Your Child's Coughini artikel yang di forward DSA saya, ya.. kalau diagnosa TB mending
ke spesialis paru, dulu reva pernah salah diagnosa, dikira TB trus minum obat baru
seminggu malah jadi panas tinggi 4 hari nggak turun turun terus dirawat, cek ini cek
itu negatif tapi kayaknya krn obat TB yg keras itu diberikan nggak pada tempatnya. ya
bayangin aja 3 antibiotik utk 6 bulan. untung reva cuma seminggu nggak kebayang deh
kalau s/d 6 bulan.
dr bambang supriyatno ada di hermina jatinegara (selasa, sabtu), klinik anakku
cinere (kamis, sabtu dgn perjanjian), klinik cikal sehat sehat (jumat dgn perjanjian)
Your Child's Cough
Your daughter seems to be coming down with the "bug" that is going around, so
you put her to bed half an hour early. After some grumbling, she finally falls asleep,
and you tackle the dishes, catch up on a little reading, then head off to bed
yourself. But at 3:30 AM, you wake up to a burst of loud coughing. What should you do?
Coughs are one of the most frequent symptoms of childhood illness, and
although they can sound awful at times, they usually are not a symptom of anything
dangerous. Actually, coughing is a healthy reflex that helps clear the airways in the
throat and chest. Occasionally, though, coughs can be cause for a visit to your
child's doctor. If you learn to recognize certain types of coughs, you will know how
to handle them and when you should seek medical help.
Types of Coughs and What They Mean
a.. "Barking" Cough
These coughs are usually caused by croup, an inflammation of the larynx
(voice box) and trachea (windpipe) brought on by allergies, change in temperature at
night, or most commonly a viral upper respiratory infection. When a young child's
airway becomes inflamed, it may swell around the vocal cords, making it harder to
breathe. Children younger than 3 years of age have croup most often because their
windpipes are narrow - some children have it practically every time they have a
respiratory illness.
Croup can occur suddenly in the middle of the night, which can be
frightening for both you and your child. Although most cases can be managed at home,
if you suspect your child has croup, call your child's doctor to determine whether
your child needs to visit him or her.
b.. "Whooping" Cough
The "whooping" sound actually occurs after the cough, when the child tries
to take in a deep breath after a round of several coughs in a row.
If your child makes a "whooping" noise (which actually sounds like "hoop")
after severe bouts of rapid coughing, it is most likely a symptom of pertussis
(whooping cough) - particularly if your child has not received her
diphtheria/tetanus/pertussis (DTaP) vaccinations.
Infants with pertussis usually do not "whoop" after the prolonged episodes
of coughing, but they may not get enough oxygen or they may even stop breathing with
this disease. In infants and very young children, pertussis can be deadly, so call
your child's doctor right away.
c.. Cough With Wheezing
When coughing is accompanied by a wheezing sound as your child exhales
(breathes out), it is a sign that something may be partially blocking the lower
airway. This might be caused by swelling from a respiratory infection (such as
bronchiolitis or pneumonia), asthma, or an object stuck in her airway. Call your
child's doctor unless your child has this problem often and you have medicine, such as
an inhaler or nebulizer, with instructions on how to use the medicine for home
treatment of your child's asthma. If the cough and wheezing do not improve with
medication, call your child's doctor.
a.. Stridor
Although wheezing usually during exhalation, stridor (pronunced: stry-door)
is noisy, harsh breathing (some doctors describe it as a coarse, musical sound) that's
heard when a child inhales (breathes in). Most often, it's caused by swelling of the
upper airway, usually from viral croup. However, it's sometimes caused by a more
serious infection called epiglottitis or a foreign object stuck in the child's airway.
If your child has stridor, call your child's doctor immediately.
b.. Sudden Cough
When a child suddenly starts coughing, it may mean she has swallowed some
food or liquid "the wrong way" (into the airway) or something (a bit of food, vomit,
or perhaps even a small toy or coin) is caught in her throat or airway. Coughing helps
clear the airway and may even continue for a minute or so simply because the throat or
airway is irritated. But if the coughing does not seem to improve or your child has
trouble breathing, call your child's doctor. Do not try to clear the throat with your
finger because you might push the obstruction even farther down the windpipe.
c.. Nighttime Cough
Lots of coughs get worse at night because the congestion in a child's nose
and sinuses drains down the throat and causes irritation while the child lies in bed.
This is only a problem if your child is unable to sleep. Asthma can also trigger
nighttime coughs because the airways tend to be more sensitive and become more
irritable at night.
d.. Daytime Cough
Allergies, asthma, colds, and other respiratory infections are the usual
culprits. Cold air or activity can make these coughs worse, and they often subside at
night or when the child is resting. You should make sure that nothing in your house,
like air freshener, pets, or smoke, is making your child cough.
e.. Cough With a Cold
Because most colds are accompanied by a cough, it's perfectly normal for
your child to develop either a wet or dry cough when she has a cold. The cough usually
lasts about a week, often after all other symptoms of the cold have disappeared.
f.. Cough With a Fever
If your child has a cough, mild fever, and runny nose, chances are she has a
simple cold. But coughs with a fever of 102 degrees Fahrenheit (39 degrees Celsius) or
higher can mean pneumonia, particularly if your child is listless and breathing fast.
In this case, call your child's doctor immediately.
g.. Cough With Vomiting
Children often cough so much that it triggers their gag reflex, making them
throw up. Usually, this is not cause for alarm unless the vomiting persists. Also, if
your child has a cough with a cold or an asthma flare-up, she may throw up if lots of
mucus drains into her stomach and causes nausea.
h.. Persistent Cough
Coughs caused by colds can last weeks, even up to 3 weeks, especially if
your child has one cold right after another. Asthma, allergies, or a chronic infection
in the sinuses or breathing passages might also be responsible for long-term coughs.
If your child's cough lasts for more than a month, you should schedule a visit with
your child's doctor.
i.. Coughs in Young Infants
Coughing can wear out babies younger than 6 months, so keep a close eye on
any cough your infant develops. These infants are also the population that is most at
risk for complications from respiratory syncytial virus (RSV), which is most common in
the winter. RSV causes colds and ear infections in older children and adults, but in
young babies, it can cause bronchiolitis and pneumonia and lead to severe respiratory
problems. The disease starts out like a normal cold but becomes worse until the child
has wheezing, a cough, and difficulty breathing. Some children may have to be admitted
to the hospital to receive oxygen and fluids.
When to Call Your Child's Doctor
Most childhood coughs are nothing to be concerned about. However, in some
instances you should consult a doctor, just to be safe. Call your child's doctor if
your child:
a.. has trouble breathing or is working hard to breathe
b.. has a blue or dusky color to the lips, face, or tongue
c.. has a high fever (particularly in a young infant or in the absence of
congestion or a runny nose; contact your child's doctor for any fever in an infant
younger than 3 monthsof age)
d.. is an infant (3 months old or younger) who has been coughing for more
than a few hours
e.. makes a "whooping" sound when she breathes after coughing
f.. is coughing up blood (if your child has had a nosebleed recently, this
usually is not a problem)
g.. has stridor when inhaling
h.. has wheezing when exhaling (unless you already have home asthma
management instructions from your child's doctor)
i.. is listless or cranky
Professional Treatment
One of the best ways to diagnose a cough is listening. Your child's doctor
will determine how to treat your child based in part on what the cough sounds like.
Because the majority of respiratory illnesses are caused by viruses, doctors
do not prescribe antibiotics for many coughs. If bacterial pneumonia or another
bacterial infection is suspected, your child's doctor will probably prescribe
antibiotics.
Unless your child's cough is keeping her from getting adequate sleep, cough
medicines are usually unnecessary. These medicines, both prescription and
over-the-counter (OTC), may have unpleasant side effects and can even be dangerous for
infants and young children. It's usually best to just let the illness run its course.
Pneumonia, pertussis, RSV, and serious cases of croup may require
hospitalization. Usually this is just for close observation and to make sure your
child gets enough fluids, but sometimes, if your child is having a hard time
breathing, oxygen may be given. A baby with croup may be placed in a "croup tent," a
little plastic oxygen tent. A water mist is continuously sprayed into the tent to
provide humidification to soothe the baby's irritated airway.
Home Treatment
Home treatments should never take the place of consulting your child's doctor
for any of the conditions listed above, but there are several things you can do at
home to make your child more comfortable when she has an annoying cough.
a.. If your child has asthma, make sure you have received asthma-management
instructions from your child's doctor. Monitor your child's progress carefully during
a flare-up and give asthma medicines according to the doctor's instructions.
b.. If your child wakes up with a "barking" or "croupy" cough in the middle
of the night, take her into the bathroom, close the door, and let the shower run on
hot for several minutes. After the room steams up, sit on the bathroom floor with your
child for about 20 minutes. The steam should help your child breathe more easily. Try
reading a book together to keep your child occupied.
c.. A cool-mist humidifier in your child's room might help her sleep through
the night.
d.. Cool beverages like juice can be soothing; avoid carbonated or citrus
drinks, however, because carbonation and citric acid can be painful on raw areas.
e.. You should not give your child (especially a baby or toddler) OTC cough
medicine without specific instructions to do so from your child's doctor. Many of
these medicines suppress coughs, but respiratory illnesses sometimes produce a lot of
secretions and coughing helps clear them out of the airway. If the cough were
suppressed with medicine, it could actually be harmful to your child. In some
instances, these medicines have even caused dangerous side effects when given to
infants or very young children. In addition, the guidelines for OTC doses for children
are often derived from adult guidelines (not formulated specifically for small
children), so the medicine may not work exactly as intended.
f.. Cough drops, which are fine for older children, are a choking hazard for
young children. It's best to leave decisions about your child's medicine to your
child's doctor.
Updated and reviewed by: Kim Rutherford, MD
Date reviewed: August 2001
Originally reviewed by: Steve Dowshen, MD
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