Many parents give their children medicine when they see a cough instead of finding out the cause. It is important to know that a child’s cough is not always bad and there is really no need to rush to “stop the cough”. Coughing is a protective defense reflex. When the whistle tract or other related organs feel stimulation (e.g. inflammation, foreign body), the impulse is transmitted to the medullary cough center, and then the efferent nerves direct the effectors (inspiratory muscles, pharyngeal muscles, etc.) to cause coughing in order to expel whistle secretions or foreign bodies and keep the whistle tract clean and clear. Occasional coughing is not only harmless but also protective and does not require medication. However, severe or frequent coughing is a medical condition that often causes discomfort and pain, affecting life, work and sleep, and may even lead to complications such as chest pain, pneumothorax, rib fractures, enuresis and syncope. American Academy of Pediatrics: Cough Care Recommendations 1. What you should know about cough 1. 3. Coughing is a good thing, a “defensive” action of the body! Coughing is a good thing, it is a “defensive” action of the body! As a doctor, you don’t want your child to not cough at all. Home cough medication: Goal: Reduce irritation in the throat, which leads to a dry cough. 1. Infants from 3 months to 1 year: Give warm juice to treat the cough. For example: apple juice with lemon juice. You can give 5-15 ml each time and 4 times a day. Note: Honey and honey water are prohibited for babies under 1 year of age. 2. For babies over 1 year old: 2-5 ml of honey can be used as a home cough suppressant. Honey can reduce sputum production & relieve cough frequency. If honey is not available, corn syrup can be used instead. 3. Children over 6 years of age: Take an oral cough suppressant to relieve throat irritation. If cough suppressants are not available at the moment, hard candy can be used instead. C. Over-the-counter cough suppressants Over-the-counter cough suppressants are not recommended. Reason: There is no evidence that cough suppressants are beneficial for children with cough, while there are still no studies in children under 4 years of age. (US FDA 2008) Honey has been shown to be more beneficial than cough suppressants. (Note: Honey is contraindicated in infants under 1 year of age.) For children over 4 years of age, if you decide to choose a cough suppressant, choose a single-ingredient “dextromethorphan” in pharmaceutical form in drops; dextromethorphan dose: every 6 to 8 hours. When to use cough suppressants: Cough suppressants are recommended when coughing seriously interferes with your child’s sleep and school. IV. Coughing episodes and persistent coughs Whistle warm water mist (e.g., from a hot shower head in a closed bathroom). Give your child warm fruit juices, such as apple and lemon juice. Juice is not suitable for babies under 3 months of age. Babies 3-12 months: give 30ml of juice at a time, up to 4 times a day. Babies over 1 year: Give juice as often as needed. Reason: It relaxes the airway and dilutes the phlegm. V. Vomiting due to cough: For vomiting due to violent cough, reduce the amount of each feeding but increase the frequency of feeding. For infants, do not exceed 60ml of milk per feeding. Reason: Most vomiting due to coughing is due to excess stomach contents. VI. Encourage drinking Try to encourage your child to drink more juice or boiled water. Goal: Ensure the child has enough water. Reason: To dilute the phlegm and make it easier to cough it up, and to make the snot easier to expel. VII. Air humidifier If the air in your home is dry, consider using a humidifier. Reason: Dry air causes coughing to worsen. VIII. Fever-reducing medication For a temperature above 39.0°C, use acetaminophen (e.g. Tylenol); or use ibuprofen (e.g. Merlin). (Parents should be aware if their child has a history of convulsions, otherwise this article does not apply!!!) Note: A body temperature below 39.0 degrees is an important response of the body to fight infection! IX. Avoid second-hand smoke Second-hand smoke aggravates cough. After the fever has completely subsided, the child can return to school. If the child feels well, he/she can participate in ordinary activities. In fact, coughs and colds cannot be prevented. Additional advice – anti-allergy medication for allergic cough Allergy medication can control allergic cough within 1 hour and, in the same way, can significantly improve allergic rhinitis. Short-acting anti-allergy medications are helpful, such as diphenhydramine. It is given every 6 hours to 8 hours until the cough disappears. XII. After healing Viral bronchitis will cause cough symptoms for 2 to 3 weeks. Sometimes, the child may cough up a lot of sputum. Usually the sputum is gray, yellow or green. Antibiotics will not help the cough! XIII. Seeking medical attention Difficulty in whistling, significantly faster whistling. Asthma attacks. A cough that has been present for more than 3 weeks. You think your child must see a doctor. The child’s general condition has worsened. Two types of “cough medicines” are banned 1. Cough medicines containing codeine Long-term abuse of codeine can cause dependence and addiction, and inappropriate use may lead to a number of adverse reactions, such as extreme drowsiness, confusion, inhibition of whistling, and even life-threatening.In early 2017, the State Drug Administration (CFDA) issued a document requiring pharmaceutical companies to revise the instructions for medicines containing codeine. One of the key items was: “Codeine is prohibited for children under 12 years of age” (link) and “It is not recommended for use in children and adolescents aged 12 to 18 years with chronic whistling disorders”. In addition to drugs clearly labeled with codeine ingredients, there are also drugs labeled with ingredients such as poppy husk and compound camphor tincture that contain similar ingredients to codeine and morphine and have similar side effects. Because the management of proprietary Chinese medicine is not as perfect as Western medicine, the ingredients of proprietary Chinese medicine will not be completely listed in the drug instructions completely, so many doctors will still go to prescribe this drug, pharmacies are also sold. 2, containing promethazine cough medicine promethazine side effects are large, may lead to children under two years of age whistling inhibition or even death. The World Health Organization has warned that finasteride (promethazine) is prohibited for children under 2 years of age and is forbidden to be used as a cough suppressant. Promethazine is often mixed with herbal cough medicines, the most common ones are: (1) Cough Syrup (2) Compound Mandarin Loquat Syrup