A few days ago, some concerned parents came to my office as their 6 month old boy had a bit of a snuffly nose, a mild fever and an occasional cough. They had been to see a local doctor the night before who had mixed up his own concoction of powder for the infant, and when I checked the ingredients of this potion I was absolutely horrified.
The powder consisted of a potent mix of mucous thinners (Bisolvon), antihistamines (Pheniramine), and steroids (Dexamethasone). These consider medications that should probably not be used on children under two years of age unless the chest condition is serious (e.g. severe asthma, bronchitis or pneumonia).
In fact, in a recent directive from the FDA (food and drug administration)of the USA, parents and caregivers have been urged not to give cough and cold medicines to children younger than 2 because of rare but serious adverse side effects including convulsions, rapid heart rates, decreased levels of consciousness, and death have been reported with use of cough and cold products. The use of cough and cold medicines in children aged 2-11 is still being reviewed.
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.
If you do choose to medicate your child (over 2 years of age) with cough / cold remedies (including decongestants, expectorants, antihistamines, and antitussives or cough suppressants) use the following guidelines:
· Always remember that these medications do not cure the cold. They don’t shorten the time that your child has a cold, and they’re only meant to help a child’s symptoms.
· Look at the active ingredients in the Drug Facts label. This will help you understand what active ingredients are in the medication and what symptoms each active ingredient is intended to treat. Cough and cold medications often have more than one active ingredient.
· Be very careful in giving more than one over-the-counter cough and cold medication to your child. Remember that many over-the-counter cough and cold products have multiple medications in them. If you use two medications that have similar active ingredients, a child could get too much of the ingredient, which could be harmful.
· Make sure to carefully follow the directions in the Drug Facts part of the label. These directions tell you how much medicine to give and how often to give it.
· Only use the measuring device -- spoon, dropper, or cup -- that comes with the medication. Common household spoons come in different sizes and are not meant for measuring medicines. If you use these, you may not be giving the right dose.
If you have the opportunity to choose cough and cold medications with a childproof safety cap, you should do so, and store these medications out of the reach of children.
Kim Patra is a qualified registered nurse and midwife who has been living and working in Bali for almost 20 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 or Hp. 081 2366 0000.
