few studies done on
over-the-counter cough medicines, and most were conducted
decades ago. Most studies also involved narcotic products
containing codeine.
“There are big holes in the scientific literature, and
this is one of them,” he says. “These products
just haven’t been studied.” Though he disagrees
with some of the wording in the new guidelines, Glomb does
agree that coughs in children should not necessarily be treated.
“When children cough it is generally because they need
to get out whatever it is that is in there,” he says.
(Web MD)
Most coughs indeed will go away by themselves; however you
should seek medical attention if you or your child:
- has trouble breathing or is working hard to breathe
- has a blue or dusky color to the lips, face, or tongue
- has a high fever (particularly in a young infant or in the
absence of congestion or a runny nose; contact your child’s
doctor for any fever in an infant younger than 3 months of
age)
- if an infant (3 months old or younger) who has been coughing
for more than a few hours
- makes a “whooping” sound when she breathes after
coughing
- is coughing up blood
- has stridor when inhaling
- has wheezing when exhaling (unless you already have home
asthma management instructions from your child’s doctor)
- is listless or cranky
- Has a persistent cough. Coughs caused by colds can last
weeks, even up to 3 weeks, especially if your child has one
cold right after another. Asthma, allergies, or a chronic
infection in the sinuses or breathing passages might also
be responsible for long-term coughs.
Any person with a persistent cough should be assessed for
TUBERCULOSIS (TB or TBC). Even those who have received the
Tuberculosis vaccine are still susceptible to the disease
(the vaccine is about 60 – 70 % effective).
If your child’s cough lasts for more than a month, you
should schedule a visit with your child’s doctor.
“Kim Patra is a qualified Registered Nurse and
Midwife that has been living and working in Bali for almost
twenty years. She now runs her own private practice and medical
referral service from her Kuta office. Kim is happy to discuss
any health concerns with you and she may be contacted via
e-mail at info@chcbali.com”.
