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A cough is one of the most common symptoms of childhood illness. Although it may sound unpleasant, it is not usually a sign of a grave condition. In fact, coughing is a healthy and important reflex that helps protect the airways in the throat and chest.

Cough is generally a self-limiting condition, which will usually get better within a few days. Researchers recommend simpler treatments such as fluids and paracetamol or ibuprofen to ease discomfort and bring down temperature in children.

Ingredients of Cough Medicines

Cough medicines include constituents such as demulcents made up of glycerine and honey that ease irritation in the throat. Other constituents of cough medicines are suppressants, expectorants, and decongestants; each of these has separate actions. Researchers have put forth that cough medicines do not work and contain only small amounts of active ingredients. [1]

Cough suppressants include pholcodine, dextromethorphan and antihistamines. They suppress the cough reflex and should only be used for dry cough

Antihistamines are usually administered at night because they help in inducing sleep. 

Expectorants, including guaiphenesin and ipecacuanha, help in getting rid of the mucus so that coughing gets easier. They are present in all cough medicines and may help in chesty coughs.

Decongestants found in some cough medicines include pseudoephedrine and phenylpropanolamine. They help to reduce inflammation and congestion. 

Antibiotics are used in case any secondary bacterial infection such as pneumonia develops.

Recent News on Cough Medicines for Children

According to new advice, parents should not give children under 12 most over-the-counter cough and cold medicines as there is evidence that they do not work and can even be harmful. The possible side effects associated with these medicines include sleep disturbances, allergic reactions, and hallucinations. Thus asking your doctor before purchasing an over the counter cough medicine for young children is recommended.

Studies involving seven children — two with antitussives, two with antihistamines, two with antihistamine decongestants and one with antitussive-bronchodilator combinations — showed the drugs were no more effective than a placebo. [2

The Commission On Human Medicines (CHM) in the UK reviewed more than 100 over the counter products used for treating coughs and colds, and recommended that they should no longer be given to children under two. [3]

It has withdrawn six medicines including Asda Children's Chesty Cough Syrup, Boots Chesty Cough Syrup One Year Plus, Boots Sore Throat and Cough Linctus One Year Plus, Buttercup Infant Cough Syrup, CalCough Chesty and Bell's Children's Chesty Cough from the shelves until they are relabelled with warnings about not administering them to children under two but for older children, they are still available via the pharmacist.  This is because the risks of side effects are reduced in older children because they weigh more, get fewer colds and can express if the medicine is doing any good.

Medicines that do work and are safe to give to children under six include Beechams Veno's Honey and Lemon, Benylin Tickly Coughs and CalCough TicklyCare Glycerin Lemon and Honey with Glucose; although it is important to note that none should be given to babies under a year old.

Also in the US, where there have been cases of fatal overdoses, the Food and Drug Administration recently announced that cough and cold preparations should no longer be given to children under two years. 

The FDA put forth problems with over-the-counter cough remedies suggesting that doses for kids are just kind of made up based on portions of adult doses, and haven't really been tested for safety. There have also been reports of these medicines causing cardiovascular problems, and possibly not doing much for cough relief anyway. The FDA is particularly concerned about the effect of the medications on children under the age of two, but hasn’t suggested anybody change their dosing habits just yet. If giving a child more than one medicine, parents are advised to be vigilant that these medicines do not contain the same active ingredient or that the maximum recommended dose for that drug is not exceeded. [4]

Please remember that while the medicines themselves are safe and effective when used as directed, rare adverse events have occurred in young children from misuse and accidental ingestion. The label changes are efforts being made by medicine makers to encourage appropriate dosing practices.

Home Treatment of Cough in Children

It is best advised to not to give your child OTC cough medicine without first checking with your doctor. Cough drops can be given to older kids, but kids younger than three years old can choke on them. Thus it is better to avoid cough drops unless your doctor advises that they are safe for your child. 

For children under six, parents should rather stick to simple remedies like keeping their child's temperature down and using a simple honey-and-lemon mixtures to ease a cough.

The following are some home remedies to help your child feel better:

  • For young babies who have difficulty feeding, nasal saline drops are recommended to help thin and clear nasal secretions.
  • Nasal suctioning with a bulb syringe — with or without saline nose drops — works very well for infants less than a year old.
  • If asthma is the associated cause of a cough, it would be wise to have an asthma care plan from your doctor. The plan should help you choose the right asthma medicines for your child.
  • One remedy for a barky cough in a child is to turn on the hot water in the shower in the bathroom and to close the door to allow it to steam up. Then, you should sit in the bathroom with your child for about 20 minutes. The steam will help your child to breathe better. Also, a cool-mist humidifier in the child's bedroom might provide some relief.
  • Cool beverages such as juice can be soothing. But do not give soda or orange juice, as these can hurt a throat that is sore from coughing. Make sure your child drinks plenty of liquids — it will help him stay hydrated. 
  • Acetaminophen or ibuprofen can be used to reduce fever and pains. Follow the product’s instructions for use!
  • Syrup containing Echinacea and mallow can work as a useful remedy for coughs and colds. Echinacea has been used for centuries to treat colds and recent research has shown that it boosts the immune system. The mallow is a nice soothing herb for a tickly cough. Another cough syrup known as the NELSONS' natural Sootha Children's Cough Syrup contains homeopathic bryonia with honey and lemon, which can be particularly effective for dry tickly coughs. This syrup is suitable for children over 12 months, has no artificial colourings or flavourings and does not cause drowsiness.