Cough in Children
Introduction
Coughing is a natural reflex that clears materials from the airways and prevents them from reaching the lungs. This material can include particles inhaled from the environment or substances originating from the lungs and airways. The most common material expelled is sputum, a mixture of mucus, debris, and cells from the lungs. However, sometimes blood may also be present. Coughs that remove material are known as productive coughs. While older children and adults usually expel the material, younger children often swallow it. On the other hand, dry or nonproductive coughs do not bring up any material.
Coughing frequently prompts parents to bring their children to a healthcare practitioner. Therefore, understanding the different causes and treatments can help manage these symptoms effectively.
Causes of Cough in Children
The likely causes of a cough depend on its duration—less than 4 weeks (acute) or 4 weeks or more (chronic).
Common Causes of Acute Cough:
- Upper respiratory infections due to viruses.
Common Causes of Chronic Cough:
- Asthma
- Gastroesophageal reflux
- Postnasal drip
Less Common Causes of Acute Cough:
- Inhaled foreign bodies
- Respiratory infections like pneumonia, whooping cough, or tuberculosis
Less Common Causes of Chronic Cough:
- Inhaled foreign bodies
- Hereditary disorders like cystic fibrosis or primary ciliary dyskinesia
- Birth defects of the airways or lungs
- Inflammatory airway or lung disorders
- Stress-related (habit or psychogenic cough)
When to See a Doctor
Certain symptoms indicate that a child’s cough requires immediate medical evaluation. Therefore, it is essential to recognize these warning signs promptly:
Warning Signs:
- Blue tint to the lips or skin (cyanosis)
- Loud squeaking noise when breathing in (stridor)
- Difficulty breathing
- Ill appearance
- Spasms of uncontrollable, repetitive coughing followed by a high-pitched intake of air (whooping sound)
Children showing any of these warning signs should see a doctor immediately. Additionally, if parents suspect that their child inhaled a foreign object, they should seek prompt medical attention. For frequent, harsh, or barking coughs without warning signs, contacting a doctor within a day or so is advisable. On the contrary, generally healthy children with occasional coughs and cold symptoms may not need urgent medical attention. However, chronic coughs without warning signs should still be evaluated by a doctor within a few days to a week.
Evaluation by a Doctor
Doctors will ask about the child’s symptoms and medical history, then conduct a physical examination. Furthermore, details about the cough, including timing, triggers, sound, and accompanying symptoms, aid in diagnosing the cause. For example, nighttime coughs often suggest asthma or postnasal drip, while a sudden onset of coughing without other symptoms may indicate the inhalation of a foreign body.
For children aged 6 months to 6 years, doctors may inquire about the possibility of swallowing a foreign object or food. Additionally, they check for recent respiratory infections, allergies, asthma, or exposure to infections like tuberculosis.
Testing:
Doctors base testing on the child’s symptoms and suspected causes. For children with warning signs, they commonly use tests like pulse oximetry and chest x-rays. Moreover, chronic or worsening coughs may also require these tests. If symptoms clearly suggest a cause, doctors may start treatment without testing. However, persistent symptoms could lead to further tests.
Treatment of Cough in Children
Treatment focuses on addressing the underlying cause. For instance, doctors may prescribe antibiotics for bacterial infections or antihistamines for allergies. Home remedies, such as inhaling moist air and drinking extra fluids, are generally safe, although they lack strong scientific backing. For children over a year old, honey can sometimes help relieve cough symptoms.
However, doctors rarely recommend cough suppressant drugs for children due to potential side effects and the essential role of coughing in clearing airways. They usually discourage expectorants, which aim to thin and loosen mucus, as well.
Conclusion
By understanding these aspects of coughs in children, parents can make informed decisions about when to seek medical help and how to manage their child’s symptoms effectively. With appropriate care and attention, most coughs can be treated safely and efficiently. Consequently, recognizing the symptoms and seeking timely medical advice ensures the well-being of the child.
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