Coughs and Colds in children – do you really need that bag of medicine?

Coughs and colds are one of the most common problems seen in Paediatrics, something that every child will have over and over. For children in day care or frequently near other children, it’s an average of one viral illness a month. Depending on the virus, a cough can linger for weeks, so it is not unusual to see a cough go on for months with only a few relatively well days in between.

Treatment is seldom necessary. Almost all cough and cold medicines are useless. Antihistamines like Zyrtec or Claritin do no good, but are still widely given as something that will “dry up your nose.” They don’t, and only work for allergies. For almost twenty years most medical societies have declared routine use of cough and cold medicines is not helpful, and more likely to cause harm. In the United States cough and cold medicines have been removed from non-prescription sale for children under 4 years – from 2004 to 2011 in the USA more than 60,000 children under 12 went to an A&E due to side effects from these medications.

So do we prescribe medicines for coughs and colds at IMC? Sometimes yes. We often try decongestants and some mucolytics. It won’t make you get better any more quickly, but may help with comfort and sleep, which is always a happy thing.

What are the signs to worry about? Worsening fevers, especially if your child seems to get better then fevers come back. Pain is also sometimes worrisome, as infants and small children tend to get ear infections more often than older children. Any worsening pain, especially with fevers, is something a doctor should see.

What about green and yellow mucous? It’s very normal to see clear runny noses get more thick and colored a few days into an illness, and if it does not improve in a week or so, especially if sinus pain and fevers are still occurring. Green or yellow snot alone is not an indication for antibiotics.

Is a fever the only dangerous thing? Some coughs and colds even without fevers can be dangerous, especially for children with asthma or toddlers who are vulnerable to croup. Any wheezing or trouble breathing is something a doctor may need to see.

So what to do with coughs and colds? Most coughs and cold are viral and will go away (sometimes very very slowly) on their own. If you are worried, especially with pain, fevers, or trouble breathing, then a visit to a doctor is always a good idea.

Maybe medicines may help, but most of the time it’s not necessary. Antibiotics are vastly overused, and most cough medicines do no good. If you have any worries, see a doctor, and you can figure out what the right choice is for your child.

If you always leave with a half dozen medicines and an antibiotic, it’s probably not right.


Dr Leo Hamilton is the senior Paediatric doctor based at IMC Paediatrics.
For appointments call: 6887 4440


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