Antitussive

Each year a normal healthy child will get several colds. Colds, medically called upper respiratory tract infections, have many symptoms including cough, runny nose, fever, sore throat, headache, and muscle aches. These illnesses are generally caused by common viruses, passed from one person to another, and last seven to ten days.

Perhaps the most frustrating symptom with a cold is the coughing. Coughing, while bothersome during the day, is particularly frustrating at night because it disrupts sleep. For the parents of coughing children, they too may be unable to sleep well due to the noise of their child's coughing.

Because their child is uncomfortable and because parents often need to be well-rested in the morning, many parents give their children over-the-counter medicines containing dextromethorphan and/or diphenhydramine. Dextromethorphan is supposed to suppress the coughing. Many cough medicines containing dextromethorphan end with "DM."

Diphenhydramine (one common brand name is Benadryl) is an antihistamine given to dry up the child's secretions. The reason for the antihistamine is that if the secretion dries up they will be less irritating, reducing the child's need to cough. While these medicines have been available for about fifty years, surprisingly there is no evidence that these medicines are effective for relieving cough in children.

Pediatricians at Penn State Children's Hospital in Hershey, PA, gave 100 children either dextromethorphan, diphenhydramine, or a non-medicated, sugar water placebo solution 30 minutes before bed. They compared the symptoms on the night when the children received either the medicines or placebo with the prior night when no treatment was given.

The research showed that the children's symptoms (cough frequency, cough severity, sleep difficulty) improved over time, but those that received the sugar water placebo improved just as much as those that got the medicines. Additionally, their parents slept just as well regardless of their treatment, meaning that there was no benefit in giving the children the medicines compared to the sugar water. Further, those that got the medicines had more side effects--difficulty falling asleep from the dextromethorphan and drowsiness from the diphenhydramine.

What now? What can you do for your child's cough? First, while cough is most often due to a cold, it can be caused by other conditions including asthma and pneumonia. If your child is having breathing difficulty or a cough that seems to be worsening or persisting, a trip to the doctor may be needed.

If it is due to cold, there are several things that may make a child more comfortable.

* Give your child age and weight appropriate doses of non-aspirin fever reducers such as acetaminophen or ibuprofen.

* Make sure your child gets plenty of fluids to prevent dehydration. The coughing, mouth breathing (common when a child has a stuffy nose), and fever all increase the amount of fluid loss. The liquids don't have to be any fancy--water, juice, popsicles, or whatever is your child's favorite--are fine.

* Salt water (saline) nose drops or spray will help loosen up any dried nasal mucus, making it easy for your child to clear his nose.

* Run a humidifier or vaporizer in your child's bedroom. This could help moisturize the nasal mucus and ease your child's breathing.

All of these things may help a child to feel better and don't have the potential side effects of over-the-counter medicines. The most important treatment is time and TLC.

Ian M. Paul, MD, MSc is Assistant Professor of Pediatrics and Health Evaluation Sciences at the Pennsylvania State University College of Medicine. Dr. Paul is a general pediatrician and research scientist. He has been an active investigator in pediatric pharmacology and serves on the Executive Committee for the American Academy of Pediatrics, Section of Clinical Pharmacology and Therapeutics.

COPYRIGHT 2004 Pediatrics for Parents, Inc.
COPYRIGHT 2005 Gale Group