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Published on May 07, 2019

Your child is coughing. Should you be worried?

There are few things that will get a parent’s attention faster than hearing their child cough. But it’s important to know the difference between a cough that can be the sign of a serious illness and a standard-issue cough associated with a seasonal cold, said Amr Daia, MD, an inpatient pediatrician at Cape Cod Hospital.

The first thing to know is that a cough is an automatic or involuntary reflex. “A cough happens when the body is trying to keep the airway clear,” he said. “It’s not always a sign of a disease.”

The most likely cause of an ongoing cough, he said, is the common cold, which is a viral infection of the airways. Asthma is another common cause.

To determine the cause of a child’s cough, a pediatrician will want to know a few things, he said.

“For example, did this cough start very suddenly or did it start slowly and progress? Is it a dry cough or wet cough? A wet cough means it produces some mucus when you cough. And I want to know if the cough is associated with difficulty in breathing,” he said.

The sound of the cough can help your doctor make a distinction between different diseases, he said.

“For example, if a child has croup, it sounds like a dog barking. If a child has whooping cough, which is also called pertussis, the coughing comes in episodes, followed by a whooping sound.”

Pediatricians also make note of the amount of congestion, whether there’s a fever and whether any blood is coming up during the cough.

A common cold often comes with a hoarse cough, a mild fever and some nasal congestion, he said.

What You Can Do

“There are plenty of over-the-counter medications and decongestants, but they are not suitable for any kids under 6 years, and I don’t advise cough medication for anyone, either child or adult,” Dr. Daia said. “The cold will pass in time, and in the meantime, your child will need plenty of fluids. If he has a fever or seems uncomfortable, you can give him Tylenol. You also can use a humidifier at home or take him into the shower to breathe in some steam. For a child 1 and older, a teaspoon of honey at bedtime may help ease the cough.”

In some cases, coughing is a sign of an illness that requires medical attention, he said.

“Croup is an inflammation of the upper airways. Most of the time it produces a barking sound, which makes it easy for a pediatrician to diagnose it. That requires some anti-inflammatory medication."

“Pertussis or whooping cough is a bacterial infection, and most of the time it affects small children or babies because they are not vaccinated yet. See your pediatrician, as the child may need an antibiotic or even need to be observed in the hospital for a while.”

A coughing child should be seen by a doctor if you suspect croup or pertussis. Get help promptly if your child has difficulty breathing, if she’s coughing blood or yellow or green mucus, if she’s not able to drink or eat, or she has a prolonged high fever.

“Even if your child has a mild cough, if it’s been there for more than two weeks, the child should be evaluated by your doctor. If you’re concerned, don’t hesitate to contact your pediatrician,” Dr. Daia said.