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 airways include the windpipe, or "trachea," and the bronchi, which are the 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 disease 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.

Will the child need tests? — Maybe. If your child sees a doctor for their cough, the doctor will do an exam and ask about the child's symptoms. They might do tests, depending on the child's age and other symptoms.

There are different tests that doctors can do to see what's causing a cough. The most common include:

●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.

How can I care for my child at home? — If the cough is from a cold, croup, or another infection, you can:

●Have the child drink plenty of fluids. Warm liquids like tea or soup can help, if the child is old enough.

●If the child is older than 1 year, a small spoonful of honey might relieve their cough and help soothe their throat. Do not give honey to babies younger than 1 year.

●If the child is older than 4 to 5 years, sucking on lozenges or hard candy might help.

●Use a cool-mist humidifier in the child's sleeping area.

●Keep your child away from smoke and places where people might be smoking.

If the cough is from croup, you can try running hot water in the shower to make steam. Sit in the bathroom with the child while they breathe in the steam. Some people also find that it helps to have the child breathe outdoor air if it is cold out.

There are certain things that 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 or COVID-19.

●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.

When should I call the doctor? — Call the 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 themselves

●Is coughing so hard that they vomit

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

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: Spirometry (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)