Cough in Children

As a parent, hearing your child cough may make you feel uneasy, yet an occasional cough doesn't always mean there is a problem. Cough protects your child's body by removing mucus, irritating substances and infections from his or her respiratory tract.

Children can cough several times a day and have coughing episodes lasting up to a couple of weeks if they have viral infections. However, coughing that lasts more than two to three weeks should prompt a visit to your physician.

Acute Cough in Children (Two Weeks or Less)

The majority of children have brief repeated periods of coughing due to viral upper respiratory tract infections, such as the common cold. Healthy preschool children in day care can have up to eight viral respiratory infections with a cough every year, each lasting about 10 days.

Infrequently, a cough occurs because of a foreign body in the airway. This may occur after an episode of choking, but sometimes the choking episode might not be noticed, especially in younger children. See your physician quickly if you think this is possible.

Causes of Chronic Cough

There are many different causes for a persistent or chronic cough in children.

• Asthma

  Most children with asthma have inflamed or swollen airways, which commonly cause wheezing. But sometimes the only symptom is a cough that is made worse by viral infections, that happens while your child is asleep, or may be triggered by exercise and cold air.

• Nasal and Sinus Disease

  Postnasal drip caused by rhinitis or a sinus infection (sinusitis) can produce chronic cough. Usually other symptoms are present, but sometimes the only symptom you notice is the cough.
  
  Allergic rhinitis may be seasonal or year-round. The seasonal allergy, often called "hay fever," typically occurs in the spring, summer or fall. Symptoms include sneezing, stuffy or runny nose and itching in the nose, eyes or on the roof of the mouth. When the symptoms are year-round, they may be caused by exposure to indoor allergens such as dust mites, indoor molds or pets. An allergist can perform testing to find out to what your child is allergic.

• Stomach and Esophageal Causes of Cough

  In some children, the cause of chronic cough is stomach fluid moving back up the throat. This is called "reflux" and may occur silently without heartburn. Some children may develop a hoarse voice and/or choking as symptoms. To determine if this is the cause, your physician may perform tests to see if acid is refluxing up out of the stomach.

• Post-Viral Cough

  After having a viral respiratory infection, otherwise healthy children can have a cough lasting for weeks. There is no specific therapy for this cough, which eventually goes away. Cough suppressant medications can be tried in school-age children, but they don't always solve the problem.

• Bacterial Infection of the Lower Airway

  Bacteria sometimes can infect the lower airways and cause irritation and cough. It's unknown why this happens, and sometimes the best course of action isn't clear. Your physician will help you sort out whether this may be relevant in your child.

• Inhaled Foreign Body

  Foreign bodies, such as toys and food, can be accidentally inhaled at any age, but most commonly occurs at ages two to four years. It can cause a cough to persist for many weeks to months until it is discovered.

• "Habit" Cough

  This is a persistent cough that has no clear physical cause. It occasionally persists after a simple viral respiratory infection. The cough is typically dry and repetitive or is a "honking" cough. Habit cough usually occurs only when your child is awake, not sleeping. A neuromuscular tic can also cause this kind of cough.

• Irritant Cough

  Exposure to tobacco smoke and other pollutants (smoke and exhaust from wood burning, air pollution and exhaust from vehicles) can lead to cough and may worsen the cough associated with asthma or rhinitis.

Treatment

If your child has a daytime cough after a viral respiratory infection, it usually doesn't need any specific treatment-particularly if it goes away in one or two weeks.

The main treatment for chronic cough should be based on the underlying cause. This search for the cause usually involves visiting your physician. Also visit your physician if your child's cough is increasingly frustrating, persists longer than you think is reasonable, if blood is coughed up or if the cough interferes with your child's daily activities.

Over-the-counter mucous thinning agents such as guaifenesin, and cough suppressing medications such as dextromethorphan can be tried. Although most of the over-the-counter cough medications are not thought to be particularly effective, it is possible that one might work better in your child than in other children.

If you think your child may have asthma, make an appointment with an allergist/immunologist, often referred to as an allergist. An allergist is the best physician to diagnose and treat this disease.

Healthy Tips

• A cough protects your child's body by removing mucus, irritating substances and infections from his or her respiratory tract.
• If your child has a cough that lasts more than two to three weeks, schedule a visit with your physician.
• Coughing that lasts more than two weeks is considered chronic. It may be caused by asthma, allergic rhinitis (hay fever), reflux or other causes. An allergist is often the best specialist to determine the cause.