May 25, 2012
Topics A-Z Children's Health Four year old with cough lasting a few months
Four year old with cough lasting a few months |
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Dear Ask The Doctor: My four year old daughter has had a cough now since October. This worsens and is mostly at night. It is causing her a lot of sleepless nights. Sometimes making her physically sick when she coughs too much. I have taken her to the Dr who prescribed Amoxicillin, after I told him I'd given her cough medicine. Both have had no effect whatsoever!! Last week I again took her to the Dr who said I should give her Gaviscon and prop up her pillows. I have propped p her pillows whuch also has had no effect. I'm running out of ideas to help her. The Dr has listened to her chest which is all clear and there is no wheezing. Please help!! Dear Natalie: I do understand your concern for your daughter's health. Healthy children may cough on a daily basis and is an important defensive reflex that protects from aspiration of foreign materials. However, a cough may also be the presenting symptom of a serious underlying pulmonary or extrapulmonary disease. Evaluation of a chough in a child is very different to that of an adult. Children with chronic cough should be evaluated with a detailed history, physical examination, chest radiograph, and spirometry if the child is able. Further evaluation depends on the provisional diagnosis and the course of the symptoms. The causes of specific chronic cough fall into the following general categories ; i) Specific cough - as a result of asthma, persistent bacterial bronchitis, chronic suppurative lung disease and bronchiectasis, airway abnormality, interstitial lung disease and extra-pulmonary causes such as cardiac disease and ear infections. ii) Nonspecific cough - is when symptoms suggesting specific cough are absent and the chest radiograph and spirometry are normal. I would suggest that you consult a pediatric respirologist to determine the cause of your child's chronic cough. If the cough is troublesome, the possibility of asthma should be considered and pursued with an empiric trial of bronchodilators and other asthma medications. If there is no response, the child should be considered to have a nonspecific cough, and the medication should be stopped. The only treatment needed for nonspecific cough is reassurance and observation of the child over time to see for possible emergence of specific symptoms. |
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| Last Updated ( Thursday, 05 January 2012 ) |
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