Children are notorious for catching every virus in town, whether the common cold or the flu. And the persistent cough that often accompanies these viruses can linger on for weeks.
Practitioners of Traditional Chinese Medicine (TCM) believe it is the still developing organs and immune system of children that make them more susceptible to infections and environmental irritants. The immaturity of their lungs, kidneys and spleen, in particular, mean that many of the illnesses and symptoms they suffer are linked to these systems – including persistent, and sometimes chronic, coughs.
What this translates into are cranky children, worried parents and sleepless nights.
Identity of a cough
TCM recognises six types of paediatric coughs: wind-heat, heat phlegm, wind-cold, damp phlegm, yin-deficiency and qi-deficiency, each of which presents differently.
Treating a cough depends on first determining what kind of cough the child has. TCM physicians look at the main characteristics of the cough – what it sounds like, when it is most frequent, the colour of the sputum – and other physical symptoms when identifying the cough and the most suitable treatment.
The kinds of cough most commonly seen in Eu Yan Sang’s clinics are wind-heat coughs and heat phlegm coughs, says EYS physician Lin Jiayi.
Children with wind-heat coughs will have a persistent cough and thick yellow phlegm. They are likely to have a sore throat and stuffy nose, as well as a fever, headaches and cold chills. It is one of the most common types of cough seen in children in tropical countries like Singapore, Ms Lin says.
Children with heat phlegm coughs often cough violently and have thick, sticky yellow phlegm that is hard to expel. Physically, someone with this kind of cough is likely to have a flushed complexion, red lips, and may feel extreme thirst, she says.
When a cough recurs or turns chronic, meanwhile, it is likely to be due to qi-deficiency. Qi-deficiency coughs are characterised by weak coughing and clear, watery phlegm. Children with this kind of cough are often lethargic and short of breath. They may also look pale, feel cold, and perspire excessively.
Qi, or a person’s vital energy, acts as protective mechanisms against diseases, explains Ms Lin. Children’s immature systems and relatively weaker qi means that they fall ill more frequently and recover more slowly, she explains. “Qi deficiency of the lungs, which causes children to be infected easily, is the root cause of the majority of recurring coughs in children.”
TCM seeks not just to treat the cough, but the child. This holistic treatment often includes a combination of herbal remedies, physical therapies like tui na (medical massage), and dietary and lifestyle changes. Treatments are individualised, based on condition, age, weight and other factors, and different children with the same condition may be treated differently. The common thread that runs through all treatment is the elimination of imbalances in the body and restoration of qi flow.
The treatment of wind-heat coughs, for example, is likely to include herbs that dispel heat and clear wind, for example chrysanthemum and mulberry leaves (link to product pages) which moisten the lung system. Radish and luo han guo are commonly prescribed for patients with heat phlegm cough as they clear heat, relieve thirst and help to expel phlegm.1
Besides herbal medication, paediatric tui na – a form of external physical therapy that stimulates specific pressure points in children – may be used to restore the flow of qi.
Using the same principles as acupuncture, in which fine needles are inserted at specific points of the body to help unblock energy channels, tui na massage techniques are used to unblock qi obstructions and improve its flow in the lungs. To tonify – or strengthen – qi energy in the lungs, a practitioner may, for example, knead a point on the ring finger.2 Tui na is also believed to promote the release of neurotransmitters that help strengthen the immune system.
Diet plays an important part as well. “Certain foods can worsen the present condition or prolong the cough,” Ms Lin cautions. Fried and greasy food can cause heat to accumulate, which thickens phlegm. Chilled drinks have cold properties and may prolong certain types of cough. Instead, easily digested foods like porridge or vermicelli in soup are recommended.
When the cough disappears, the work isn’t quite done. It is important to continue the healing process by boosting the child’s immune system and strengthening his general health, Ms Lin says. A good TCM physician will be able to advise on the right nourishing herbs to take, and give longer term lifestyle and dietary tips for optimal health.
|Type of paediatric cough||Symptoms|
|Wind-heat cough||Persistent cough and thick yellow phlegm, likely accompanied by a sore throat and stuffy nose, as well as a fever, headaches and cold chills.|
|Heat phlegm cough||Violent cough and thick, sticky yellow phlegm that is hard to expel. This is likely to be accompanied by a flushed complexion, red lips and a feeling of extreme thirst.|
|Wind-cold cough||Constant coughing and white clear phlegm. Other symptoms include a stuffy nose and clear mucus. The patient may also suffer from cold chills, fever, body aches and headaches.|
|Damp phlegm cough||Deep heavy cough with a large amount of clear watery phlegm. There may be tightness in the chest area and poor appetite|
|Yin-deficiency cough||Dry persistent cough without phlegm or a minimal amount of sticky phlegm which is hard to expel. There may be some blood in the phlegm. The mouth may feel dry and the throat may be dry and itchy. There may be a feeling of thirst.|
|Qi-deficiency cough||Weak cough accompanied by clear watery phlegm. The patient may feel lethargic, look pale, be short of breath, have cold chills and sweat excessively.|
1 TCM Wiki. (2017). Radish. Retrieved from TCM Wiki Website: https://tcmwiki.com/wiki/radish
2 Du, L. (2010, April 8). Treating Cough with paediatric massage. Retrieved from TCM centre: http://tcmcentre.com/2010/04/08/treating-cough-with-paediatric-massage/