Childhood Coughs
What causes my child to cough?
There are a lot of different causes of coughs, but the most common cause of coughs is usually just a virus. Viruses are very common and you would think it is your normal cold that causes your child to cough. Indeed coughs are very interesting. In children, coughs often sound very phlegmy, very rattily and very loud. You may even, if you're holding their back, feel their chest rattling. But what often is happening is that their nose is stuffy and it's running in the back of their throat. This post-nasal drip causes them to choke and cough, and that resonates throughout their chest cavity causing that very resonant cough. So often it's just an upper respiratory infection, not necessarily in the lungs. That's probably the most common cause of a cough.
How do I treat my child's cough?
There's no good remedy for treating cough. It's usually just waiting it out and waiting for the virus to go away. Some viral coughs can last three to four weeks at a time. Of course you want to see your paediatrician if the cough is related to fever, or if the cough is causing your child problems breathing, or they really have had a persistent cough for a long time because you want the doctor to listen to their lungs and make sure they're not having a secondary infection. There are over-the-counter remedies. We've all seen the over-the-counter cough and cold medicines; Dimetapp, Robitussin, Triaminic. The truth is that these have never been proven to work well in children. The original ingredient that was in a lot of these, which is pseudoepinephrine, which helps with the runny nose and the congestion, they took out, and now they use an ingredient called phenylephrine, which is never proven in kids to be helpful. So, what I tell families is that there's really no proof that these medicines help. The best thing is really supportive care; maybe elevating their head at night to help that post-nasal drip, running a vaporizer or humidifier in the room to loosen up the mucus, going into a steamed up shower and, unfortunately, just riding it out.
How do I know if my child's cough is a serious problem?
I get concerned with cough if it is prolonged, it has been lasting several weeks, and it really is affecting their daily life. That is the time where we really should check the cough out and make sure there is nothing else that we are hearing in the lungs; no signs of pneumonia or bacterial infection, there is no wheezing or asthma which also can represent as coughing. We also need to work out if during these episodes of coughing, or in general, it looks like your child is working hard to breathe. You know that, not by the sound necessarily of the cough, or the congestion, but by looking at their chest. In a child who's working hard to breathe their chest looks like they are running a marathon. You see all the rib cage moving in, so you see all the little ribs. You may even see that their neck is caving in because they are really trying to force air and work hard. Whenever it looks like your child is working hard to breathe, that should be investigated immediately.
What is "croup"?
Croup is also a viral infection, and is caused by a couple of different viruses. Croup produces a very specific type of cough which they call a seal bark, or a dog bark cough, and it often gives you breathing called strider. This is when your upper airway collapses and you make a wheezing sound. Now croup can seem extremely scary, not just to doctors, but to parents. Croup often happens out of the blue, in the middle of the night, and it is scary when your child wakes up out of the blue, coughing like a seal and gasping for air. So the most important thing with croup is to stay calm.
How do I relieve my child's croup?
Croup is a virus, and the best thing for this is to go into a steamed-up bathroom, and then outside in the cold air. Being in the bathroom actually loosens up the mucus and the secretions, and the cold air opens up the upper airway. Because what happens in croup is this virus causes inflammation of the big airways that lead to the lungs, and it causes that big airway to shrink. So when you try to get air through it, that's why you sound like that -- that strider sound, and you bark like a dog. The cold airway opens it up.Now, if that doesn't work and your child is still having trouble breathing, that's the time you want to go to the emergency department. One of the first things they actually do in the emergency room is put a mask blowing cold air into your mouth, so it is helpful sometimes to try that first. Or when you get in the car, drive with your windows down, because a lot of times by the time you get to the emergency department, your child is all better.
How will my doctor treat my child's croup if it is a serious problem?
There are some other medications the doctors in the emergency room may use, such as steroids called Decadron, or nebulised treatments of medications that may help open up the upper airway, but that's for a doctor to decide. The most important thing is: stay calm. I know it's very scary. Go into the steamed up bathroom for a couple minutes, go outside in the cold air, and then re-evaluate. The other thing with croup is that it commonly causes extremely high fevers: one-o-three to one-0-five fevers. So, just like any other virus with fever, treat the fever with Tylenol or Motrin. Usually, it doesn't last more than 72 hours, and if anything is prolonged or you're concerned, talk to your paediatrician.
