Dry and wet cough in a newborn: drug treatment

A cough in a newborn can appear due to many reasons, and considering that the baby is very small, this can be a serious problem for him. First of all, you can think that the child is sick, and only then think about other reasons. Therefore, you need to pay attention to other symptoms, and be sure to consult a doctor.

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Epidemiology

Statistics on cough in newborns show that this symptom is rare as a sign of illness. In 76% of children, cough is not the first symptom precisely because of the structure of the respiratory system. More than 40% of causes of cough in a newborn are caused by problems with pregnancy and childbirth, and only 26% of newborns have inflammatory diseases of the respiratory tract. This indicates the importance of proper management of pregnancy and childbirth and the importance of the process of childbirth for the expectant mother.

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Causes newborn cough

A newborn's cough has a slightly different character than that of an older child. This is due to the incomplete development of receptors in the respiratory tract, the child's low voice and inactive respiratory muscles. Therefore, it is not always possible to accurately determine that a newborn is coughing, because sometimes it resembles a strong cry. Therefore, it is necessary to clearly understand where the crying is and where the cough is. In any case, a child's cough occurs when the receptors located in the pharynx, larynx, trachea and bronchi are irritated. When these receptors are irritated, impulses come to the medulla oblongata, where the cough center is located. This causes the muscles to contract intensively in order to evacuate the irritant from the respiratory organs. Thus, the cough performs its main protective role.

In newborns, the respiratory tract features an uneven distribution of cough receptors, so the cough does not always correspond to the nature and type of irritant. This must be taken into account when conducting differential diagnostics.

The main causes of cough in a newborn can be in the form of several groups of factors:

1. inflammatory infectious lesions of the respiratory tract;
2. mechanical irritants of the receptor apparatus;
3. congenital malformations of the respiratory system.

The reasons are given in proportion to the decreasing prevalence of these factors, taking into account the young age of the child.

Among infectious agents of respiratory diseases, viruses and bacteria are distinguished. Among bacteria, the most common pathogens of respiratory diseases can be the cause - these are Haemophilus influenzae, pneumococcus, streptococcus, staphylococcus, mycoplasma. Among viruses, there are many pathogens of the respiratory tract - these are the influenza virus, parainfluenza, adenovirus, respiratory syncytial virus. In a newborn, the main role in the development of the infectious process of the respiratory tract is played by bacteria in the first two weeks after birth, and viral agents - later. This is due to the fact that immediately after birth or during this there is a greater risk of infection with bacteria, and later the risk of epidemiological danger of a viral infection increases when relatives begin to visit the child and contact him.

If the cough appears immediately after birth or after a few days and is deep and intense, then the cause may be pneumonia - inflammation of the lungs. Pneumonia can be congenital early and late, depending on the time of manifestation of symptoms. This condition has a number of other symptoms besides cough, so you need to carefully assess the baby's condition. Pneumonia is not very common in newborns, so it is necessary to identify risk factors that can lead to such a pathology. Pregnant women with chronic inflammatory diseases of the ovaries are at risk of infecting the child in utero. Risk factors also include complicated pregnancy and childbirth, meconium contamination of amniotic fluid, post-term pregnancy, premature birth. All these factors increase the risk of infection of the baby in utero or during childbirth.

Speaking about other inflammatory diseases of newborns that can cause coughing, viruses often affect the upper respiratory tract. In such children, a simple runny nose can often cause a lot of problems and cause coughing due to simple mucus flowing down the back of the throat.

Among mechanical irritants in newborns, the cause of coughing may be water getting in during bathing or part of a toy. Of course, newborns have a low risk of swallowing a foreign body, but if there are little brothers or sisters who want to play with the baby, then you should not exclude a foreign body in the respiratory tract as a possible cause of coughing.

Not so often, but a very real cause of cough can be congenital malformations of the respiratory tract. Unfortunately, this is a serious problem, the severity of which affects the clinical course and prognosis. The pathogenesis of cough in congenital malformations depends on the type of defect. If we are talking about bronchopulmonary dysplasia or agenesis/aplasia of the lung, then the symptoms of cough appear from the first days and are accompanied by other serious problems. It is very important to diagnose a congenital defect in time, because sometimes early correction plays a big role in the further normal development of the baby.

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Symptoms newborn cough

Cough is rarely the only symptom of the disease, especially if we are talking about an infectious lesion of the respiratory tract. If we are talking about pneumonia, then in a newborn baby it is always bilateral, so the first symptom can be considered the appearance of severe shortness of breath. The child lies on his back and it feels like he is groaning, since the degree of damage to the respiratory tract does not allow him to breathe normally. You can see that when inhaling, the area above the collarbones or the muscles between the ribs are drawn in, which indicates severe shortness of breath. This is usually the first symptom of pneumonia. A mandatory manifestation of the disease is severe intoxication syndrome. The child refuses to breastfeed, is capricious, does not sleep, the body temperature rises. Moreover, in newborns, you should not expect an increase to 39 degrees or higher, and the figure 38 is already considered a serious increase in body temperature. This is due to the fact that such a child does not have a fully developed thermoregulatory center, so such a reaction is considered high.

Cough appears after some time already against the background of shortness of breath and intoxication, when a sufficient amount of mucus accumulates in the alveoli. Therefore, fever and cough in a newborn are serious symptoms of alarm about the development of pneumonia.

Speaking of a viral infection, it is always accompanied by catarrhal symptoms, and in children of the first month of life, this is often rhinitis. The disease begins acutely, when the child becomes restless and soon mucous liquid discharge appears from his nose. The child refuses the breast, since he has nothing to breathe with when breastfeeding. When the child sleeps at night, the horizontal position contributes to the fact that mucus flows to the back of the throat. This can reflexively cause a cough, so a runny nose and cough in a newborn can be considered a manifestation of a viral infection, which simplifies diagnosis.

Another manifestation of an infectious lesion of the respiratory tract is acute bronchitis. A wet cough in a newborn can be a symptom of an acute process in the bronchi. In small children, the pathological process can quickly spread to the lower respiratory tract, which causes inflammation. Bronchitis is accompanied by inflammation of the bronchi and the accumulation of a large amount of sputum. It gradually leaves the respiratory tract, which causes a cough. But the baby cannot completely cough up all the secretion due to the constant horizontal position and insufficient muscle contractions. Therefore, the cough is low-intensity, but wet in nature, with a feeling of "gurgling" in the child's chest. There are other symptoms - shortness of breath, fever, anxiety, but they are less pronounced than with pneumonia.

In a child of the first 28 days of life, it is very difficult to talk about the topic of the respiratory tract lesion, since the inflammatory process very quickly spreads to several sections. Therefore, by the nature of the cough, one can only guess which section is more affected. A dry or barking cough in a newborn may indicate damage to the upper respiratory tract, and if there are no changes in the bronchi, then it is highly likely that this is a viral process.

A dry or barking cough in newborns without an increase in body temperature, as well as a cough during feeding should always alert in terms of congenital defects. Particularly if the cough occurs immediately after birth or after some time and has a monotonous, constant character. There are many congenital defects of the respiratory system, but the most common of them are cystic fibrosis, underdevelopment of the lungs, congenital stenosis of the larynx and congenital tracheobronchomalacia.

Cystic fibrosis is a hereditary disease that consists of a dysfunction of the ion channels of the exocrine secretion glands, including the glands of the bronchopulmonary system. The pathology is characterized by the fact that a newborn child literally from the first days begins to have severe pneumonia, and already during the first month of life it can recur. With this disease, a chronic inflammatory process develops in the bronchi, which is supported by the constant persistence of highly pathogenic bacteria. This is manifested by a frequent wet cough in a child with very viscous sputum. The pancreas can also be affected with symptoms from the digestive function.

Considering the completeness and diversity of the clinical picture of pathologies that cause cough in a newborn, the importance of timely and correct differential diagnosis between these pathologies is explained.

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Complications and consequences

Speaking about the consequences of coughing in such a small child, it must be said that everything depends on the cause. If the cause of the cough is pneumonia or bronchitis, then literally in six to twelve hours the child's condition can become very serious. This threatens the development of severe respiratory failure and intoxication-toxic shock. Complications of the cough itself in congenital defects of the bronchopulmonary system can be in the form of pneumothorax - a rupture of the bronchus or alveoli and air entering the pleural cavity. If the child coughs because of a runny nose, then this can often be a consequence of acute otitis. This is due to the easy penetration of pus from the nose through the auditory tube into the ear and the development of inflammation there. If rhinitis is not treated, then during a cough, mucus from the back wall of the pharynx can flow down the esophagus into the stomach, which easily causes diarrhea in newborns. This dehydrates the baby's body and can lead to serious problems in the future, even death.

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Diagnostics newborn cough

Diagnosis of any disease in a newborn child should be timely, since all processes in the baby's body develop very quickly and can lead to complications. Therefore, it is necessary to carefully examine the baby, paying attention not only to the disease, but also to the physiological state that a child of this age should have.

It is necessary to question the mother and clarify when the cough appeared, whether it is associated with feeding, whether there are any other symptoms. When examining a child with a cough, special attention should be paid to the respiratory system. It is necessary to count the number of breaths per minute to determine whether there is shortness of breath. For a newborn, shortness of breath is considered more than 60 breaths per minute. It is necessary to pay attention to the respiratory muscles and exclude their participation in the act of breathing. If there are no symptoms of shortness of breath, then you can proceed to a thorough examination of the child. When auscultating the lungs under normal conditions, such a child's breathing is close to vesicular and is carried out on all areas of the lungs. If the cough is caused by bronchitis, then upon auscultation the breathing will be harsh or wheezing will be determined. A diagnostic sign of pneumonia can be considered weakened breathing, crepitation and local moist rales. Already on the basis of a simple examination, a preliminary diagnosis can be established. If there are no changes during auscultation of the lungs and examination, then the upper respiratory tract should be examined. Examination of the pharynx in a newborn should be done last, always using a spatula. There may be no changes if it is a simple runny nose. But there may also be hyperemia of the back wall of the pharynx and mucus may flow from the nasopharynx into the oral cavity, which can be considered the cause of the cough.

It is quite difficult to conduct tests on a newborn child. If there is a suspicion that the cough is caused by pneumonia or bronchitis, then the child is necessarily hospitalized for further examination. In the hospital, the child undergoes general clinical examination methods. A general blood test is needed exclusively for the purpose of differential diagnosis of cough of viral and bacterial etiology. If the etiology is viral, then the number of lymphocytes will be increased, and if bacterial, then there will be an increased number of leukocytes and band neutrophils (shift of the formula to the left). If a certain bacterial infection is suspected, then a blood test is performed to determine antibodies to a particular type of bacteria. But it is necessary to take into account the principle of minimal intervention in the body of such a young child.

Instrumental diagnostics of cough can be performed only if pneumonia is suspected. Then it is necessary to perform an X-ray of the lungs to confirm the diagnosis. In order to minimize the radiation dose for such a small child, an ultrasound examination can be performed in the future to monitor the condition and determine the effectiveness of treatment. This method allows you to see the condition of the bronchi and lungs, and determine the remnants of the inflammatory process.

If cough symptoms occur against the background of other clinical signs or external manifestations of disorders in the structure of the respiratory system, then there is a suspicion of congenital defects. In order to diagnose defects, it is often necessary to perform a bronchoscopy - an examination of the respiratory tract using a special endoscope, which is performed under general anesthesia. This allows you to see the structure of the bronchi, lungs, as well as the location and anatomical structure of the larynx.

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Differential diagnosis

Differential diagnosis of cough must be carried out at the pre-hospital stage to exclude conditions that threaten the life of the newborn. Therefore, it is necessary to differentiate pneumonia and aspiration of a foreign body first. If there are no alarming symptoms, then the child can be examined more thoroughly. It is also important to diagnose the cough symptom between pathology of the respiratory and cardiovascular systems. Many congenital heart defects manifest themselves already in the first month of life in the form of a cough. But cough of cardiac etiology is combined with shortness of breath and cyanosis, unlike pathology of the lungs and bronchi. But in any case, for accurate differentiation, it is necessary to conduct electrocardiography and ultrasound examination of the heart at the initial stage.

Treatment newborn cough

Treatment of cough in a child during the first 28 days of his life must be carried out, since it disrupts the normal condition of the child and quickly leads to hypoxia. But it should be taken into account that many drugs are not used in children under one month, so when approaching treatment, you need to carefully select drugs.

If the cough is caused by bronchitis or pneumonia, then in a newborn child this is an indication for prescribing an antibiotic. In newborns, unprotected penicillins or cephalosporins are mainly used. If the child is hospitalized, then the treatment is carried out parenterally.

1. Ampicillin is an antibiotic from the group of unprotected penicillins, which have activity against gram-positive and some gram-negative microorganisms, which play a key role in the development of inflammatory diseases of the respiratory system in newborns. The drug is active against staphylococcus, pneumococcus, Escherichia coli, Haemophilus influenzae. The drug acts by disrupting the cell wall and its easy lysis, which leads to the death of the parasitic microorganism. The method of administration of the drug is intravenous, which accelerates the effect and action of the substance in the focus of infection. The dosage of the drug is calculated at 50 milligrams per kilogram of the child's weight in four doses. Side effects can be frequent in the form of allergic reactions, as well as effects on the nervous system.
2. Ceftriaxone is a beta-lactam antibiotic, especially effective against gram-positive and gram-negative flora. The drug has a bactericidal effect on possible anaerobic pathogens of respiratory tract infections, taking into account the spectrum of possible pathogens in newborns. The dosage of the drug is from 50 to 100 milligrams per kilogram of weight per day, for at least ten days. Side effects are possible when affecting the stomach - colitis or dysbacteriosis develops, which is manifested by bloating, stool disorders. Precautions - the drug cannot be used if you are allergic to penicillin antibiotics.
3. Considering the fact that the use of cough syrups in newborn babies is limited, inhalations for better expectoration are one of the main treatments.

Pulmicort is a glucocorticoid drug that exhibits its bronchodilator effect in severe cough in children. The dosage of the drug is 0.1 milliliter per kilogram of the child's body weight. For a newborn, the dose should not exceed 0.3 milliliters. The method of administration is inhalation after dilution with a solution - for 0.3 of the drug, you need to take 0.6 saline. Side effects may occur with prolonged use in the form of stomatitis, gingivitis and the formation of erosions of the mucous membranes of the oral cavity.

Ventolin is a drug from the group of beta-adrenergic agonists, the active substance of which is salbutamol. The drug dilates small bronchi, relieves spasms and improves breathing. Treatment with this drug in newborns can only be carried out if there are special indications, such as severe obstructive syndrome. The dosage of the drug is 0.5 milliliters diluted in saline 2:1. Method of administration - at least twice a day and at least three days. Side effects may be in the form of local allergic reactions.

1. If a child's cough is caused by a viral pathology - acute rhinitis or nasopharyngitis, then it is necessary to use antiviral drugs in the treatment of such a cough. In newborns, in the acute period of a viral disease, drugs of the interferon group are used.

Laferobion is a drug that contains recombinant human interferon, which increases the activity of antibodies in the fight against viral infections. The drug can be used in the first three days of treatment of viral infections in newborns. The dosage of the drug for children under one year is 150,000 IU twice a day in the form of suppositories. Treatment is carried out for three or five days. Side effects are possible: itching at the injection site, redness, and allergies.

1. Symptomatic treatment of cough can be used in newborns only in case of active inflammatory process and as prescribed by a doctor. Sometimes in some patients recovery without expectorants is very delayed. Therefore, there is a need to use such drugs, priority is given to ambroxol.

Ambroxol is a drug that affects the respiratory tract by increasing the secretion of the bronchial glands and enhancing the synthesis of surfactant. Syrup for newborns can only be prescribed by a doctor, taking into account age restrictions. The method of using the drug in the form of syrup, there are also ampoules for inhalation. The dosage of syrup for children under two years is 1.25 milliliters twice a day. Side effects can be in the form of taste distortion.

Vitamins in the treatment of newborns have limited use, as it can cause allergic reactions. The mother can take vitamins if there are no special contraindications.

Physiotherapeutic treatment in sputum discharge and improvement of cough character is of great importance. For newborns it is recommended to use drainage massage, the simplicity of which allows even mother to perform it. The main principle of such massage is to improve sputum discharge by smooth massaging movements in the direction of lymph nodes and along the bronchial tree.

Folk remedies for cough in newborn babies

Treating cough with folk remedies in such small children is not recommended, however, if the mother is breastfeeding, she can use hypoallergenic folk remedies. As for the child, some methods can be used, for example, for viral infections.

1. If a child has acute rhinitis and mucus flow causes cough, then the treatment of such cough consists of treating rhinitis. The main thing is to evacuate mucus and rinse the child's nose. You can rinse the nose with folk remedies. To do this, you need to boil half a liter of water, cool it a little and add half a tablespoon of sea salt. You need to drip a warm solution into the child's nose with a pipette four times a day, one drop at a time.
2. Milk with honey has long been known as a cough remedy. To prepare a more useful medicine, you need to boil the milk and add two teaspoons of honey, twenty grams of butter and a few drops of olive oil to a cup of milk. The mother should drink the milk at night, this improves the quality of breast milk and the child may feel better.
3. Grinded viburnum with honey has many useful properties, including stimulating the child's body's defenses and reducing coughing. For the medicine, the mother should take 20 grams of this medicine every day. It can be prepared by grinding viburnum berries with a blender, and then adding a teaspoon of honey. Treatment should be started with half the dose to assess the baby's reaction.

Herbal treatment can also be widely used by the mother, or you can humidify the air in the room with the addition of some herbs. Any cough is accompanied sooner or later by dryness of the mucous membrane of the respiratory tract. Therefore, if the child is sick with a viral or bacterial pathology, then it is necessary that the air in the room is periodically humidified. For this, herbs are used that have a beneficial effect on the respiratory system.

1. To humidify the air in the room after light airing, you need to put a saucepan with steamed herbs. To do this, take ten grams of chamomile and the same amount of marshmallow for three liters of water, steam it and put it with the lid half open. Such humidification should be in the opposite corner from the baby's crib and for no more than half an hour. The room should not be all wet from the amount of steam, but only so that the moisture from the water with herbs is slightly felt.
2. A decoction of plantain and marshmallow herbs has high antiviral activity. These herbs have an anti-inflammatory effect and thin the secretion in the bronchi, which improves the discharge of sputum and improves breathing. For the decoction, you need to take 20 grams of each herb and make tea. Considering that the child is a newborn, you first need to make tea from plantain and take it throughout the day, taking into account the child's reaction. If there are no allergic reactions, then the next day you can add marshmallow.
3. Coltsfoot leaves are also known for their properties that improve breathing and reduce the severity of cough. For medicinal tea, take 50 grams of the herb, make tea from two liters of water and drink in small sips throughout the day. You can add ivy if the cough is dry.

Homeopathy in the treatment of cough in newborns can be used by the mother, which has no less effect than other medications. This is explained by the fact that all remedies have the ability to accumulate in milk to some extent and be transferred to the baby. Therefore, breastfeeding plays a priority role in the speedy recovery of the newborn.

1. Agnus compositum is an organic homeopathic preparation, which includes herbs. It is used to treat cough caused by viral infection and severe catarrhal symptoms. The method of administration of the drug is oral in the form of granules for mother's use. Dosage - one granule twice a day. Side effects are possible in the form of increased salivation and nausea. Precautions - do not use in combination with honey.
2. Gripp-compositum is an organic homeopathic preparation, which includes many medicinal herbs. It is used to treat cough caused by a viral infection with pronounced redness of the throat, conjunctivitis and intoxication. Method of application - in the form of drops for the mother. Dosage - three drops twice a day. Side effects are possible in the form of hyperemia of the skin of the hands and feet, as well as a feeling of heat.
3. Althea heel is a plant used to treat cough of bacterial etiology against the background of pneumonia with difficult expectoration and in children with concomitant diseases. The method of using the medicine has three stages. The dosage begins with three granules every three hours on the first day for mother to take, then three granules every six hours the next day, and from the third day, three granules twice a day. The prophylactic dose can be started at half the therapeutic dose after contact with infectious patients. Side effects may be on the first day of taking in the form of redness of the conjunctiva of the eyes.
4. Actinaria is a homeopathic herbal remedy that is effective in treating cough in the third dilution in newborns, especially those born in winter. The drug has very strong antiseptic properties and is used in the form of a tincture. The dosage is three drops per glass of juice every day for the mother. Side effects may include intestinal dysfunction in the baby or slight yellowing of the skin.

Answering the question of what can be given to a newborn for a cough, it can be said that any prescriptions should come from a doctor. And even traditional medicine, due to its safety, can be used on the recommendation of a doctor.

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Prevention

The main measures to prevent cough in a newborn baby are proper care of the baby and avoiding close contact during this period. After all, in the first month of life, the child is most vulnerable to various factors. A very important element of prevention is exclusive breastfeeding, which prevents many infections by transmitting antibodies from the mother.

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Forecast

The prognosis is favorable with timely and correct treatment tactics.

Cough in a newborn is most often caused by infectious diseases, but other causes should not be ruled out. And the earlier such a cough appears, the more likely it is that we are talking about a congenital pathology or a genetic disease. Treatment of cough as an isolated symptom is not carried out, only a comprehensive approach to treatment is used. In any case, disease prevention has advantages over any treatment.

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