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10-minute module
Children’s cough and sore throat
Products with naturally-derived ingredients suitable for the whole family
It is important that you are equipped with knowledge to support parents and caregivers with advice and recommendations for children’s cough and sore throat.
Natural honey has been used for thousands of years for its antimicrobial and anti-inflammatory attributes and use in providing a soothing effect.1
LEARNING OBJECTIVES
Understand common types and causes of cough and sore throat in children and when to refer to the pharmacist or GP
Understand the different self-care tips and advice you can share with customers who have a cough and/or sore throat
Educate customers on protecting themselves and others, particularly around flu season
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Cough and sore throat2,3
Coughs and sore throats often present together, e.g. with a cold, sinusitis or COVID-19 infection. Non-infectious factors, like allergies, may also cause a sore throat and cough.
Viral infections (common cold, COVID-19 etc) are the most common cause of cough and sore throat. They are often accompanied by post-nasal drip, when mucus trickles down the back of the throat, which can worsen symptoms. Coughs and sore throats are sometimes caused by bacterial infections, which may require referral.
However, if the child is eating, drinking and breathing normally and there is no wheezing, a cough is usually nothing for parents or carers to worry about. In fact, 70% of children with a cough will feel better within 3 weeks, whether or not they take antibiotics.4
Test your knowledge on types of cough3,5
Using your knowledge of common coughs in children, which type of cough best matches the definitions below?
1. A cough that produces phlegm or mucus
DRY COUGH
CHESTY, WET COUGH
CROUP
WHOOPING COUGH
ASTHMA
2. An irritating cough with no phlegm caused by an irritant like smoke
DRY COUGH
CHESTY, WET COUGH
CROUP
WHOOPING COUGH
ASTHMA
3. Short, violent coughs sometimes followed by an intake of breath that sounds like a whoop
DRY COUGH
CHESTY, WET COUGH
CROUP
WHOOPING COUGH
ASTHMA
4. A distinctive barking cough which will make a harsh sound, known as stridor, when they breathe in
DRY COUGH
CHESTY, WET COUGH
CROUP
WHOOPING COUGH
ASTHMA
5. A cough associated with a chronic condition that affects 1 in 10 children and can be exacerbated and triggered by environmental factors
DRY COUGH
CHESTY, WET COUGH
CROUP
WHOOPING COUGH
ASTHMA
You scored:
0 of 5
Remember, if a child has signs of croup, a whooping cough, uncontrolled asthma, breathlessness or any wheezing, they should be referred
Bacterial infections
It is important to recognise when a cough or sore throat may be caused by a bacterial infection and how to appropriately refer customers. A cough lasting more than 3 weeks should be referred to the GP. Sometimes, when sore throat and cough are not accompanied by each other, it could indicate a bacterial infection.2
Click on the tabs to find out more.
Occasionally, a cough can develop into a chest infection. This happens when the initial infection spreads to the lower respiratory tract (bronchi or lungs). Symptoms of a chest infection can come on over 24-48 hours or more slowly over several days. A child with a chest infection is usually very tired and looks unwell. The following symptoms would require referral to the GP:
Prolonged fever- Being too breathless to feed (young children) or complete sentences (older children)
- Breathing faster than usual
- Chest pain when breathing or coughing
- Using extra effort when breathing
- Feeling hot and shivery
An acute sore throat infection due to a suspected streptococcal infection may be treated in the pharmacy, via the Pharmacy First service for eligible children aged 5 years and above. Children under the age of 5 with a suspected bacterial infection should be referred to the GP.
The FeverPAIN diagnostic tool can help you determine the likelihood of the infection being bacterial.
Award 1 point to each of the following symptoms:
(over 38°C)
Purulence (pus/white spots at the back of the throat)
First Attendance within 3 days after onset of symptoms
Severely Inflamed tonsils
No cough or coryza (cold symptoms)
A FeverPAIN score of 4 or 5 should be referred to the pharmacist as the child may be eligible for treatment via the Pharmacy First service. However, your professional judgement should always be exercised when assessing a child’s symptoms and wellbeing.
What can you do to help?2-5
Cough and sore throat self-care advice can include:
AND LEMON
For children over the age of 1 year, a warm drink of lemon and honey can help to provide a soothing effect
IRRITANTS
These can include cigarette smoke, dust and allergens
HUMIDITY
A cool-mist humidifier or a warm bath/shower can help ease a child’s breathing
Rest can help the child regain their health
Increasing fluid intake can help to thin and break down mucus and reduces the risk of dehydration
THROAT LOZENGES
Sucking on a peppermint or menthol lozenge can have a cooling effect. Medicated options can offer pain relief but are not suitable for everyone. Children under 6 years should not be offered lozenges due to the risk of choking
MEDICINES
Cough suppressants and expectorants can help to relieve a cough. Remember to check the product information as they may not be suitable for all children and all types of cough
PAINKILLERS
Paracetamol or ibuprofen can be used for pain relief. Ibuprofen can also help reduce inflammation, however this may not be suitable for all children, including those with asthma
Before offering these analgesics, ensure that the child is not already using any other products that contain them.
Introducing Zarbee’s
Zarbee’s is backed by over 10 years’ commitment to naturally-sourced ingredients. The range is made with over 95% naturally-sourced ingredients and all products are free from artificial flavours and colours.
Click on the icons below to reveal more information about Zarbee’s Children’s Cough and Sore Throat Syrup, the Zarbee’s Adult Cough and Sore Throat Syrup and Cooling Throat and Immune Support Lozenges.
INGREDIENTS
Pure honey acts as a protective barrier in the throat, reducing cough frequency and severity. It also helps to provide a great taste to support adherence.
Ivy leaf works as an expectorant and has a mucolytic effect. It increases the hydration of mucus, liquefying it and aiding in its expulsion.
Glycerol is used in Zarbee’s Children’s Cough & Sore Throat Syrup due to its lubricating properties, which soothe the upper respiratory tract while also working as a humectant and demulcent.8
DOSAGE
From 2 to 5 years: 5ml to be given 2-3 times a day
From 6 to 12 years: 10ml to be given 2x a day
EFFECTS
Ingredients combine to relieve both dry and chesty coughs and soothe sore throats. Made with a great taste to support adherence.
It achieved a viscosity reduction (reduction in mucus thickness) of 52.2% after 5 minutes and 63.1% after 10 minutes (p<0.0001) under experimental conditions.7 This shows that it helps to break down mucus and therefore eases a chesty cough
ABOUT
Zarbee’s Adult Cough and Sore Throat Syrup is made with scientifically proven, naturally sourced pure honey, ivy leaf and glycerol to relieve any type of cough – dry or chesty – while soothing and protecting irritated throats.
DOSAGE
Adolescents (+12 years old) and Adults: 10ml, 3 times a day
EFFECTS
Ingredients combine to relieve both dry and chesty coughs and soothe sore throats. Made with a great taste to support adherence.
ZARBEE’S® COOLING THROAT & IMMUNE SUPPORT LOZENGEScan be used for children aged 6 years and over.
ABOUT
Dual benefit: peppermint oil cools the throat, while zinc and vitamin C support the normal functioning of the immune system
DOSAGE
From 6 years of age: 1 lozenge every 4 hours when required. Maximum of 3-6 lozenges per day
Immune Support Lozenges are food supplements and should not substitute a varied balanced diet. Vitamin C & zinc contribute to the normal function of the immune system.
How customers can protect themselves and others2
Bacteria and viruses that cause coughs and sore throats are contagious and often transmitted through contaminated droplets emitted when children talk, sneeze or cough. These droplets can also contaminate surfaces and objects, which can transmit the infection.
Alongside frequent handwashing, disinfection techniques and social distancing, there are various ways to support your immune system so that the body is prepared when exposed. Parents and caregivers should be conscious of these tips so that they can protect not only themselves, but their whole family. Some techniques include:
Customer scenario: Apply your knowledge
Buzz is suffering from a cold. Although he is getting better, his dad wants something to help relieve his symptoms.
Using the WWHAM framework, you establish:
Who: The treatment and advice are for Buzz, a 5-year-old boy- What symptoms: He has been suffering from a viral cold, which has left him with a sore, scratchy throat and a chesty, phlegmy cough, but no fever
How long: He has suffered for the past 5 days, although he seems to be improving
Action: His dad has not tried anything yet as he is quite uneasy using medicines with Buzz
Medicines and medical conditions: Buzz does not take any regular medication but suffers from eczema
You ask dad about why he is uncomfortable using medicines and he tells you:
“Buzz has not got on very well with medicated cough syrups in the past, as he is very fussy about the taste and they have made him drowsy, so I would prefer not to use them.
I have been making him a honey and lemon drink when I have time. It seems to help, but I was wondering if you had something similar that may be more convenient?”
Select which product you think would be most suitable for Buzz.
Zarbee’s Children’s Cough and Sore Throat Syrup soothes sore throats and relieves chesty coughs, and is made with more than 98% naturally derived ingredients, with a great taste too.
CORRECT!
Zarbee’s Cooling Throat + Immune Support Lozenges are food supplements that can be used to cool the throat whilst supporting the normal functioning of the immune system.
INCORRECT!As Buzz is 5 years old, the lozenges are not suitable for him. In addition, these would only help to cool a dry, irritated throat and are not indicated for cough and sore throat.
Dad is happy with your recommendation and agrees to purchase the product. He tells you that he and his daughter, Bea, who is 3 years old, can both feel their throats becoming dry and irritated and asks if there is anything you could recommend.
What could you say to dad?
Select the correct options below.
Although the lozenges are not suitable for the children in this scenario, dad could use them for himself as they can quickly cool the throat, while zinc and vitamin C support the normal functioning of the immune system
CORRECT!
Dad could use the Zarbee’s Adult Cough and Sore Throat syrup for himself if he starts to suffer from symptoms
CORRECT!
You offer self-care tips, including staying hydrated and resting
CORRECT!
You explain that coughs and sore throats are contagious and the different ways he can protect himself and others
CORRECT!
Dad is happy with your recommendation and agrees to purchase the product. He tells you that he and his daughter, Bea, who is 3 years old, are starting to feel similar to Buzz and asks if there is anything you could recommend.
Alongside the advice provided, you explore the Zarbee’s® Immune Support Range with him.The products are made with honey, vitamins and 95% naturally sourced ingredients. Zarbee's Immune Support is a kind and effective way to support the immune system,* taking care of the whole family.
CHILDREN'S MULTIVITS & IMMUNE SUPPORT LIQUID
CHILDREN'S IMMUNE SUPPORT LIQUID
ADULT IMMUNE SUPPORT LIQUID
ADULT EVENING IMMUNE SUPPORT LIQUID
*Vitamins C & D contribute to the normal function of the immune system.
Food supplements are intended to supplement the diet and should not be substituted for a varied diet or healthy lifestyle. 3+ years.
1. Eteraf-Oskouei T, et al. Traditional and Modern Uses of Natural Honey in Human Diseases: A Review. 2013.
Iranian J of Basic Med Sci, 16 (6), pp. 731-742. doi: 10.22038/ijbms.2013.988
2. Doherty C. Sore throat and cough: Causes and treatment. Verywell health. 2024.
Available at: verywellhealth.com/sore-throat-and-cough-7369467?print
3. NHS. Colds, coughs and ear infections in children. 2021.
Available at: https://www.nhs.uk/conditions/baby/health/colds-coughs-and-ear-infections-in-children/
4. NHS Healthier Together. Cough/cold in children 1 year and over – Advice sheet. 2024.
Available at: https://www.what0-18.nhs.uk/application/files/5515/9109/6760/NHS_Cough_Cold_in_children_OVER_1_year_old_Advice_Sheet.pdf
5. Children’s health. What your child’s cough is telling you. 2024.Available at: https://www.childrens.com/health-wellness/what-your-childs-cough-is-telling-you
6. NHS England. NHS Pharmacy First – Clinical Pathway Acute Sore Throat. 2024. Available at: Pharmacy First – Acute Sore Throat – Clinical Pathways
7. Kenvue data on file
8. Eccles R, et al. Soo thing Properties of Glycerol in Cough Syrups for Acute Cough Due to Common Cold.
Pharmacy (Basel). 2017 Jan 20;5(1):4. doi: 10.3390/pharmacy5010004.
Online resources last accessed October 2024.
Content developed by Kenvue working together with CIG Healthcare Partnership. © 2024 CIG Healthcare Partnership
UK-NP-2024-82424 December 2024