Pediatrics Common Questions, Quick Answers

Cough

Donna D'Alessandro, M.D.
Lindsay Huth, B.A.
Peer Review Status: Internally Reviewed
Creation Date: February 2002
Last Revision Date: April 2002

• What is a cough?
• What causes a cough?
• What are the different kinds of coughs and their treatments?
• What are signs of a serious problem?
• What can I do?
• When should I call the doctor?

What is a cough?

• A cough occurs when the lungs suddenly push out air.

What causes a cough?

• Coughing is a reflex. It happens to the body automatically.
• The force of a cough can clear an airway that is blocked.
• It clears mucus and pus from the airways.
• Irritation in the throat can cause a cough.
• It is sometimes the symptom of asthma, heartburn, or allergies.
• Smoking, second-hand smoke, and pollutants in the air can cause a long-lasting cough.
• Coughing can be a symptom of a viral infection, such as the common cold.
• Coughing can be a symptom of a bacterial infection, such as bronchitis.
• Coughing can be a side effect of some drugs and medications.
• Coughing can be caused by congestive heart failure.
• Babies who cough while feeding may be getting milk in their airways.

What are the different kinds of coughs and their treatments?
There are many different kinds of coughs caused by many different things. Treatment is also different. Never use cough medication for children under 2 years old before you talk to a doctor.

Cough with runny nose

• May be caused by mucus running down the back of the throat.
• Treated with a decongestant, available as over-the-counter cold medications.
• Do not use for children under 2 years old before talking to your doctor.

Cough related to an allergy

• Avoid whatever allergen is causing the reaction.
• Often caused by dust or allergies to pets.
• Take antihistamines.

Dry cough, tickling cough

• Caused by throat irritation.
• Sometimes helped by sucking on cough lozenges or hard candy.
• Do not give hard candy or throat lozenges to children under 3 years old.

Habit cough, psychogenic cough

• Often described as a barking or honking cough.
• Has no physical cause.
• Habit cough can be caused by nervousness.
• Emotional problems are probably the cause of a psychogenic cough.
• For example, a child might cough to get their parents' attention.
• Many people cannot stop themselves from coughing. They need to see a doctor for help.

Short, dry, wheezing cough

• Heard in asthma, bronchitis, or pneumonia.

Loose, wet cough that brings up mucus

• Usually caused by an upper respiratory infection, a cold, or sinus infection.
• Caused by mucus dripping down the back of the child's throat.
• Child may also vomit mucus.

Croup

• Cough often begins at night after child has been sleeping.
• Cough can occur during the day, too.
• Child may have trouble breathing.
• Continuous cough that sounds like a barking seal.

Remember that no cough medicine should be taken for longer than 3 weeks. Call your doctor if the cough has not gone away by this time.

What are signs of a serious problem?

• Coughing up blood.
• Coughing with chest pain.
• Troubled breathing.
• Shortness of breath.
• Losing weight without trying.
• High-pitched sound or stridor when inhaling.

What can I do?

• Notice all of the details about your child's cough to help find out what is causing it. What does it sound like? When does he cough? Does it bring up mucus?
• Humidity sometimes helps ease coughing. Put a vaporizer near your child's bed or steam up the bathroom.
• Give your child plenty of fluids. It will help thin out the material in his throat and make it easier to cough up.
• Dextromethorphan (such as Delsym or Vick's Formula 44) is an over-the-counter medication that may help ease cough.
• Coughing spreads colds and infections from person to person. Teach your child to cover his mouth and nose when he coughs. Have him wash his hands after he coughs or sneezes into them.

When should I call the doctor?

• Call immediately if your child has any of the symptoms described above in "Serious problem."
• Call if your infant less than 3 months old has a cough.
• Call if your child also has a fever or abdominal (stomach) swelling.
• Call if the cough brings up thick, greenish mucus that smells bad.
• Call if the cough lasts for more than 10 days.
• Call if your baby often coughs while feeding.

Quick Answers

• A cough occurs when the lungs suddenly push out air.
• Coughing can be caused by a partially blocked airway. It is also the symptom of different viral infections, bacterial infections, and lung diseases.
• Coughs may sound dry, gasping, wet and loose, or like a bark. Some coughs bring up mucus. Treatment may aim to decrease the cough or to help it.
• Signs of a serious problem include coughing up blood, having a cough and losing weight without trying, troubled breathing, or a high-pitched sound when breathing in.
• Call the doctor if your infant less than 3 months old has a cough or if your child has a cough that lasts for more than 10 days.

References

• American College of Chest Physicians. Understanding and Treating a Problem With Many Causes. (cited 2002 January 22). Available from: URL: http://www.chestnet.org/health.science.policy/patient.education.guides/cough.pted.html
• Epstein BA, The Child Who Coughs, the Doctor's Office. (cited 2002 January 22). Available from: http://www.allkids.org/Epstein/Articles/Child_Who_Coughs.html
• Kaufman DA. Cough. MEDLINEplus. 2001 October 16 (cited 2002 January 22). Available from: URL: http://www.nlm.nih.gov/medlineplus/ency/article/003072.htm

See related Patient Topics Cough, Lungs and Breathing or Symptoms and Manifestations.

See related Provider Topics Lungs and Breathing or Symptoms and Manifestations.

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