Coughs, colds and more serious illnesses

Why it is important ?

• Coughs, colds, sore throats and runny noses are common in the lives of children. Usually they are no cause for alarm.
• In some cases, however, coughs are danger signs of more serious illnesses, such as pneumonia or tuberculosis. Pneumonia is the world's leading cause of death in girls and boys under age 5, closely followed by diarrhoea. Around 2 million children die from pneumonia every year. Pneumonia kills more children than AIDS, malaria and measles combined. One out of every five deaths of children under age 5 is caused by this respiratory infection.
• All girls and boys have the right to quality health care to make sure that respiratory infections and other illnesses are accurately diagnosed and treated before it is too late.

What every family and community has a right to know ?

1. A child with a cough or cold should be kept warm and encouraged to eat and drink as much as possible.
2. Sometimes, coughs are signs of a serious problem. A child who is breathing rapidly or with difficulty might have pneumonia, an infection of the lungs. This is a life-threatening disease. The child needs immediate treatment from a trained health worker, who can also provide a referral to a health facility.
3. Families can help prevent pneumonia by making sure babies are exclusively breastfed for the first six months and that all children are well nourished and fully immunized.
4. A child who has a prolonged cough that persists for more than three weeks needs immediate medical attention. The child may have tuberculosis, an infection in the lungs.
5. Children and pregnant women exposed to smoke from tobacco or cooking fires are particularly at risk of pneumonia or other breathing illnesses.

Supporting information

Key Messages - A child with a cough or cold should be kept warm and encouraged to eat and drink as much as possible.

• Babies and very young children lose their body heat easily. When they have a cough or cold they should be kept covered and warm.
• Children with coughs, colds, runny noses or sore throats who are breathing normally can be treated at home and will recover without medicines. They need to be kept warm, but not overheated, and to be given plenty to eat and drink. Medicines should be used only if prescribed by a trained health worker.
• A child with a fever needs careful attention. She or he should be sponged or bathed with cool but not cold water. The child should be kept well hydrated with additional fluids. In areas where malaria is common, the fever could be caused by malaria, which is dangerous to the health and survival of the child. A child with a fever in these areas should be checked by a trained health worker immediately.
• The nose of a child with a cough or cold should be cleared often, especially before the child eats or goes to sleep. A moist atmosphere can make breathing easier. It can help if the child breathes water vapour from a bowl of water that is hot but not boiling. The parent or other caregiver should make certain the water is not too hot and that the child is carefully supervised when breathing the water vapour.
• A breastfed child who has a cough or cold may have difficulty breastfeeding. Since breastfeeding helps to fight the illness and is important for the child's growth, the mother should continue to breastfeed often. If a child cannot suckle, the breast milk can be expressed into a clean cup and the child can then be fed from the cup by the mother, father or other caregiver. Before putting the baby to the breast or feeding the baby breast milk (or breast milk substitute) from a cup, it helps to clear the baby's nose if it is blocked with secretions.
• Children who are 6 months of age or older should be encouraged to breastfeed, eat and drink frequently. When the illness is over, the child should be given extra nutritious foods every day until she or he is at least the same weight as before the illness.
• Coughs and colds spread easily. People with coughs and colds should avoid coughing, sneezing or spitting near children. They should cough or sneeze into their elbow or a tissue and dispose safely of the tissue. This should be followed by hand washing with soap. This helps stop the spread of germs.

Key Messages - Sometimes, coughs are signs of a serious problem. A child who is breathing rapidly or with difficulty might have pneumonia, an infection of the lungs. This is a life-threatening disease. The child needs immediate treatment from a trained health worker, who can also provide a referral to a health facility.

Most coughs, colds, fevers, sore throats and runny noses end without requiring medication. But sometimes a cough and a fever are signs of pneumonia, which needs to be treated by a trained health worker.

If a trained health worker provides antibiotics to treat the pneumonia, it is important to follow the instructions and give the child all the medicine for as long as the instructions say, even if the child seems better.

Many children die of pneumonia at home because their parents or other caregivers do not realize the seriousness of the illness and the need for immediate medical care. Millions of child deaths from pneumonia can be prevented if:

• Parents and other caregivers know that rapid and difficult breathing is a danger sign, requiring urgent medical help
• Parents and other caregivers know where to get medical help
• Medical help and appropriate and low-cost antibiotics are readily available.

The child should be taken immediately to a trained health worker or clinic if any of the following symptoms are present:

• The child is breathing much more quickly than usual: from birth to 59 days – 60 breaths a minute; 2 months to 12 months – 50 breaths a minute or more; over 12 months to 5 years – 40 breaths a minute or more
• The child is breathing with difficulty or gasping for air
• The lower part of the chest sucks in when the child breathes in, or it looks as though the stomach is moving up and down
• The child has had a cough for more than three weeks
• The child is unable to breastfeed or drink
• The child vomits frequently.

Health-care providers have a responsibility to provide parents and other caregivers with this information on the health risks for a child with pneumonia and the preventive steps and treatments to take.

Key Messages - Families can help prevent pneumonia by making sure babies are exclusively breastfed for the first six months and that all children are well nourished and fully immunized.

• Breastfeeding helps to protect babies from pneumonia and other illnesses. It is important to give breast milk alone for the first six months of a baby's life.
• After six months of age, a child should eat a variety of healthy foods and continue to breastfeed, to ensure that she or he gets the nutrients necessary to stay healthy and be less susceptible to respiratory infections and other illnesses. Some examples of healthy foods include fruits and vegetables (including green leafy vegetables), liver, red palm oil, dairy products, fish and eggs.
• Safe water and good hygiene practices help to reduce the number of respiratory infections and other illnesses, such as diarrhoea. These practices include washing vegetables and fruits, keeping food preparation surfaces clean, and washing hands with soap and water or with a substitute, such as ash and water.
• Every child should complete a recommended series of immunizations. Early protection is critical; the immunizations in the first year and into the second year are especially important. The child will then be protected against measles, pertussis (whooping cough), tuberculosis and other respiratory illnesses, which can lead to pneumonia.
• Parents and other caregivers should ensure that both girls and boys are equally provided with a varied and healthy diet and all immunizations. Health workers can provide parents and other caregivers with information on diets, hygiene and immunizations and how they protect against pneumonia and other illnesses.

Key Messages - A child who has a prolonged cough that persists for more than three weeks needs immediate medical attention. The child may have tuberculosis, an infection in the lungs.

Tuberculosis is a serious disease that can kill a child or permanently damage the lungs. Families and caregivers can help prevent tuberculosis if they ensure that children:

• Are fully immunized – BCG immunization offers some protection against some forms of tuberculosis
• Are kept away from anyone who has tuberculosis or has a cough with blood in the sputum.

If a trained health worker provides special medicine for tuberculosis, it is important to give the child all the medicine according to the instructions. It must be given for as long as specified, even if the child seems better. If not, the child could build up resistance to the medicine, reducing its effectiveness the next time it is needed.

Key Messages - Children and pregnant women exposed to smoke from tobacco or cooking fires are particularly at risk of pneumonia or other breathing illnesses.

• Children are more likely to get pneumonia and other breathing illnesses if they live in an environment with smoke.
• Exposure to smoke can harm a child, even before birth. Pregnant women should not smoke or be exposed to smoke. Babies especially should be kept out of smoky kitchens and away from cooking fires.
• Tobacco use generally begins during adolescence. Adolescents are more likely to start smoking if (1) the adults around them smoke, (2) tobacco advertising and promotion are common, and (3) tobacco products are cheap and easily accessible. Adolescents should be encouraged to avoid smoking and caution their friends about its dangers.
• Second-hand smoke is particularly harmful to young children. It stays in the air for hours after cigarettes, pipes or cigars have been put out. Non-smokers who inhale this smoke are more vulnerable to respiratory infections, asthma and cancer.
• Parents and other caregivers need to be aware of the detrimental effects of second-hand smoke and take responsibility to refrain from smoking around children. Governments and communities can work together to inform the public of the harmful effects of smoky environments and second-hand smoke on children.

Source: UNICEF