Cough, constipation and rashes are the three common minor childhood illnesses in T&T. Diarrhoea used to be prominent. In the past 25 years, constipation has taken its place.
Of the three, cough can be the most serious. It usually is not a major problem, though. Cough can be caused by anything that causes a blockage in the upper respiratory tract, the nose, throat and larynx, or by disorders of the lower respiratory tract, the trachea, bronchial tubes and lung material itself. (Diagram upper vs lower) Those of the lower part tend to be more serious. It can also be caused by items outside the respiratory tract, the heart, the gastrointestinal tract and by the mind.
The three main causes of cough in T&T are colds, sinus and asthma. Colds are by far the most common. Children “live” with colds and a healthy child between the ages of one and three in a day-care centre will, on average, get five to six colds a year. Children do seem to be getting more colds today than fifty years ago. What has changed?
There are lots more children who spend their lives in day care. When I was a child, my environment consisted of me, my two younger sisters, Sonny Boy, the son of the maid next door, and Peter, the boy who lived opposite. My afternoons were spent running around big, empty Victoria Square with other like-minded children while our mothers shared the latest tidbits of gossip. Today, mothers work outside the home, so children are sent to day-care centres to learn their ABC. Too many day-care centres are carpeted and air-conditioned, simply the worst place for a small child: no fresh air, cold viruses and house dust mites imprisoned by the million. The children are constantly exposed to viruses and allergens.
The name, ‘cold’, originated because some observant person in Europe noted that colds are more common in cold weather. But that has nothing to do with cold weather. People get more colds in cold weather because they stay indoors more, and it’s when you are locked up indoors that the virus spreads more easily. In the West Indies, we should call colds “ACs”, because it’s when you lock yourself inside air-conditioned rooms full of other people that you get the cold. All pretty air-conditioned day-care centres are set-ups for transmitting colds. Add in carpets which harbour dust mites, and it’s colds and sinus all year round.
Colds are self-limiting viral infections and the well-known but seldom-applied aphorism, “untreated colds last a week, treated colds last a week,” has no traction in T&T, where, still to this day, too many doctors and pharmacists prescribe antibiotics and cough medicines which are not only useless but dangerous.
The American Food and Drug Administration, the FDA, has been warning parents since 2007 to never give cough and cold medicines to children under the age of 6. The warning is part of a broad reassessment by the agency of the safety of these popular medicines, which have been blamed for hundreds of adverse reactions and a handful of deaths in children.
Coughing is the attempt of the respiratory system to remove the blockage, an attempt to clean the system of inflammation. It should not be suppressed.
Antibiotics do not kill viruses. They are useless for treating colds. There is no such thing as a useful “cough medicine”. Cough syrups are a waste of money. They do nothing for a cough caused by a cold. All contain multiple ingredients, responsible for another aphorism, “if many drugs are prescribed for a disease, you can be sure none of them work”. Some may make the child sleep at night, which is wonderful for parents, or in school, which is wonderful for teachers. If there was one single medication effective against the cold virus, there would be no need to be constantly hunting and changing cough remedies and taking advice from your partner in the office who swears by this one and that one but doesn’t work for your child’s cough.
The only things that help a cold are: i) rest, stay home; ii) keep the child away from dust, both outside and inside; iii) if you can, keep the inside temperature around 24 degrees Celsius; iv) keep the room environment moist by using steam or a warm-air humidifier; v) clearing the nostrils with salt water, either by nasal suction in children under two or by saline nasal rinse using the Neti pot system in older children; vi) keep the child well hydrated; vii) using a mixture of honey and lime to moisturise the throat and possibly reduce the inflammation; and, viii) the judicious use of a painkiller, like paracetamol or ibuprofen.
