Coughs and Coughing in Babies and Toddlers

Coughs and Coughing in Babies and Toddlers

Coughing is a symptom that frequently leads parents to seek medical attention for their children. 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 protect the airways in the throat and chest. Most of the time it can be managed by simple home treatment rather than by using medicines or cough remedies.

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. When a lot of mucus is secreted — during a cold, for example — 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 caused by allergies, ingestion of a foreign object (such as a small toy or a nut), or a temporary irritation that is breathed in, such as paint fumes or tobacco smoke.

Why don't all coughs sound the same?

Most often, the location of the infection determines the sound of the cough. For example, an irritation in the windpipe or bronchi sounds deeper and raspier than when it’s located in the larynx. Most common colds are accompanied by a dry or wet cough that may last even after other symptoms are gone.

When does a cough need medical attention?

Call your child's healthcare provider immediately in the following situations:

• if your infant younger than 3 months is coughing and has a fever of 101 degrees Fahrenheit or higher, or is breathing erratically;
• if your child older than 3 months is coughing and has a fever of 101 degrees Fahrenheit or higher that lasts for more than 48 hours;
• if coughing makes it difficult for your child to breathe;
• if your child is breathing fast — 40 to 50 breaths per minute — and she "sucks in" between the ribs with each breath;
• if coughing is painful, persistent, and/or accompanied by a "whooping" sound;
• if your child coughs so hard that her lips turn blue or dusky;
• if coughing appears suddenly and is associated with fever;
• if coughing begins after your child chokes on food or another object.

Treating a cough. Since most coughs are caused by viral infections, antibiotics are not usually recommended for treating it. Instead, let the cough run its course. A viral infection can last for two weeks or longer. In 2008, the FDA issued a Public Health Advisory strongly recommending against giving infants and small children over-the-counter cough and cold products because of serious side effects that could occur. In any case, there’s little evidence that these products are effective in children, so avoid them unless your healthcare provider specifically recommends it.

Keeping your coughing child comfortable. Most coughs will go away on their own, but until then, you can do the following to help your child feel more comfortable:

• Encourage extra fluids to keep the airway moist and your child well hydrated.
• Turn on a humidifier or vaporizer, especially if your home is very dry.
• Sit with your child in a closed bathroom while a hot shower is running; this can loosen and ease any cough, especially before bedtime.

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