“What is the best medicine for bronchitis for kids?”
My 10 year old son was diagnosed with bronchitis. What is the best medicine for bronchitis for kids?
1 Answer
Hello,
In response to your question, "What is the best medicine for bronchitis for kids?" I find the answer to be rather complex and dependent on what you hope the medicine will do. Firstly, almost all bronchitis in children is viral and will not require antibiotics. Secondly, viral bronchitis can be mild and require no therapy if the child is comfortable and breathing normally.
Although there are many cough and cold products available to treat symptoms of a cold or bronchitis, most are not needed and some can be harmful. Over the last few years, cold and cough medications for children under the age of 6 years have been removed from pharmacy shelves. The FDA withdrew approval for these medications a few years ago because there were a few deaths in kids under age 6 from incorrect dosing and there has never been sufficient evidence of effectiveness. The pharmaceutical industry can bring these medications back to commercial use if they provide the FDA evidence of safety and effectiveness. It is very unlikely they will go through this expense as they've known for many years that there is no evidence of benefit. The medications remain available for persons over age 6 without evidence of benefit as their approval was historically "grandfathered" by the FDA and overdose tragedies in older persons are extremely rare.
I like to explain to families that "cough" is G-d's gift to humanity to prevent "drowning" from airway mucus from any cause. So, we expect a cough with bronchitis, even some fever and malaise. But "comfortable cough" is what's expected. Cough that keeps one up at night or causes chest pain is not acceptable and you should talk to your child's doctor. Uncomfortable
cough associated with labored breathing or out-of-breathness or breathlessness also is not acceptable and requires communication with your doctor. Comfortable fever for a few days is common. Some appetite loss is expected and the ability to take fluids is important. Terrible headaches and body aches are NOT the norm.
Bronchitis, like a cold and most illnesses, has a beginning, a middle where symptoms peak and an end. Usually fever, when present, is gone by the 3-5 day, congestion and cough peak in frequency and intensity by day 3-7, then diminish over the next 2 weeks. Yes, coughing can take about 2-3 weeks to go away. A person with viral bronchitis usually feels better within a week or so, even though the improving cough may take another 1-2 weeks to completely go away. Cough lasting longer than 3-4 weeks in an otherwise well child should be called to the doctor's attention.
So, best medications include Tylenol or ibuprofen in the appropriate dose for fever that makes your child feel bad. Comfortable fever requires no medication unless your doctor advises otherwise. Adequate hydration is important, so frequent fluids when awake are useful. Nutritious fluids (soups) hydrate and provide some needed nutrition as well. A soft, nutritious diet until the child feels better and a normal appetite returns is also important.
When cough disturbs sleep many pediatricians suggest dark honey at bedtime for kids over one year of age. Ask your doctor for an appropriate dose. Sleeping with the head of the mattress elevated 10-15 degrees can be helpful allowing mucus to flow better. A cool mist humidifier near the child also can help mucus remain loose and flow better. We don't recommend expensive humidifiers ($90 or so) because they can create water particles that are too small and can get into the lower airways irritating the lungs. Steam vaporizers can be effective, but present a danger of burning the child directly from the steam jet or if the child overturns the unit on him/herself.
Nasal saline spray, drops or gel can help nasal secretions remain loose and flow more successfully. Nasal suction/aspiration similarly can unclog the nasal airway. Of course, most kids hate the suction bulb so choose your battles wisely. You don't want the treatment to be worse than the symptom.
Don't forget to educate your child on proper cough and hand hygiene, age permitting. Covering one's mouth with one's hand is 20th century technology. Today we encourage coughing into one's elbow to reduce hand contamination. Frequent use of a hand sanitizer can reduce spread in the home or at school in children old enough not to put their "sanitized" wet hands in their mouths. Lysol spraying the "touch" places in the home (a few times a day) often can also reduce family viral spread: stairwell banisters, TV remotes, keyboards, refrigerator handles, door knobs, toilet flush levers, etc. This can be a great job for well persons and older sibs who won't spray their faces to help make parent work a little easier.
Lastly, we can't forget about COVID-19_also one virus among many that can cause bronchitis. As parents, you should already be immunized against COVID-19. If you are not, it's not too late to get immunized. Similarly influenza can cause bronchitis. So, when the flu shot becomes available this Autumn, both you and your child (over 6 months of age) should get immunized against the flu. Children 12 years and older should get the COVID-19 vaccine as well and hopefully this Autumn, kids under age 12 years will be able to get a COVID vaccine as well. More important than any "medication for bronchitis" are COVID-19 and flu shot to PREVENT bronchitis and other complications that you've heard about in the media.
This link from the American Academy of Pediatrics Family Website can tell you more about cough:
https://www.healthychildren.org/English/tips-tools/symptom-checker/Pages/symptomviewer.aspx?symptom=Cough&_ga=2.176103586.1624770254.1627745502-222233170.1619280832&_gl=1*pjbumk*_ga*MjIyMjMzMTcwLjE2MTkyODA4MzI.*_ga_FD9D3XZVQQ*MTYyNzc0NTUwMS43LjEuMTYyNzc0NTY0MC4w
Also, more important than medicine for your child's bronchitis is your ability to tell a comfortable child with cough and normal breathing from a child with uncomfortable cough and troubled breathing:
https://www.healthychildren.org/English/tips-tools/symptom-checker/Pages/symptomviewer.aspx?symptom=Trouble%20Breathing&_gl=1*uodpdc*_ga*MjIyMjMzMTcwLjE2MTkyODA4MzI.*_ga_FD9D3XZVQQ*MTYyNzc0NTUwMS43LjEuMTYyNzc0Njk3NC4w&_ga=2.147833783.1624770254.1627745502-222233170.1619280832
I hope you have found this helpful and encourage you to have your family immunized against COVID-19 and influenza for this winter viral sick season.
Best regards,
Dr. T
In response to your question, "What is the best medicine for bronchitis for kids?" I find the answer to be rather complex and dependent on what you hope the medicine will do. Firstly, almost all bronchitis in children is viral and will not require antibiotics. Secondly, viral bronchitis can be mild and require no therapy if the child is comfortable and breathing normally.
Although there are many cough and cold products available to treat symptoms of a cold or bronchitis, most are not needed and some can be harmful. Over the last few years, cold and cough medications for children under the age of 6 years have been removed from pharmacy shelves. The FDA withdrew approval for these medications a few years ago because there were a few deaths in kids under age 6 from incorrect dosing and there has never been sufficient evidence of effectiveness. The pharmaceutical industry can bring these medications back to commercial use if they provide the FDA evidence of safety and effectiveness. It is very unlikely they will go through this expense as they've known for many years that there is no evidence of benefit. The medications remain available for persons over age 6 without evidence of benefit as their approval was historically "grandfathered" by the FDA and overdose tragedies in older persons are extremely rare.
I like to explain to families that "cough" is G-d's gift to humanity to prevent "drowning" from airway mucus from any cause. So, we expect a cough with bronchitis, even some fever and malaise. But "comfortable cough" is what's expected. Cough that keeps one up at night or causes chest pain is not acceptable and you should talk to your child's doctor. Uncomfortable
cough associated with labored breathing or out-of-breathness or breathlessness also is not acceptable and requires communication with your doctor. Comfortable fever for a few days is common. Some appetite loss is expected and the ability to take fluids is important. Terrible headaches and body aches are NOT the norm.
Bronchitis, like a cold and most illnesses, has a beginning, a middle where symptoms peak and an end. Usually fever, when present, is gone by the 3-5 day, congestion and cough peak in frequency and intensity by day 3-7, then diminish over the next 2 weeks. Yes, coughing can take about 2-3 weeks to go away. A person with viral bronchitis usually feels better within a week or so, even though the improving cough may take another 1-2 weeks to completely go away. Cough lasting longer than 3-4 weeks in an otherwise well child should be called to the doctor's attention.
So, best medications include Tylenol or ibuprofen in the appropriate dose for fever that makes your child feel bad. Comfortable fever requires no medication unless your doctor advises otherwise. Adequate hydration is important, so frequent fluids when awake are useful. Nutritious fluids (soups) hydrate and provide some needed nutrition as well. A soft, nutritious diet until the child feels better and a normal appetite returns is also important.
When cough disturbs sleep many pediatricians suggest dark honey at bedtime for kids over one year of age. Ask your doctor for an appropriate dose. Sleeping with the head of the mattress elevated 10-15 degrees can be helpful allowing mucus to flow better. A cool mist humidifier near the child also can help mucus remain loose and flow better. We don't recommend expensive humidifiers ($90 or so) because they can create water particles that are too small and can get into the lower airways irritating the lungs. Steam vaporizers can be effective, but present a danger of burning the child directly from the steam jet or if the child overturns the unit on him/herself.
Nasal saline spray, drops or gel can help nasal secretions remain loose and flow more successfully. Nasal suction/aspiration similarly can unclog the nasal airway. Of course, most kids hate the suction bulb so choose your battles wisely. You don't want the treatment to be worse than the symptom.
Don't forget to educate your child on proper cough and hand hygiene, age permitting. Covering one's mouth with one's hand is 20th century technology. Today we encourage coughing into one's elbow to reduce hand contamination. Frequent use of a hand sanitizer can reduce spread in the home or at school in children old enough not to put their "sanitized" wet hands in their mouths. Lysol spraying the "touch" places in the home (a few times a day) often can also reduce family viral spread: stairwell banisters, TV remotes, keyboards, refrigerator handles, door knobs, toilet flush levers, etc. This can be a great job for well persons and older sibs who won't spray their faces to help make parent work a little easier.
Lastly, we can't forget about COVID-19_also one virus among many that can cause bronchitis. As parents, you should already be immunized against COVID-19. If you are not, it's not too late to get immunized. Similarly influenza can cause bronchitis. So, when the flu shot becomes available this Autumn, both you and your child (over 6 months of age) should get immunized against the flu. Children 12 years and older should get the COVID-19 vaccine as well and hopefully this Autumn, kids under age 12 years will be able to get a COVID vaccine as well. More important than any "medication for bronchitis" are COVID-19 and flu shot to PREVENT bronchitis and other complications that you've heard about in the media.
This link from the American Academy of Pediatrics Family Website can tell you more about cough:
https://www.healthychildren.org/English/tips-tools/symptom-checker/Pages/symptomviewer.aspx?symptom=Cough&_ga=2.176103586.1624770254.1627745502-222233170.1619280832&_gl=1*pjbumk*_ga*MjIyMjMzMTcwLjE2MTkyODA4MzI.*_ga_FD9D3XZVQQ*MTYyNzc0NTUwMS43LjEuMTYyNzc0NTY0MC4w
Also, more important than medicine for your child's bronchitis is your ability to tell a comfortable child with cough and normal breathing from a child with uncomfortable cough and troubled breathing:
https://www.healthychildren.org/English/tips-tools/symptom-checker/Pages/symptomviewer.aspx?symptom=Trouble%20Breathing&_gl=1*uodpdc*_ga*MjIyMjMzMTcwLjE2MTkyODA4MzI.*_ga_FD9D3XZVQQ*MTYyNzc0NTUwMS43LjEuMTYyNzc0Njk3NC4w&_ga=2.147833783.1624770254.1627745502-222233170.1619280832
I hope you have found this helpful and encourage you to have your family immunized against COVID-19 and influenza for this winter viral sick season.
Best regards,
Dr. T
