Managing Persistent Cough and Infections in Young Children

Children with colds and coughs?

I would like to ask the doctor, my child is about 4 years old and was hospitalized for pneumonia in mid-February this year.
However, since last year, he has been experiencing intermittent coughing.
Every time he catches a cold, he either has yellow nasal discharge or persistent coughing.
On March 27 of this year, I took my child to see a doctor again.
The doctor performed an X-ray and found some small spots in the lungs, indicating inflammation.
However, during the auscultation, the doctor said the lungs were fine and that the throat was slightly inflamed with phlegm, which was a viral infection.

Q1: I forgot to ask the doctor why the lung auscultation was normal but the X-ray still showed some grayish spots indicating inflammation.
Shouldn't a normal lung X-ray appear completely clear? The doctor said medication was not necessary because viral infections resolve on their own.
Since my child is in kindergarten, he often catches colds, but it seems like he gets sick every week! After taking medication for about a week, he feels better for three or four days and then catches another cold.
He has been on medication for a long time, and I don't want him to keep taking it.
Q2: What are some ways to boost his immunity? Is drinking chicken essence effective? Should he avoid drinking it when he has a cold to prevent worsening inflammation? Additionally, my child has skin and nasal allergies, and other doctors have mentioned that children with allergies do not recover on their own without medication, stating that medication is necessary for colds!
Q3: Do viral infections require continuous medication for colds?
Q4: Also, is chest physiotherapy useful? Some doctors say that a four-year-old does not need it, while others say it is necessary to prevent pneumonia.
Q5: Should he avoid sweet foods? Some doctors say it has no effect, while others say it can produce phlegm.
However, sometimes the snacks at school are sweet, like red bean cereal.
Is it okay for him to eat that? Otherwise, should I send him with bread and salty crackers to school? These additives may not be good either, right?
I apologize for having so many questions, but these issues have been troubling me for a long time! Thank you!

Zhu, 0~9 year old female. Ask Date: 2018/03/28

Dr. Pei Rensheng reply Pediatrics

Hello! 1.
Children who just started kindergarten are particularly susceptible to respiratory or gastrointestinal infections, and this situation may not improve until they reach the upper grades of elementary school.
2.
Ways to boost immunity include vaccinations, exercise, and a balanced diet; probiotics or multivitamins may also be considered.
3.
Most viral infections can improve on their own with the body's immune response, but there are exceptions, such as influenza, which often requires antiviral medications prescribed by doctors.
4.
Severe coughing or nasal congestion can be alleviated with certain medications.
5.
Sugary foods can sometimes increase saliva or phlegm production; it is not recommended to consume sweets when coughing up phlegm.
Wishing you health and happiness! Sincerely, Ren Sheng.

Reply Date: 2018/03/28

More Info

Managing persistent cough and infections in young children can be quite challenging, especially when they have a history of respiratory issues like pneumonia. Your concerns are valid, and I will address each of your questions in detail.

Q1: Why can a child have a normal lung examination but still show signs of inflammation on an X-ray?
It is not uncommon for a child to have a normal lung examination while still showing some abnormalities on an X-ray. The lungs can appear normal upon auscultation (listening with a stethoscope) if there is no significant obstruction or fluid accumulation at the time of the exam. However, X-rays can reveal subtle signs of inflammation or infection that may not yet have manifested as clinical symptoms. The "little gray spots" you mentioned could indicate mild inflammation or residual effects from a previous infection. In many cases, viral infections can cause transient changes in the lungs that resolve on their own without the need for medication.

Q2: What are some ways to boost immunity?
To enhance your child's immune system, consider the following strategies:
- Balanced Diet: Ensure your child has a diet rich in fruits, vegetables, whole grains, and lean proteins. Foods high in vitamins C and D, zinc, and antioxidants can help support immune function.

- Hydration: Encourage your child to drink plenty of fluids, which can help thin mucus and keep the respiratory system moist.

- Regular Exercise: Physical activity can boost overall health and immune function.

- Adequate Sleep: Ensure your child gets enough sleep, as rest is crucial for recovery and immune health.

- Hygiene Practices: Teach your child proper handwashing techniques to reduce the spread of infections.

- Avoiding Allergens: Since your child has allergies, managing these can also help reduce the frequency of respiratory infections.

As for chicken essence or other traditional remedies, while they may provide some nutritional benefits, there is limited scientific evidence to support their effectiveness in preventing infections.

Q3: Do viral infections require continuous medication?
Viral infections typically do not require antibiotics, as they are ineffective against viruses. Most viral infections, including the common cold, resolve on their own. Symptomatic treatment, such as fever reducers or cough suppressants, may be used as needed. If your child is experiencing recurrent infections, it may be worth discussing with your pediatrician about potential underlying issues, such as allergies or asthma, that could be contributing to their susceptibility.

Q4: Is chest physiotherapy (like percussion) necessary for a 4-year-old?
Chest physiotherapy, including techniques like percussion (or "cupping"), can help mobilize mucus in some cases, particularly in children with conditions like cystic fibrosis or severe bronchiectasis. However, for most children with simple viral infections, this may not be necessary. It is essential to follow your pediatrician's advice on this matter, as they can provide guidance based on your child's specific condition.

Q5: Should children avoid sweets?
The relationship between sugar intake and mucus production is somewhat debated. While excessive sugar can lead to inflammation and may affect overall health, moderate consumption of sweets is generally acceptable. It is essential to focus on a balanced diet and limit processed foods high in sugar. If your child enjoys sweet snacks, consider healthier alternatives, such as fruits or whole-grain snacks, which can provide nutrients without excessive sugar.

In conclusion, managing your child's health involves a combination of proper nutrition, hygiene, and regular medical check-ups. If your child's cough persists or worsens, or if you have ongoing concerns, it is crucial to consult with a pediatrician for further evaluation and tailored advice.

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