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Q: My two-and-a-half-year-old has had a loose cough for a week -- no other symptoms. Should I be using an expectorant to loosen it? It is just in her throat, not in her chest.
A: As you know, there are hundreds of over-the-counter medicines available on the shelves in the pharmacy or supermarket. However, these medicines have not scientifically been proven to make a cold go away any faster. There are four types of ingredients in a majority of these preparations: a decongestant meant to break up the stuffiness; an antihistimine meant to stop the runniness (but that's only with a runny nose that is associated with allergies); an expectorant meant to loosen up the cough and help bring the phlegm out; and lastly, a cough suprressant meant to quiet the cough. These preparations come as individual ingredients or in various combinations.
In general, you should try to make your child comfortable and monitor her breathing. Certainly it's no fun having a cough or being congested. These medicines don't prevent progression from an upper respiratory tract infection to an ear or lung infection, which does happen in a minority of patients. If these medicines make your daughter more comfortable. Use them, but make sure there are no medical reasons she can't have any of the ingredients. Remember each of these medicines do have side-effects and often times don't taste so great, so kids aren't always anxious to take them anyway.
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Henry Bernstein, M.D., is currently the associate chief of the Division of General Pediatrics and director of Primary Care at Children's Hospital, Boston. He also has an academic appointment at Harvard Medical School.