From the Guidelines
For a baby with a dry cough, the most effective treatment approach is to focus on keeping them hydrated and comfortable while the cough resolves naturally, as there is no evidence to support the use of medications for symptomatic relief of cough in children, as stated in the Chest guideline and expert panel report 1.
Key Recommendations
- Offer frequent small amounts of fluids appropriate for their age to keep them hydrated.
- Use a cool-mist humidifier in their room to add moisture to the air, which helps soothe irritated airways.
- Saline nasal drops followed by gentle suctioning with a bulb syringe can help clear congestion that may contribute to coughing.
- Elevate the head of the crib slightly by placing a towel under the mattress to reduce nighttime coughing.
Important Considerations
- Over-the-counter cough and cold medications are not recommended for babies and children under 4 years old, as they can cause serious side effects and have not been proven effective in young children, as highlighted in the Journal of Allergy and Clinical Immunology 1.
- If the cough persists beyond 3-4 days, worsens, is accompanied by difficulty breathing, high fever (over 100.4°F), or if the baby seems unusually irritable or lethargic, contact a healthcare provider immediately.
Additional Guidance
- According to the Chest guideline and expert panel report 1, cough in children should be treated based on etiology, and environmental influences should be discussed and managed accordingly.
- The use of honey may offer more relief for cough symptoms than no treatment, diphenhydramine, or placebo, but it is not better than dextromethorphan, as suggested in the Chest guideline and expert panel report 1. However, this should be considered on a case-by-case basis, taking into account the child's age and individual needs.
From the Research
Dry Cough in Babies: Treatment Options
- Dry cough in babies can be caused by various factors, including acute viral respiratory infections, which may last up to 3-4 weeks 2.
- Treatment of dry cough in babies remains a challenge, and symptomatic relief must be considered when the cough interferes with the baby's daily activities 3.
Available Treatment Options
- Antitussive preparations, such as codeine or dextromethorphan, combined with antihistamines, decongestants, and expectorants, can provide effective symptomatic relief of dry cough 3.
- First-generation antihistamines like chlorpheniramine and centrally acting opioid derivatives like codeine are often used alone or in combination in the management of nonspecific cough 3.
- However, the efficacy of dextromethorphan in treating cough associated with acute upper respiratory tract infection is questionable, with one study showing little difference between dextromethorphan and placebo treatment 4.
Considerations for Treatment
- Many remedies for cough are self-prescribed, reflecting strong demand, but significant evidence of their efficacy and safety is missing in pediatric populations 5.
- Lack of clear indications for dosing and treatment duration, the number of available drugs, and multiple caregivers administering medication to children have been considered contributors to an increased risk of inappropriate prescribing, accidental overdosing, and adverse events 5.
- Over-the-counter medication for cough seems to have no documented benefit in children under the age of 5 years, and the use of dextromethorphan may be effective in older children and adults, but its efficacy in babies is unclear 6.