Coughs and Coughing

A cough is one of the most common symptoms of childhood illness. Although a cough can sound awful, it's not usually a sign of a serious condition. In fact, coughing is a healthy and important reflex that helps clear and protect the airways in the throat and chest. Coughing is the symptom that most often leads parents to seek medical attention for their children, but most of the time it can be managed by simple home treatment (see below).

 What Causes a Cough?

 What Makes Coughs Sound Different?

 When a Cough Needs Medical Attention?

 Treatment for a Cough

 Making Your Coughing Child Comfortable

 Prevention Strategies for Coughs (and Colds)


What Causes a Cough?

Coughing is the body's way of keeping the airways clear. It is almost always due to an irritation of the air passages. When the nerve endings in the throat, windpipe, or lungs sense the irritation, a reflex causes air to be forcefully ejected through the passageways.

The most common irritant is mucus—a fluid that cleans and moisturizes the nasal passages. We swallow normal amounts of mucus without knowing it, but when there is a lot of mucus secreted, as there is with a cold, this fluid accumulates in the back of the throat and can trigger a cough.

Coughs are usually associated with respiratory illnesses such as colds, bronchiolitis, croup, flu, and pneumonia. However, a cough can also be due to allergies, ingestion of a foreign object such as a peanut or small toy, or a temporary irritation that is breathed in, such as paint fumes, tobacco smoke, or insecticide sprays.

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What Makes Coughs Sound Different?

Most often, the location of the infection determines the sound of the cough. An irritation in the larynx (voice box) such as croup causes a cough that sounds like the bark of a seal or a dog; irritation of the larger airways such as the trachea (windpipe) or bronchi sounds deeper and raspy and is often worse in the morning. Most common colds are accompanied by a dry or wet cough that may last even after other symptoms are gone.

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When a Cough Needs Medical Attention?

Call your child's health care provider if your child is coughing AND:

• your infant is under 3 months of age. It is especially important/urgent to call if your baby has a fever of 101 degrees Fahrenheit or higher, and/or if your baby's breathing is faster or more labored than usual, or if your baby is feeding poorly.

• your infant who is 3 months or older, or an older child, has a fever of 101 degrees Fahrenheit or higher that lasts for more than 48 hours. Fever is common with respiratory infections and generally is not a cause for concern unless it's high or lasts for a long time, or the child acts really ill.

• coughing makes it difficult for your child to breathe.

• your child is breathing fast—40 to 50 breaths per minute—and/or she "sucks in" between the ribs with each breath. You can easily see this if you take your child's shirt off.

• coughing is painful, persistent, and/or accompanied by a "whooping" sound.

• your child coughs so hard that her lips turn blue or dusky.

• coughing appears suddenly and is associated with fever.

• coughing begins after your child chokes on food or another object.

• your child appears ill and is not playing as usual or drinking fluids well. It is not worrisome if her appetite is decreased, but she should eat small amounts and drink plenty of fluids.

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Treatment for a Cough

Most coughs are caused by viral infections, which do not respond to antibiotics. So antibiotics are not usually recommended for treating cough. If the cough is caused by a virus, it just needs to run its course. A viral infection can last for two weeks or longer, and especially during the winter, frequent colds are common, particularly if children attend day care or preschool.

In January 2008, the FDA issued a Public Health Advisory strongly recommending that over-the-counter cough and cold products should not be used in infants and young children because serious and potentially life-threatening side effects can occur. In addition, to date there is minimal evidence that these products are effective in children. So it's best to avoid giving your child these products or any other type of medication unless your child's health care provider specifically recommends it.

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Making Your Coughing Child Comfortable

Most coughs will go away on their own, but until your child's cough disappears you can do the following to help him feel more comfortable:

• Encourage extra fluids to keep the airway moist and your child well hydrated.

• Add moisture to the air with a humidifier or vaporizer, especially if your home is very dry. A cold water vaporizer/humidifier is just as effective as a hot water one and considerably safer if accidentally knocked over. Be sure to clean the device daily with soap and water as harmful germs can breed there.

• Sit with your child in a closed bathroom while a hot shower is running; this can loosen and ease any cough, especially before bedtime.

• Elevate the head of the crib or bed, but don't put an infant on pillows or fluffy bedding as this increases the risk of SIDS (sudden infant death syndrome).

• Use popsicles, lollipops, and cool drinks to soothe an irritated throat. However, avoid citrus or carbonated beverages.

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Prevention Strategies for Coughs (and Colds)

Nothing you can do will completely protect your child from getting a cough or a cold. But there some steps you can take to reduce the frequency of coughs and colds.

• Keep your child away from sick people, if at all possible, including household members, child care workers, and babysitters.

• Avoid smoke-filled environments.

• Make sure that your child and all child care providers (including you) wash their hands often.

• Frequently wash favorite toys and objects that an infant or toddler might put in her mouth.