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When Should You Worry About Your Child’s Cough?


cough child

I don’t know about you, but my household is a cacophony of sound from October through March — and I’m not talking about joyful laughter. I mean stubborn, persistent coughs that come and go all cold season long. So, when do the kiddos need to go to the doctor, and when do they just need time, TLC, and a Sofia the First marathon on TV? Dr. Christina Johns, pediatrician, pediatric emergency physician, and Senior Medical Advisor for PM Pediatrics, gives us the inside scoop in this helpful guest post.

When Should You Worry About Your Child’s Cough? Guest Post by Dr. Christina Johns

As a parent and a pediatric emergency physician, there are few more common, frustrating, scary (annoying, irritating, agitating…) symptoms than a COUGH.  It worries us, hurts our little ones’ chests, and can keep us up all night for many nights in a row, leaving everyone feeling bad. It’s important to know that all coughs are not created equal; some need attention right away and others need more patience and supportive care rather any medicine that exists. Let’s get into it.

When in Doubt…

First, if any child has a cough that is so constant and severe that she can’t catch her breath or speak, then a medical evaluation needs to happen right away, no matter the cause. Respiratory distress — like flaring of the nostrils, constant belly breathing, and sustained rapid breathing — are not something to take lightly. If you have concerns that your child is truly having trouble breathing, please seek care right away. I’d rather hear that a child was evaluated and deemed “OK” any day over hearing that a child wasn’t assessed and had a bad outcome. When in doubt, check it out.

Listen Up

Coughs have their own character depending on the cause. If there’s a barky cough that sounds like a seal, that’s most commonly croup — a viral infection of the voicebox (larynx). There are some medicines that can help this cough, and if your child makes noise as he inhales and exhales in addition to the barky cough, then he needs to be seen by a clinician right away. If the cough sounds dry and tight, this can be due to wheezing or asthma-like symptoms. A different kind of medicine called a bronchodilator helps to settle this cough. In a very young baby or an unvaccinated person, a constant staccato-like cough could be whooping cough (pertussis), and antibiotics would be needed for the patient as well as all her close contacts (a hot mess indeed!). A cough that is loose and productive of mucus is the wild card — it can be due to sinusitis or pneumonia, which would need to be treated with antibiotics, or it could just be a plain ol’ virus like the common cold or even the flu. Patience and supportive care are the mainstays of these.

Whew.  That’s a lot.  So now what?

Treat It Right

Once you know what KIND of cough your child has, you can set about getting the right medicine, if any is needed at all. Do that first. Next, don’t discredit the supportive care measures — coughs are painful, uncomfortable, and exhausting. I’m a big fan of making sure the air isn’t dry, so use a humidifier in the dry months or hang out in a steamy bathroom a few times a day. For children older than 12 months, 2-3 teaspoons of honey in some weak, warm (not hot) decaffeinated tea has actually been shown to help coughs in some medical studies. So that one’s worth a try, too.

Coughing season is upon us indeed, so let’s all pay attention to washing our hands (the very best means of prevention), notice the character of our children’s coughs and act accordingly, support them with every comfort measure we can, and have patience that we’ll all get through another winter. Here’s to coughing into our elbows, everyone!

dr-christinaDr. Christina Johns is a pediatrician and pediatric emergency physician who joins PM Pediatrics as their Senior Medical Advisor. As the face of this cutting-edge organization providing specialized pediatric urgent care, she is responsible for sharing the wealth of expertise of the PM Pediatrics staff with patients and families everywhere.

Disclaimer: Neither Mommy A to Z nor its creator, Meredith Hale, is a physician. The material in this post represents the views of the guest author, who is not an employee or affiliate of Mommy A to Z. Please always consult your child’s physician with any medical concerns you may have. 

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