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When Should I Worry: Coughs in Children

coughs in children

Nothing disrupts a peaceful evening of Netflix binging like the mid-fall mania caused by a sudden barking cough from a child’s bedroom.

Well, except vomiting.

Sometimes the two even coincide, and then you really have a night on your hands.

The end of October is only days away. The uncommonly warm temperatures we’ve experienced in Maryland will ultimately subside, replaced by cooler weather – and that means significantly more coughs in children. It’s just a fact of life.

However, like a fever, a cough is an important function of the human body, serving to protect and clear the airways of mucus and bacteria and other assorted irritants.

The question is – when does your child’s cough signal something else, something more severe than the common cold? The key, unsurprisingly, is the same for most concerns and quandaries in life: Listen carefully.

  • A barking cough may signify the croup. This nasty and distinctive viral illness often pops up late at night after the child has gone to bed, causing swelling in the voicebox and windpipe. Children younger than 3 are more at risk because of the narrowness of their upper airways, making it harder for them to breathe. The coughing caused by croup is sometimes accompanied by a stridor, which is a severe and noisy wheeze when inhaling. These barking coughs should prompt a call to your pediatric provider.
  • Pertussis – or “whooping” cough – is a respiratory disease hallmarked by a constant barrage of hacks with no breaks. These coughs are followed by a deep “whooping” breath. Frequently, this illness is accompanied by initial cold symptoms like runny nose, congestion, and fever. Whooping cough is bacterial in nature, and manifests most often in children under 1 year of age or those who did not receive their DTaP vaccinations. Pertussis is incredibly contagious – consult your doctor if you believe your child may have contracted this illness.
  • Coughs caused by asthma or bronchiolitis are practically indistinguishable, punctuated by a wheeze when exhaling. This could also occur if the child has swallowed something that is blocking their airway.
  • Wet, phlegm-filled coughs accompanied by fever are often a sign of the common cold and, unless the fever is in excess of 102, are likely self-resolving. However, phlegmy coughs that come with mucus drainage – particularly green discharge –may be a sign of sinusitis, while a worsening cough and faster breathing could be a possible indication of pneumonia.

Coughs in children often worsen at nighttime, when drainage irritates the throat, disrupting sleep. Activity and cold air can exacerbate coughs during the day, as well as allergens such as pet dander, cigarette smoke, and certain scents like perfume or air fresheners. And, as mentioned, coughs can cause vomiting if they are forceful enough, or if any resulting drainage causes nausea.

Unfortunately, coughs in children– even the harmless variety – can persist for weeks in some cases, and that can be incredibly worrisome for parents and guardians.

So, when should you call your doctor? Here are the rules of thumb:  

  • If cough has lasted for more than 3 weeks
  • If the cough is accompanied by a fever exceeding 102 degrees
  • If you child is younger than 3 months and has a fever of any kind
  • If your child is having difficulty breathing or is breathing abnormally (faster than usual)
  • If the cough is accompanied by “whooping,” wheezing, or stridor
  • If the cough is accompanied by blood
  • If your child is weak, irritable, dizzy, drowsy, or shows signs of dehydration (no tears when crying, no wet diapers, a dry mouth, etc.)

What You Can Do To Help

  • Use a cool mist humidifier in your child’s room to alleviate symptoms.
  • Occasionally, brief exposure to cold outdoor air can provide some relief. Similarly, steam in an enclosed bathroom can temporarily relieve the symptoms of croup.
  • DO NOT give children Over the Counter (OTC) cough medicines unless first consulting with your pediatric provider. Shared ingredients – like acetaminophen – can lead to overdose in toddlers, if also treating with Tylenol or Motrin for fever. Also, syrups by themselves often have a reverse effect on young children – making them wildly alert, instead of drowsy.
  • DO NOT give small children cough drops, as they can be a choking hazard. Instead, try warm tea with some honey or even popsicles.
  • Encourage fluids to keep your child hydrated and to soothe his or her throat – but avoid carbonated beverages and acidic juices, which can burn.

Questions about coughs? KinderMender’s specialists have heard them all. Give us a call any day of the week at (443) 492-4000.

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