Medical Minutes: Answers to frequently asked questions
Child Coughing
Karen Smith Wong
PNP
Question: I AM WORRIED ABOUT MY CHILD'S COUGH, WHAT SHOULD I DO?
Coughing serves a very important purpose. It is a way the body removes mucous, bacteria, dust, or other foreign objects (such as a swallowed toy) from the throat.
Another purpose is to remove mucous that is brought up from the lungs. Excess mucous is produced during illness such as cold or flu.
Another reason we cough is due to post-nasal drip. This is when excess mucous is produced from the nose and and drips to the back of the throat.
WHAT ILLNESSES CAUSE COUGHING?
The most common reason for a cough is the cold. Colds are caused by viruses that attack the upper respiratory system, which increases mucous in the throat, nose, windpipe and the Eustachian tube. There are over 250 types of viruses that cause colds.Young children can have up to 10 colds per year. They last for approximately 10 days but the cough associated with colds can last up to 4 weeks.
Coughing can be a symptom of the Coronavirus. The CDC also lists the following symptoms: fever and shortness of breath. Children seem to have milder symptoms than adults. If your child does develop a cough, monitor them for other symptoms and call the DOH if your child’s symptoms worsen, if they have been in contact with someone with the virus or have recently traveled and been in one of the CDC high risk locations.
Asthma is another reason children cough. Asthma is a chronic respiratory disease that causes your airways to become swollen and produce excess mucous. The cough may also be due to the body trying to remove an irritant from the lungs such as mold.
Bronchiolitis is another reason children cough. This is when a virus gets into the small, lower airways of young children. Bronchitis is different than bronchiolitis in that it affects the larger upper airways and trachea and usually affects older children and adults.
Pneumonia is another condition in children and adults that can produce a cough. This is usually a bacterial infection of the lungs that causes air sacs at the end of the bronchioles (small lower airways) to produce pus. Coughing occurs to clear mucous that has come up from the lungs.
WHEN IS COUGHING WORRISOME?
Your health care provider should be notified when a cough is associated with the following symptoms: fever greater than 101F, frequent or worsening cough, with chest pain or wheezing, or if breathing becomes difficult.
WHAT CAN BE DONE TO SLOW OR PREVENT A COUGH?
This can be a frustrating question for parents and health care providers. Depending on what’s causing the cough, there are limited medicines that can slow it down. As we look at these, it’s important to keep in mind that the cough has an important purpose in helping remove mucous from the lungs.
If the cough is due to the common cold or flu, there are 2 types of over the counter medicines marketed for cough: suppressants and expectorants. Research has repeatedly shown that cough suppressants such as dextromethorphan do not work at stopping the cough. Mentholated lozenges (cough drops) can reduce the urge to cough temporarily but does not stop the production of mucous or underlying reason for a cough. They also should not be given to young children. Honey can have a similar effect of soothing the throat and temporarily stopping the urge to cough. Honey should not be given to children younger than 1 year old.
Stronger medicine can be used to slow a cough in adolescents and adults but often aren’t recommended for children. Expectorants such as guaifenesin are medications that loosen mucous which creates a more productive cough. There is some evidence that OTC expectorants will help loosen coughs. One of the best expectorants is hydration or drinking a lot of water. Also, using a humidifier can help loosen up coughs.
Contact your health care provider if you are worried about your child’s cough, especially if it’s associated with fever, chest pain or wheezing.