It’s the season of colds, flu – and cough. Leila Yoonessi, M.D., a pediatric pulmonologist at Dignity Health – St. Mary Medical Center in Long Beach, reminds parents to watch out for rhinovirus (the common cold), as well as respiratory syncytial virus, which can be truly dangerous in younger children. She also has tips about managing cough.
Is cough ever harmful in and of itself?
Cough is a natural defense mechanism. Our lungs are lined with these little ciliary projections – you can think of them as little hairs – called the mucociliary escalator. Whenever we inhale something that’s irritating the lungs or we have mucus, those little hairs are like an escalator that lifts it up and out. We basically are clearing secretions and irritants from our lungs when we cough. In general, I do not want to suppress cough, especially in children less than 4.
What are your red flags that mean a cough is cause for concern?
It’s always better to err on the conservative side. A lot of times people say a normal cold lasts 10 to 14 days. I usually say you want to see them starting to get better by three to four days.
Also, the cough should not be progressive in nature, not harsh or forceful, not wet.
If a child is turning blue or they look red in the face or they’re really struggling, or look like they’re in pain, then I start thinking this kid might have reactive airway disease or something else going on besides just normal cough and cold.
And because the vaccination rates are declining, I’m worried about pertussis. So if a parent sees a baby cough, cough, cough, cough, cough and change color, that baby has to go to the ER.
If a parent has a kid with a cough and is not seeing these red flags, what are some steps they can take to make the child feel better?
I am really passionate about parents using their healthcare provider to guide them in these decisions, and I am very wary of parents managing colds on their own in babies less than 3 months old. A lot of times parents use Google, and then they go and buy a lot of over-the-counter remedies. Unfortunately, cough suppressants can be dangerous. I wouldn’t suggest using them unless you have consulted your physician.
There is no data to support the use of Vicks BabyRub from birth to 3 or Vicks VapoRub after 3, but it makes mommies feel good to do something, and it can be soothing. The only other thing I’m OK with when it comes to babies is Zarbees Baby Cough Syrup with agave and thyme. Nasal saline drops with vigorous suctioning to clear the nose can also provide a lot of relief.
After 1 year of age you can use Zarbees honey cough syrup. You can also use natural mommy remedies like chamomile tea, herbal teas with lemon and honey or salt gargles. You could do a cool mist, or put them in the shower and let them drain their sinuses. One of the other things that helps older kids is Mucinex, because it thins the secretions and helps kids expel them from the lungs.
For all kids, they want to be held and paid attention to. I always tell moms, don’t underestimate the importance of you.