Myths!

another myth...

Kids Get Bronchitis

I’ve been really struggling with this one, because I have to come up with a summary about coughing in childhood, and it’s nearly impossible without writing a book chapter.

So, let’s start out with this: kids don’t get bronchitis. Adults get bronchitis, mostly because they smoke, and the destruction of the lining of the lung from the smoke sets up a situation perfect for growing bacteria.

Most of us associate having bronchitis with needing antibiotics, mostly because, as adults, antibiotics may have a role in treatment and we have gotten them prescribed from our doctors. In order for the antibiotics to work, the “bronchitis” needs to be caused by a bacteria, which happens frequently in adults. But, most of the cough illnesses in childhood are caused by viruses and we have no cure but time for them.

That doesn’t mean we haven’t tried antibiotics: millions of prescriptions were written just last year. And along the same lines, millions upon millions of dollars were spent on “cough medicines.” Those cough medicines have never been tested in children and the American Academy of Pediatrics has said that we should not be giving over the counter cough medicines to our children (http://www.aap.org/policy/970603.html). So we’ve spent lots of millions for stuff that doesn’t work.

The medicines that treat asthma may be beneficial to children with a long term cough. Albuterol, the medicine we use for asthma, can be of great benefit in treating coughs, and unlike over the counter cough medicines, has actually been shown to be safe and effective in treating cough illnesses, even short term. But most of the time, only supportive stuff needs to be done.

The stuff that helps with coughing is warm fluids, both to drink and to have in the room in the form of a humidifier. Try to keep the nasal drainage from worsening the cough by getting the kids to blow their nose or by using the dreaded nasal bulb syringe. Keep the kids propped up at night, by elevating the head of the crib, or by having them sleep in the car seat or some other clever solution. And again, if you want to use an over the counter medication, which I don’t think is necessary, try Benadryl, as its side effect is sleep in most kids.

And, it’s probably good to know that coughs can last more than 14 days after the muscle aches, fever, sneezing and sore throat have gone away. A child who seems “susceptible to bronchitis” or gets “bronchitis every year” probably has asthma. And we can treat asthma, quickly and effectively. It’s important that a child with a cough that seems to occur after exercise, or who has a cough that hangs on for long after everyone’s else’s cough has gone away, or who coughs lots at night, has an evaluation for asthma.