Patient education: Cough in children (The Basics)

What is a cough? — A cough is an important reflex that helps clear out the body's airways (the branching tubes that carry air within the lungs). Coughing also helps keep people from breathing things into the airways and lungs that could cause problems (figure 1).

It is normal for children to cough once in a while. But sometimes, a cough is a symptom of an illness or other condition.

A cough is called "dry" if it doesn't bring up mucus, and "wet" if it does. The sound of a child's cough can be different depending on if it is wet or dry. Some coughs are mild, but others are severe. A severe cough can make it hard to breathe.

What causes a cough? — In children, possible causes of a cough include:

●Infections of the airways or lungs – Often, a cough is related to the common cold. Other infections, including coronavirus 2019 (COVID-19), can also cause a cough.

●Having an object stuck in an airway

●Asthma – This is a lung condition that can make it hard to breathe.

●Other lung problems, including conditions that some children are born with

●Coughing out of habit – This type of cough usually goes away when a child is sleeping.

Should the child see a doctor or nurse? — Call the doctor or nurse if you live in an area where people have COVID-19. They will ask you questions about the child’s symptoms and whether they might be at risk. The doctor or nurse can also tell you if the child should get tested for the virus.

You should also see a doctor or nurse right away if the child:

●Is younger than 4 months old

●Is having trouble breathing, has noisy breathing, or is breathing very fast (figure 2)

●Gets a cough after they choked on food or another object, even if they choked on the object days or weeks ago

●Is coughing up blood, or yellow or green mucus

●Refuses to drink anything for a long time

●Has a fever and is not acting like themself

●Is coughing so hard that they vomit

●Has had the cough for more than 2 weeks and is not getting any better

Will the child need tests? — Maybe. The doctor or nurse will ask questions about the child's symptoms and examine them. They might do tests, depending on the child's age and other symptoms. There are different tests doctors can do to see what's causing a cough. The most common include:

●A chest X-ray

●Tests to check for an infection – For example, the doctor can use a cotton swab to take a sample from the inside of the child's nose or throat. Then they will do lab tests on the sample.

●Breathing tests – Breathing tests involve breathing hard into a tube. These tests show how the lungs are working. Most children 6 years old and older are able to do breathing tests.

●Bronchoscopy – This is a procedure in which a doctor uses a thin tube with a camera on the end (called a "bronchoscope") to look inside the child's airways. If the doctor finds an object stuck in the airway, they can remove it during this procedure.

Is there anything I can do to help the cough? — Yes. If the cough is from a cold, croup, or another infection, you can:

●Have the child drink lots of fluids

●Use a humidifier in the child's sleeping area

If the cough is from a cold or croup, you can also try running hot water in the shower to make steam. Sit in the bathroom with the child while they breathe in the steam.

There are certain things you should not do:

●Do not give over-the-counter cough and cold medicines to children, especially if they are younger than 6 years old. Cough and cold medicines are not likely to help, and they can cause serious problems in young children.

●Do not give aspirin to children younger than 18 years old. Aspirin can cause a life-threatening condition called Reye syndrome in young people.

How is a cough treated? — Treatment depends on the cause of the child's cough. For example:

●Some infections are treated with antibiotic medicines. If an infection is caused by bacteria, doctors can treat it with antibiotics. Antibiotics do not work on infections caused by a virus, such as the common cold.

●Asthma is treated with medicines that a child usually breathes into their lungs.

●If a child has an object stuck in their airway, the doctor can do bronchoscopy to look for it and remove it.

Doctors do not usually give children medicines that "suppress" or quiet a cough. These medicines don't usually work well, and they can have serious side effects in children.

More on this topic

Patient education: Cough, runny nose, and the common cold (The Basics)
Patient education: Acute bronchitis (The Basics)
Patient education: Asthma in children (The Basics)
Patient education: Pneumonia in adults (The Basics)
Patient education: Bronchiolitis and RSV in children (The Basics)
Patient education: Croup (The Basics)
Patient education: Whooping cough (The Basics)
Patient education: Giving your child over-the-counter medicines (The Basics)
Patient education: Coughing up blood (The Basics)

Patient education: Asthma symptoms and diagnosis in children (Beyond the Basics)
Patient education: Bronchiolitis and RSV in infants and children (Beyond the Basics)
Patient education: Croup in infants and children (Beyond the Basics)