Dr. Mersch received his Bachelor of Arts degree from the University of California, San Diego, and prior to entering the University Of Southern California School Of Medicine, was a graduate student (attaining PhD candidate status) in Experimental Pathology at USC. He attended internship and residency at Children's Hospital Los Angeles.
Dr. Perlstein received his Medical Degree from the University of Cincinnati and then completed his internship and residency in pediatrics at The New York Hospital, Cornell medical Center in New York City. After serving an additional year as Chief Pediatric Resident, he worked as a private practitioner and then was appointed Director of Ambulatory Pediatrics at St. Barnabas Hospital in the Bronx.
Due to the diversity of causes (etiologies) of childhood cough the therapies available need to be directed to the proper causative agent.
Routine upper respiratory infections ("common cold") respond best to rest, fluids, and tender loving care. Multiple studies have demonstrated no benefit for the various over-the-counter (OTC) medications. Moreover, a number of studies have demonstrated potential side effects to children below six years of age due to the nature of the medications included in these formulations.
Use of a cool mist humidifier may be very helpful for the treatment of the laryngeal ("voice box") swelling associated with croup. Occasionally a single dose of an anti-inflammatory medication dexamethasone (Decadron) is indicated.
Bacterial infections (for example, pneumonia, sinus infections) respond well to selected antibiotics.
Wheezing is treated with various inhaled medications, and if there is a concern regarding aspiration of a foreign object it may require removal by bronchoscopy (see above).
GERD may be treated via thickening of formula for infants and/or oral medications depending of severity of symptoms and complications of acid reflux into the esophagus. Treatment of rare conditions (for example, cystic fibrosis) utilizes a team approach to control and minimize the course of these diseases.
When should I contact my doctor for childhood cough symptoms?
You should contact your child's pediatrician if your child:
Is less than three months of age or was more than 3 weeks premature
Is struggling to breath (i.e. looks like he/she just ran up a flight of stairs), is unable to breath and feed comfortably or has very noisy breathing
Starts coughing after having a small object in his/her mouth or while eating
Coughs so hard or repetitively that he/she can't catch their breath, or turns blue during coughing episodes. This is especially critical if the child hasn't been fully immunized against pertussis (whooping cough)
Coughs so hard that repeated episodes of vomiting occur
Refuses to eat or drink for an extended period or is drooling uncontrollably
Has a cough lasting greater than two weeks
UpToDate.com. Approach to Chronic Cough in Children.
Thomas F. Boat, MD. et al. Chronic or Recurrent Respiratory Symptoms. Nelson Textbook of Pediatrics (18th edition). Chapter 381, 1758-62.
UpToDate.com. Causes of Chronic Cough in Children.
UpToDate.com. Patient Information: Cough in Children (The Basics).