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Cough

06 July 2018

A parent's guide to coughing

Dealing with a sick child can be stressful, but being clued up alleviates some of that anxiety.

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Parents often find themselves in the position of doctor when their children develop a cough. Deciphering your child's cough and its cause can create anxiety as no parent wants to see their little one sick and in pain.

However, if you are aware of the different coughs that children are vulnerable to and the symptoms that accompany them, it can make the stressful situation much easier to navigate. 

This guide should come in handy the next time your child wakes you up in the middle of the night sounding like a barking seal. 

Types of coughs 

There are four types of coughs that distinctly occur in children, from a dry cough to a whooping cough. It is important to know exactly what type of cough your child has so that you can treat it properly:

1. Dry cough 

A dry cough, often referred to as a hacking cough, is usually caused by an infection of the upper respiratory tract, for example in the case of a cold or flu. However, a dry cough can also be an early sign of an infection of the lower respiratory tract; this includes bronchitis and pneumonia. Other causes of a dry hacking cough include asthma and exposure to cigarette smoke. 

2. Wet cough 

A wet cough is caused by fluid secretions as well as mucus being present in the lower respiratory tract, i.e. the windpipe and lungs. What commonly causes a wet cough in a child is either an infection or asthma. The coughing removes the fluid from the lower respiratory tract. 

3. Croup cough 

Croup is a virus that results in the swelling of the airways. A croup cough is fortunately easy to spot, as it can be compared to the sound of a seal's bark. If it is in fact croup cough, your child will also make a high pitched squeaky noise when they breathe. The accompanying symptoms of a croup cough are similar to that of a cold, a runny nose and a fever. As the airways become swollen as a result of the virus, your child's voice may become hoarse, leading to the "barking" cough.

4. Whooping cough (pertussis) 

Whooping cough is an infection of the respiratory system, causing intense coughing spasms which results in a "whooping" sound when the child breathes after the coughing episode. Whooping cough often goes undiagnosed or is misdiagnosed in adults and children alike. The cough is often misdiagnosed as either bronchitis or asthma.

Treating the pesky cough

Once you have determined which cough your child is suffering from, the next step is treating it effectively.

The following treatments have been proven to be effective when combatting a child's cough:

  • Give your child plenty of fluids to drink, which will prevent any mucus present from thickening. In order to alleviate this, feed your child hot soups and liquids to ease the pain and irritation in their chest while simultaneously loosening the mucus. 
  • If possible, let your child inhale humidified air, which is air with a high moisture content. Water vapour has been proven to ease and reduce coughing.   

You can humidify the air in the following ways:

  • Use a humidifier in your child's bedroom.
  • Hang a damp towel in your child's bedroom.

If your child has a dry cough or a croup cough, let them inhale cool air. According to Pocket Book of Hospital Care for Children: Guidelines for the Management of Common Childhood Illnesses, breathing in cool air should reduce the swelling in the respiratory tract, which will help reduce the coughing.

You can provide cool air in these three ways:

  • Open up a window so that your child can inhale cool and humid air.
  • Take your child out for a drive while keeping the car windows down. 
  • Allow your child to inhale the air from an open refrigerator or freezer.

Whooping cough (pertussis) can be prevented by the DTaP vaccine; however, even with the vaccine, it is still possible for children to develop a more mild case of the disease. Infants who have not been immunised are also susceptible to infection.

Medication 

Over-the-counter medication is a treatment option as well. There are two types of cough medicines effective for children's coughs:

  • Expectorant cough medicines help loosen mucus in the case of a wet cough.
  • Cough-suppressant medicines help to stop the cough reflex in a dry cough that prevents sleep. These should not be taken when treating a wet cough since the cough is needed to clear mucus. 

When to visit the doctor 

While most coughs will clear up after a few days if treated correctly, some coughs, such as whooping and croup, can become more serious and might need medical assistance.

If your child has croup cough, head to the ER if symptoms such as a blue tongue or lips and stridor develop. Stridor is a rough, raspy, high-pitched sound when the child inhales. Steroid medications provided by a doctor will reduce inflammation safely and quickly.

If your child is under two years old, whooping cough can be life-threatening. While the infection isn’t as serious in older children, it is important that they are examined by a doctor. Antibiotics will shorten the infectious period to five days, but they will not significantly reduce symptoms once coughing spasms have started. 

Image credit: iStock 

 

Ask the Expert

Cough Expert

Professor Keertan Dheda has received several prestigious awards including the 2014 Oppenheimer Award, and has published over 160 peer-reviewed papers and holds 3 patents related to new TB diagnostic or infection control technologies. He serves on the editorial board of the journals PLoS One, the International Journal of Tuberculosis and Lung Disease, American Journal of Respiratory and Critical Medicine, Lancet Respiratory Diseases and Nature Scientific Reports, amongst others. Read his full biography at the University of Cape Town Lung Institute.

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