It is a distressing sight, seeing mothers with their babies in the hospital seeking help for conditions that can’t be helped medically. That is assuming that, in those cases when we reassure such mothers that all is well, and no intervention is required medically, we are not helping them.

Whilst in Accra, I realized that some of the most difficult to please patients are the rich. They have all the money with which to buy all the drugs that money can buy.

A neatly dressed couple enters my consulting room with their 8 month old son. This couple is very rich, firstly because they have subscribed onto a private insurance policy. Secondly, I smell their perfumes 10 metres away. Thirdly, everyone is laughing with them whilst playing with the baby, trying to make them feel welcome. Finally, they speak to me as if money isn’t an issue. (money no be problem).

Their son is coughing and has runny nose. There is no fever, baby feeds well and is active. On examination, chest has no problem and baby’s breathing is okay.

The main problem is the nuisance value of the cough especially at night.

I am bringing this up for discussion because we are in the flu season. I am recovering from my own bout of flu and I hope I become immune for the rest of the season.

When my 5-months-old son started coughing, especially at night, I knew full well, the many things I couldn’t do. Yet, seeing my son cough to the point of waking up from sleep, and knowing how, I as an adult suffered with a sore throat and clogged nostrils, I was emotionally driven to find a solution, come what may.

Back in Accra, I kept a certain article from Medscape which highlighted the need to stay off antibiotics in instances of flu as much as possible because most were caused by viruses. I also knew that cough mixtures could be harmful to infants. So to the difficult-to-convince parents, I would pull that article up and say that, even in America where there are medicines in plentiful supply, where there are the Donald Trumps and Steve Jobs ( he was alive then), parents are still told not to use antibiotics (except in special cases) and cough mixtures for infants with flu.

This usually worked, but sometimes, a reason to use an antibiotics would actively be searched for and justified medically. (eg. Child feels warm at night, hence mum had to give Calpol- preferred antipyretic for the rich).

In my case, I decided to reread. The verdict remained the same. I will summarise.

In an article by the US Food and Drugs Administration published in 2008, over the counter cough and cold medicines are to be avoided by children less than 2 years of age. The spectrum includes drugs described as antitussives, expectorants, cough suppressants and antihistamines. In fact, this covers just about everything your chemist will recommend for a cough. The reason for this guideline is that, such drugs don’t help and also lead to serious side effects including death.

Remedies that are beneficial and safe include normal saline nasal drops, cool mist vaporizer (steam inhalation can harm if care isn’t taken), bulb syringe, increased fluid intake. Honey is beneficial, but not recommended in children under 1 year due to the risk of  picking up a potentially lethal infection.

So thankfully, without doing anything, my son’s cough has subsided. But this isn’t always the case with other babies-cough persists. In such cases it could be asthma or another more serious chest infection. Bottom line, consult your doctor. If he/she says all your child has is flu, and reassures you and tells you there is no need for either an antibiotic or cough syrup, please trust him, regardless of the anxiety you will feel.

Ironically, those who can read and verify information we offer are not as hard to convince as those who can’t read. They can’t imagine leaving the consulting room empty handed without medicine for a perceived serious condition.

In this era of evidence based medicine, Doctors are encouraged to offer solutions that are proven to work, guided by research. In other words, until evidence exists to the contrary in future, parents should know that shopping for drugs for ailments, for which maybe simply expressing tender loving care will be beneficial, may be detrimental in the long run.

In other words, more isn’t always good.

Dr. Gubli Natogmah

Akunye Memorial Hospital

Pusiga-UER.