Your Child's Cough

While I was watching Nicole sleep, I went browsing the internet for some articles related to cough and fever. Here's one that I stumbled across from KidsHealth.org and it may be of use to other parent bloggers out there. This article was published on MSN's Health and Fitness.

Coughs are one of the most frequent symptoms of childhood illness, and although they can sound awful at times, aren't usually a sign of a serious condition. In fact, coughing is a healthy and important reflex that helps clear the airways in the throat and chest.

Occasionally, though, your child's cough is going to warrant a visit to the doctor. Recognizing certain types of coughs will help you know how to handle them and when to seek medical help.

About Different Types of Coughs

Here's some guidance on different types of coughs and the kinds of conditions they're typically associated with. If you're concerned that your child's cough is an indication of a larger illness, call your doctor.

"Barky" Cough

Barky coughs are usually caused by an inflammation or swelling in the upper part of the airway. Most often they're caused by croup, an inflammation of the larynx (voice box) and trachea (windpipe).

Croup can be brought on by allergies, change in temperature at night or, most commonly, a viral upper respiratory infection. When a young child's airway becomes inflamed, it may swell near, or just below, the vocal cords, making it harder to breathe. Kids younger than 3 years of age tend to get croup because their windpipes are narrow.

Croup can come on suddenly and in the middle of the night, when kids are at rest. Often it's accompanied by stridor, a noisy, harsh breathing (some doctors describe it as a coarse, musical sound) that occurs when a child inhales.

"Whooping" Cough

Whooping cough is another name for the illness pertussis, an infection of the respiratory tract caused by the bacteria bordetella pertussis. The illness is marked by severe coughing spells that end in a "whooping" sound when a child breathes in. Other symptoms of pertussis include a runny nose, sneezing, mild cough, and a low-grade fever.

Although pertussis can occur at any age, it's most severe in infants under 1 year old who aren't immunized. The pertussis vaccine, which is part of the DTaP (diphtheria, tetanus, acellular pertussis) immunization, is routinely given in five doses before a child's sixth birthday. It's important to follow the immunization schedule that your doctor provides.

Pertussis is highly contagious. The bacteria can spread from person to person through tiny drops of fluid in the air from an infected person's nose or mouth, which get propelled by sneezes, coughs, or laughs. Other people can become infected by inhaling the drops or getting the drops on their hands and then touching their mouths or noses.

Cough With Wheezing

When coughing is accompanied by a wheezing sound during exhalation, it may be a sign that your child's lower airway is inflamed. It's also possible, particularly in younger kids, that the lower airway is being blocked by a foreign object or mucus from a respiratory infection.

Nighttime Cough

Lots of coughs get worse at night because the congestion in the nose and sinuses drains down the throat and causes irritation during sleep. This is only a problem if your child is unable to sleep. Asthma can also trigger nighttime coughs because the airways tend to be more sensitive and become more irritable at night.

Daytime Cough

Allergies, asthma, colds, and other respiratory infections are the usual culprits of daytime coughs. Cold air or activity can make these coughs worse, and they often subside at night or when a child is resting. Try to make sure that nothing in your house — like air freshener, pets, or smoke (especially tobacco smoke) — is making your child cough.

Cough With a Fever

A child who has a cough, mild fever, and runny nose probably has a common cold. But coughs with a fever of 102? Fahrenheit (39? Celsius) or higher can mean pneumonia, particularly if a child is listless and breathing fast. In this case, call your doctor immediately.

Cough With Vomiting

Kids often cough so much that it triggers their gag reflex, making them throw up. Usually, this is not cause for alarm unless the vomiting persists. Also, a child who has a cough with a cold or an asthma flare-up may throw up if lots of mucus drains into the stomach and causes nausea.

Persistent Cough

Coughs caused by colds can last weeks, especially if your child has one cold right after another. Asthma, allergies, or a chronic infection in the sinuses or breathing passages might also be responsible for these persistent coughs. If the cough lasts for 3 weeks, notify your doctor.

When to Call the Doctor

Most childhood coughs are nothing to be concerned about. However, consult a doctor if your child:

• has trouble breathing or is working hard to breathe
• is breathing more quickly than usual
• has a blue or dusky color to the lips, face, or tongue
• has a high fever (particularly in a young infant or in the absence of congestion or a runny nose; contact your doctor for any fever in an infant younger than 3 months)
• is an infant (3 months old or younger) who has been coughing for more than a few hours
• makes a "whooping" sound when she breathes after coughing
• is coughing up blood
• has stridor when inhaling
• has wheezing when exhaling (unless you already have home asthma management instructions from your doctor)
• is listless or cranky

Professional Treatment

One of the best ways to diagnose a cough is by listening. Your doctor will determine how to treat your child based in part on what the cough sounds like.

Because the majority of respiratory illnesses are caused by viruses, doctors typically do not prescribe antibiotics for coughs. If some kind of bacterial infection is suspected, the doctor will probably prescribe antibiotics. Some coughing-related illnesses just need to run their course.

Unless your child's cough is preventing sleep, cough medicines are usually unnecessary. If you do choose to use an over-the-counter (OTC) cough suppressant, consult the doctor to be sure that the dose is correct since all medications can have side effects and, in some cases, can even be dangerous for infants and young children.

Home Treatment

Home treatments should never take the place of consulting your doctor for any of the conditions listed above, but you can help make your child more comfortable:

• If your child has asthma, make sure you have received asthma-management instructions from your doctor. Monitor progress carefully during a flare-up and give asthma medicines according to the doctor's instructions.
• Take a child who wakes up with a "barky" or "croupy" cough in the middle of the night into the bathroom, close the door, and let the shower run on hot for several minutes. After the room steams up, sit in the bathroom with your child for about 20 minutes. The steam should help ease breathing. Try reading a book together to pass the time.
• A cool-mist humidifier in your child's bedroom might help with sleep.
• Cool beverages like juice can be soothing; avoid carbonated or citrus drinks, however, because they can be painful on raw areas.
• You should not give your child (especially a baby or toddler) OTC cough medicine without specific instructions to do so from your doctor.
• Cough drops, which are fine for older kids, are a choking hazard for young kids. It's best to avoid them unless your doctor says that they are safe for your child.

Reviewed by: Aaron S. Chidekel, MD
Date reviewed: October 2005
Originally reviewed by: Steven Dowshen, MD