When a Cough Won’t Quit
By Dan Miller, Today's family
It starts with a sniffle. Then comes the cough.
A few days later, the runny nose may be gone, your child’s energy is back and everything seems normal—except for that cough that just won’t leave.
Coughing is one of the most common reasons parents call the pediatrician, particularly as children return to school and respiratory illnesses begin making their seasonal rounds. While most coughs are nothing to worry about, the sound, timing and symptoms that accompany them can offer clues about what may be going on.
“Parents often expect a cough to disappear as soon as the rest of a cold gets better, but sometimes coughing can linger. The important thing is looking at the whole child—how they are breathing, how they are acting and eating and whether the symptoms are improving or getting worse,” says Dr. Laura Caserta of Senders Pediatrics in South Euclid.
Why do we cough?
Although annoying, coughing serves an important purpose. It is one of the body’s ways of clearing mucus, irritants and other material from the airway.
In children, a cough is most commonly caused by a viral respiratory infection. Even after the infection itself has passed, irritated airways and lingering mucus can keep a child coughing for days or sometimes a few weeks.
Postnasal drainage from colds or allergies can also trigger coughing, particularly when a child lies down at night.
Not every cough is caused by a simple viral cold.
A persistent nighttime cough or coughing during exercise, for example, can sometimes be associated with asthma. Children with allergies may cough because of drainage or airway irritation. Less commonly, prolonged coughing may result from pneumonia, pertussis—commonly called whooping cough—or another condition that requires medical treatment.
Dr. Caserta says, “A cough by itself usually doesn’t tell us exactly what is causing it. We want to know when it started, whether there is fever, whether the child is wheezing or short of breath and whether certain things such as exercise or lying down make it worse.”
Does the sound matter?
Sometimes.
A harsh, barking cough—often compared to the sound of a seal—is commonly associated with croup, which causes swelling around the upper airways and is especially common in younger children.
Wheezing is different from coughing. It is usually a high-pitched or whistling sound produced while breathing and is associated with irritation in the lungs or lower airways. In young children, coughing can be indistinguishable from wheezing in a viral condition called bronchiolitis.
A severe coughing spell followed by a gasping or “whooping” sound can occur with an unusual bacterial illness called pertussis or whooping cough, although not every child with pertussis develops the classic whoop.
Helping a child feel better
For an uncomplicated viral illness, comfort measures may be all that is necessary. Encourage fluids, which can help thin mucus and keep the throat moist. A cool-mist humidifier may make dry air more comfortable. And a Neti-Pot which helps wash out sinuses can often help eliminate the post-nasal dripping
For children older than age 1, a teaspoon of honey can soothe an irritated throat and may reduce nighttime coughing. Honey should never be given to babies younger than 12 months because of the risk of infant botulism.
Dr Caserta says, “Parents should be cautious with over-the-counter cough and cold medicines. These products are not appropriate for every age and provide limited benefit, so in general it is best to avoid them”
When should parents call?
A cough deserves medical attention when it is accompanied by difficulty breathing, persistent or significant wheezing, high or prolonged fever, unusual tiredness, signs of dehydration, chest pain or symptoms that are clearly worsening instead of improving.
Parents should also contact their pediatrician if a cough continues for several weeks, repeatedly interferes with sleep or activity, or disappears and then returns.
Seek emergency care for severe difficulty breathing, bluish or gray coloring around the lips or face, or other signs that a child is not getting enough oxygen.
Dr. Caserta adds, “Eating and drinking appropriately is a good sign of health. If the coughing impairs your baby’s ability to drink from the breast or bottle, or affects your child’s appetite, make sure to let your pediatric provider know about it. “
Most of the time, the most reassuring treatment is simply patience.
That intermittent but stubborn cough following your child from breakfast to bedtime may be frustrating, but in many cases it is simply the last guest to leave after a respiratory virus has moved on.
A few days later, the runny nose may be gone, your child’s energy is back and everything seems normal—except for that cough that just won’t leave.
Coughing is one of the most common reasons parents call the pediatrician, particularly as children return to school and respiratory illnesses begin making their seasonal rounds. While most coughs are nothing to worry about, the sound, timing and symptoms that accompany them can offer clues about what may be going on.
“Parents often expect a cough to disappear as soon as the rest of a cold gets better, but sometimes coughing can linger. The important thing is looking at the whole child—how they are breathing, how they are acting and eating and whether the symptoms are improving or getting worse,” says Dr. Laura Caserta of Senders Pediatrics in South Euclid.
Why do we cough?
Although annoying, coughing serves an important purpose. It is one of the body’s ways of clearing mucus, irritants and other material from the airway.
In children, a cough is most commonly caused by a viral respiratory infection. Even after the infection itself has passed, irritated airways and lingering mucus can keep a child coughing for days or sometimes a few weeks.
Postnasal drainage from colds or allergies can also trigger coughing, particularly when a child lies down at night.
Not every cough is caused by a simple viral cold.
A persistent nighttime cough or coughing during exercise, for example, can sometimes be associated with asthma. Children with allergies may cough because of drainage or airway irritation. Less commonly, prolonged coughing may result from pneumonia, pertussis—commonly called whooping cough—or another condition that requires medical treatment.
Dr. Caserta says, “A cough by itself usually doesn’t tell us exactly what is causing it. We want to know when it started, whether there is fever, whether the child is wheezing or short of breath and whether certain things such as exercise or lying down make it worse.”
Does the sound matter?
Sometimes.
A harsh, barking cough—often compared to the sound of a seal—is commonly associated with croup, which causes swelling around the upper airways and is especially common in younger children.
Wheezing is different from coughing. It is usually a high-pitched or whistling sound produced while breathing and is associated with irritation in the lungs or lower airways. In young children, coughing can be indistinguishable from wheezing in a viral condition called bronchiolitis.
A severe coughing spell followed by a gasping or “whooping” sound can occur with an unusual bacterial illness called pertussis or whooping cough, although not every child with pertussis develops the classic whoop.
Helping a child feel better
For an uncomplicated viral illness, comfort measures may be all that is necessary. Encourage fluids, which can help thin mucus and keep the throat moist. A cool-mist humidifier may make dry air more comfortable. And a Neti-Pot which helps wash out sinuses can often help eliminate the post-nasal dripping
For children older than age 1, a teaspoon of honey can soothe an irritated throat and may reduce nighttime coughing. Honey should never be given to babies younger than 12 months because of the risk of infant botulism.
Dr Caserta says, “Parents should be cautious with over-the-counter cough and cold medicines. These products are not appropriate for every age and provide limited benefit, so in general it is best to avoid them”
When should parents call?
A cough deserves medical attention when it is accompanied by difficulty breathing, persistent or significant wheezing, high or prolonged fever, unusual tiredness, signs of dehydration, chest pain or symptoms that are clearly worsening instead of improving.
Parents should also contact their pediatrician if a cough continues for several weeks, repeatedly interferes with sleep or activity, or disappears and then returns.
Seek emergency care for severe difficulty breathing, bluish or gray coloring around the lips or face, or other signs that a child is not getting enough oxygen.
Dr. Caserta adds, “Eating and drinking appropriately is a good sign of health. If the coughing impairs your baby’s ability to drink from the breast or bottle, or affects your child’s appetite, make sure to let your pediatric provider know about it. “
Most of the time, the most reassuring treatment is simply patience.
That intermittent but stubborn cough following your child from breakfast to bedtime may be frustrating, but in many cases it is simply the last guest to leave after a respiratory virus has moved on.