What’s the cause of my child's cough?

During the winter season, coughs become more and more common.  The problem is, not all coughs sound the same.  With the varieties of cough, it is often important to identity what type of cough is occurring so we can ultimately identify the source and possible need for treatment. 

The first step in identifying the cough is seeing if this is a new cough or a chronic cough.  Some common causes of chronic cough are acid reflux, postnasal drip due to allergies, or asthma.  However, acute coughs usually occur suddenly, and often have some associated symptoms.  These types of cough may also require more immediately action from your healthcare providers.  Some of the acute cough causes are:

  • Croup – This viral illness is very common and often affects children less than 3 years of age.  The type of cough associated with croup is “barking” in nature due to the inflammation or swelling of the voice box and windpipe. 
  • Bronchiolitis – Bronchiolitis is another type of viral infection that affects younger children.   This type of cough is rapid in onset and is usually accompanied by a wheeze. 
  • Asthma Exaggerbation – This is another cause of cough that results in a wheeze.  In this situation, your child usually has known asthma that can worsen triggered by an allergy or an illness. 
  • Pneumonia – Children with pneumonia appear ill.  They will have a cough accompanied by a high fever, weakness, and sometimes a very fast breathing rate.
  • Influenza – Much like pneumonia, these children appear to be ill.  This is caused by a virus, but has similar symptoms like a high fever, fatigue, muscle aches, and an increased breathing rate.     
  • Pertussis – This is also called “whooping cough” due to the sound the child makes.  Children that have a cough for more than 2 weeks, have vomiting after coughing fits, and a mild fever may be suffering from pertussis.  This infection is on the rise and is extremely contagious.  This infection is usually not severe but can be very dangerous for the very young and the elderly.  Luckily, we have a vaccine to prevent this. 
  • Common cold – Unlike most of the causes above, the common cold is usually self-limited and does not require interventions except for supportive care.  The common cold usually causes a mild cough, a low-grade fever, and a runny nose.  Unfortunately, although not serious, coughs from the common cold and other similar viruses can last for weeks.

Most causes of cough are benign and are easily treated with supportive care, inhalation treatments, or antibiotics, if appropriate, as directed by your healthcare professional.  However, keep in mind, some cough “alarm signs” should warrant a more expedited appointment with your healthcare provider.  These signs are:

  • Shortness of breath
  • High fever (>102°F)
  • Ill looking appearance
  • Stridor (High-pitched sounds with inhalation)
  • Accessory muscle use (Children needing their neck and chest muscles to breath)

So with all this information what can we do?  First, make sure your children are up to date on their vaccines, epically against Pertussis and Influenza.  Make sure to seek immediate medical help if you notice any of the “alarm signs” associated with a cough.  Last but not least, don’t forget about common supportive measures.  At night use a cool mist humidifier, cool liquids or tea with honey in the daytime, and beware of cold and flu medication in children, as many are inappropriate based on age.


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