Treating cough less than two

Here’s a question from Holly: “What can you recommend, if anything, for nighttime coughing? Adults can just knock back some cough medicine, but there doesn’t seem to be any equivalent solution for young children (under 2). It’s sad when the coughing is bad enough that they wake themselves up and then start crying because they really just want to sleep. I’m not asking about chronic coughing, just the kind related to a regular cold.”

This question is also addressed in this post from last month. Cough and cold medicines really don’t work very well at any age, but for children less than two there are none that are approved for use in the United States. Cough medicines that have been prescribed in the past are ineffective, and even worse, they’re potentially dangerous.

Here, we’re talking about an otherwise healthy child, having no trouble with breathing, acting entirely well. If your young child has a cough plus a high fever, trouble breathing, or is acting sick, you ought to be getting advice directly from your own pediatrician about the next steps to take.

So what can you do for a child less than two with a cough? Some simple home remedies, like a humidifier, sitting together in a steamy bathroom, or using saline nose drops can help. Cool drinks or a popsicle can also be soothing for a throat.

A study published in 2007 found that a single dose of buckwheat honey relieved nighttime coughs better than the cough suppressant dextromethorphan in children. Honey can safely be given to babies older than one year, and is certainly worth a try as a safe alternative to medications. Do not give honey to a baby who has not yet reached the first year birthday.

The most important thing to keep in mind is that a cough, though annoying, is going to go away, and your child is going to be fine even if both of you have a few sleepless nights. Medications that have been used for cough in babies have caused deaths, and since they’re entirely ineffective there is no point in taking the risk of trying them. A cough itself is a natural reflex meant to expel mucus and infected material from the lungs, and may be an important way for children to fight their infections. That might not be great consolation next time you’re having a sleepless night with a coughing baby, but for now that’s the best that we can do.

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6 Comments on “Treating cough less than two”

  1. Holly M Says:

    Thanks, Dr. Roy. I had read about the honey solution as well, but had been too chicken to attempt a honey shot in the middle of the night. 🙂 Will have to give that a try next time I have miserable kiddies, particularly since you have re-confirmed that the OTC stuff is a bad idea.

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  2. Stephanie Says:

    How much is “a single dose”?

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  3. Dr. Roy Says:

    The amount of honey they gave varied by age from 1/2 tsp for 2 year olds to 2 tsp for 18 year olds. A single dose was given at bedtime, and the effectiveness in ameliorating cough was compared to children who were given a single dose of dextromethorphan, which was also dosed based on the age of the child. The editors of Archives of Pediatric and Adolescent Medicine have posted the original article online for free access here.

    I haven’t had many patients try this– or at least, I haven’t heard back from many people about whether honey seems to help or not. If any of you try it, let us know!

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  4. Jean Says:

    To say that night-time coughing is simply an annoyance and will go away after a few sleepless nights really overlooks the impact this can have on a person’s well-being. My personal opinion is that there is something hereditary in this night-time cough episode. In my family it’s only me and my daughter that suffer from this. A few days? How about the potential of a few weeks of disturbed nights due to coughing fits that can’t be stopped? My Mother has this problem, too. Not my husband, my son or anyone else in my family. They get a cold and they recover. We get a cold and can plan to spend nights sleeping upright, running the humidifier, drinking glass after glass of water and all the other “remedies” the Internet and doctor’s try to pacify us with. The only thing that works for my daughter is a dose of cough syrup with codeine. It upsets me that the doctors I have spoken to in all seriousness about this situation tell me the same SIMPLE things that don’t do anything to help fix or prevent the problem. Post nasal drip – muscle spasm? WHAT IS IT!?!?!? We are healthy people – no allergies or other underlying issues. Those who dismiss this simply as a few nights of bad sleep obviously do not suffer from this problem.

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  5. Dr. Roy Says:

    Jean, the most likely diagnosis from the story you’ve told is asthma. That causes a rather severe and lingering cough in children especially during and after respiratory infections. Not all children with asthma have wheezing, and asthma may have been overlooked in both you and your child. I suggest you discuss this with your physician, or perhaps ask for a referral to a pulmonary specialist for clarification. Best of luck to you.

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  6. Rukmini Says:

    Honey works very well for me. A definite cure for me is half and half of honey and ginger juice. I lick a bit of the mixture every time I cough.The cough slowly disappears in about 2 days. There are some ayurvedic cough powdrs can be taken with honey. But they don’t suit me as I get dry cough – and that is terrible.

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