Cough

Description

A cough is the sound made when the cough reflex suddenly expels air and secretions from the lungs. A coughing spasm is > 5 minutes of continuous coughing.

Cause

Most are part of a cold, a viral infection of the large airway (viral bronchitis). Other common causes: croup, bronchiolitis, asthma, allergic cough.

Sputum or phlegm:

Yellow or green phlegm is a normal part of the healing process of viral bronchitis
This means the lining of the trachea was damaged by the viral infection and is being coughed up as new mucosa replaces it
Bacteria do not cause bronchitis in healthy children. Antibiotics are not indicated for the yellow or green phlegm seen with colds
The main treatment of a productive cough is to facilitate it with good fluid intake, a humidifier (if the air is dry) and warm chicken broth or apple juice for coughing spasms (if over age 1).

See More Appropriate Topic (instead of this one)

If barky cough and hoarseness, see Croup
If previous diagnosis of asthma, see Asthma Attack
If wheezing but no previous diagnosis of asthma, see Wheezing

Call 911 Now If:

Severe difficulty breathing (struggling for each breath, unable to speak or cry because of difficulty breathing, making grunting noises with each breath)
Child has passed out with coughing spasms
Lips are bluish when not coughing

Call Your Doctor Now If:

Your child looks or acts very sick
Choked on a small object that could be caught in the throat
Difficulty breathing (< 1 year old) not relieved by cleaning the nose
Difficulty breathing (> 1 year old) present when not coughing
Lips have turned bluish during coughing
Birth to 12 weeks with fever > 100.4°F (38°C) rectally
Fever > 105°F (40.6°C) at any age
evere chest pain, coughed up blood or wheezing

Call Your Doctor Within 24 Hours If:

You think your child needs to be seen
Continuous (nonstop) coughing
Age < 1 month old with any cough
Age 1 to 3 months with a cough for > 3 days
Earache or sinus pain/pressure is also present
Fever present > 3 days
Chest pain present even when not coughing

Call Your Doctor During Weekday Hours If:

You have other questions or concerns
Coughing has kept home from school for 3 or more days
Symptoms of nasal allergy are also present
Cough has been present > 3 weeks

Home Care (Read "Call Your Doctor…" first):

Cough Medicine for Mild Coughs

After age 1 year, use corn syrup ½ to 1 tsp as needed as a homemade cough medicine. It can thin the secretions and loosen the cough. After age 4, use cough drops.

Cough Suppressant for Severe Coughs

For coughs that interfere with sleep, school or work, use dextromethorphan (DM) which is present in most cough syrups. Do not use under 1 year old.

Coughing Spasms

For coughing spasms, give warm fluids (e.g. apple juice). Expose to warm mist (e.g. foggy bathroom). (Reason: both relax the airway and loosen up the phlegm). (Avoid juice if < 4 months old).

Children > 4 years can suck on hard candy or cough drops. (Reason: to coat the irritated throat). Also, try not to talk or cough at these times.

Vomiting

For vomiting that occurs with hard coughing, reduce the amount given per feeding (e.g. in infants, give 2 oz. less formula). (Reason: cough-induced vomiting is more common with a full stomach).

Humidifier

If the air is dry, use a humidifier. (Reason: dry air makes coughs worse).

Fever Medicine

For fever > 102°F (39°C), give acetaminophen (e.g. Tylenol) or ibuprofen.

Avoid Tobacco Smoke

Active or passive smoking makes coughs much worse.

Contagiousness

Your child can return to day care or school after the fever is gone and your child feels well enough to participate in normal activities. For practical purposes, the spread of coughs and colds cannot be prevented.

Expected Course

Viral bronchitis causes a cough for 2 to 3 weeks. Sometimes the child coughs up lots of phlegm (mucus). The mucus can normally be gray, yellow or green. Antibiotics are not helpful.

Coughing up mucus is very important for protecting the lungs from pneumonia. We want to encourage a productive cough, not turn it off.

Call Your Doctor If:

Difficulty breathing occurs
Wheezing occurs
Cough lasts > 3 weeks
Your child becomes worse or develops any of the "Call Your Doctor…" symptoms

Seattle Children's provides healthcare for the special needs of children regardless of race, sex, creed, ethnicity or disability. Financial assistance for medically necessary services is based on family income and hospital resources and is provided to children under age 21 whose primary residence is Washington, Alaska, Montana or Idaho.