Treating coughing children

Paediatrics is heading into its busiest time of the year where GPs, Emergency Departments and Children’s Units will be seeing hundreds of children a day with respiratory symptoms including coughing, colds, and temperatures.

Firstly coughs and colds in children are extremely common, and nine times out of 10 are caused by a self-limiting viral infection (so do not need antibiotics), and will get better with rest, plenty of fluids and possibly paracetamol and/or ibuprofen.

A lot of parents find the symptom of cough troublesome, particularly as it can persist for several weeks after the infection has gone, and worry that it is damaging their child in some way.

A lot of parents find the symptom of cough troublesome, particularly as it can persist for several weeks after the infection has gone, and worry that it is damaging their child in some way.  

Most of the time it is more of an annoyance/disturbs sleep than actually causing any real harm. However, parents still like to reach for the over the counter (OTC) cough syrups that are widely available but there is a lot of conflicting advice about their use, which parents understandably find confusing.

A lot of OTC cough and cold medicines contain active ingredients such as nasal decongestants, antihistamines and “cough suppressors”, that may in large doses have adverse effects or be toxic if consumed in large quantities particularly to the under 6s who are much more susceptible. They may also contain ingredients such as paracetamol, and parents may unintentionally find themselves overdosing their child with cough medicine and paracetamol. Also, as with any medicine, there remains a potential risk that any of the ingredients could cause an allergic reaction or other unwanted side effect.

As for older children, the Medicines and Healthcare product Regulatory Agency highlights that codeine-containing cough medicines are contraindicated in under 18 year old as codeine can exacerbate respiratory conditions in the teenage group.

I think the bottom line is there is absolutely no evidence that cough medicines work as there has been very little research with regards to their use, and potentially they could actually do the child more harm than good. They often also contain a lot of sugar, which is also not good for children’s overall health.

My advice would be to stick to old fashioned honey and lemon, rest, lots of fluids and paracetamol and/or ibuprofen as per the pack instructions. If symptoms persist beyond a few days or there are other worrying signs, have a chat to your GP or pharmacist.

Dr Ollie Bevington

Dr Ollie Bevington

Dr Ollie Bevington is a senior registrar in paediatrics at Southampton Children's Hospital and also Chair of the Royal College of Paediatrics and Child Health Trainees Committee.
Dr Ollie Bevington

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