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When your kid is coughing through the night, and you're both exhausted, your first thought is probably, "What can I give them to make this better?" We all want a quick fix. But those colorful bottles of cough medicine at the pharmacy are not doing what you think they're doing.
The FDA and pediatricians agree that over-the-counter cough and cold medicines are not recommended for very young children. The FDA specifically warns against using them in kids under 2 years, and many products carry labels saying “do not use under 4.” The American Academy of Pediatrics advises avoiding them for children under 4, and for children 4 to 6, you should only use them if your doctor specifically tells you to. Even after age 6, these medicines won't make the cold go away faster.
So what's a tired parent supposed to do? The good news is that there are safe, simple remedies that actually help.
Why Your Child Is Coughing
Coughing is your child's body doing its job. It's clearing out mucus and protecting the lungs from infection. When we try to completely stop a cough, we're working against what the body needs to do to heal.
Most childhood coughs come from viral infections like the common cold. Kids can get 8 to 10 colds a year, and each one can last 10 to 14 days. That's a lot of sniffles and coughs. But remember, this is normal, and it's actually helping build their immune system.
The Honey Fix (Ages 1 Year and Up)
Honey works better than store-bought cough syrups at reducing nighttime coughing. Multiple studies, including ones from the American Academy of Pediatrics, have shown this.
How to use it:
- Give your child ½ to 1 teaspoon of honey before bedtime
- For children 1 to 5 years: start with ½ teaspoon
- For children 6 years and older: you can give up to 1 teaspoon
- You can mix it with warm water or lemon juice if they don't like it straight
The honey coats the throat and thins out mucus, making it easier to cough up. Some parents mix 1 to 2 teaspoons of honey in warm lemon water, which creates a soothing drink.
Warning: Never give honey to babies under 12 months old. Honey can contain spores that cause infant botulism, a rare but very serious illness. Their digestive systems aren't mature enough to handle these spores. Even a small amount can be dangerous. This includes any processed foods with honey, like honey graham crackers or cereals. Wait until after their first birthday.
Saltwater Gargles (Ages 6 and Up)
Saltwater gargles are one of those old remedies that actually work. They're recommended by the American Cancer Society and supported by pediatricians for reducing throat pain and swelling.
The right way to do it:
- Mix ¼ to ½ teaspoon of regular table salt in 8 ounces (1 cup) of warm water
- Stir until the salt completely dissolves
- Have your child gargle for 15 to 30 seconds, then spit it out
- Never let them swallow it
- Repeat 2 to 3 times in one sitting
- Do this 2 to 4 times daily, especially after meals and before bed
Age matters here: Most children can safely gargle starting around age 6 to 8 years old. Before that age, kids usually can't gargle properly without swallowing the water, which can cause an upset stomach. If your child is younger than 6, skip this remedy and use other options instead.
Warning: If your child has high blood pressure or needs to limit salt intake for any medical reason, check with your doctor first before using saltwater gargles.
Steam and Humidity (All Ages)
Dry air makes coughs worse. Adding moisture to the air helps loosen mucus and soothes irritated airways.
What works:
- Use a cool-mist humidifier in your child's bedroom at night (never use a warm-mist one because it can cause burns)
- Let them breathe in steam from a warm shower for 10 minutes
- For croup-like barking coughs specifically, pediatricians recommend steam followed by cold air
Safety first: Clean your humidifier regularly according to the manufacturer's instructions. Dirty humidifiers can grow mold and bacteria, which makes things worse instead of better.
Warm Fluids (Ages 3 Months and Up)
Warm liquids help in multiple ways. They thin mucus, soothe the throat, and keep kids hydrated.
What to give:
- Ages 3 months to 12 months: Prioritize breastmilk or formula. If your pediatrician approves, you can offer very small amounts (1–3 teaspoons) of warm, clear fluids occasionally.
- Ages 1 year and older: Warm water, caffeine-free tea, chicken broth, or warm apple juice
Keep offering fluids throughout the day. When kids are sick, they need more liquids than usual to stay hydrated.
Saline Nose Drops (All Ages)
This one's simple but effective. Saline drops clear out the nose, which stops postnasal drip. When mucus stops dripping down the back of the throat, the cough gets better.
How to use them:
- Put 2 to 3 drops in each nostril
- Use 2 to 3 times per day (more than that can irritate the nose)
- For babies under 1 year, use a bulb syringe to gently suction out mucus after putting in the drops
What NOT to Do
Some things seem helpful but aren't safe:
- Don't use vapor rubs on children under 2 years old. For ages 2 and up, you can apply mentholated rub to the chest and neck area, but always store it safely afterward.
- Don't give aspirin to anyone under 18. It's linked to a serious illness called Reye syndrome.
- Don't prop pillows for babies or toddlers under 2 years old. This is a suffocation risk. For kids over 2, an extra pillow can help with drainage.
- Don't assume every cough needs medicine. If your child is playing normally, eating okay, and sleeping fine, they probably don't need any treatment at all.
When to Actually Worry
Most coughs are just annoying, not dangerous. But call your pediatrician right away if you notice:
- A high-pitched or barking cough
- Trouble breathing, wheezing, or grunting sounds
- Blue or very pale skin color
- Cough lasting more than 4 weeks
- Fever over 100.4°F in babies under 3 months
- Fever 102°F or higher that persists or comes with low energy or signs of illness
- Your child seems lethargic or won't play
- Difficulty swallowing or refusing liquids for 4+ hours
Trust your gut. You know your child better than anyone. If something feels wrong, call the doctor.
Conclusion
Your job isn't to stop every symptom; it's to keep them comfortable while their immune system does its work.
Use honey for kids over 1. Try saltwater gargles for kids who can actually gargle. Keep the air moist. Give them plenty of fluids and rest. Skip the drugstore cough medicines unless your doctor specifically recommends them.
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