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Special Health Report: Your Kid's Cough

You can't sleep. All you hear from your child's room is that nasty cough, over and over again.

The good news: Coughs usually sound much worse than they are. "It's the body's way of clearing and protecting the airways from irritating mucus and other secretions," says Charles Shubin, M.D., director of the Children's Health Center at Mercy FamilyCare in Baltimore. In addition, coughs offer valuable clues about your child's illness.

Follow our guide to decipher what's trouble — and what's not — and which comforts and cures really work.

COUGH CLUES: A distinctive, shrill, dry, seal-like bark, which frequently starts in the middle of the night.
Other symptoms: Your child's illness is better during the day, worse at night. She may have a slight fever. In severe cases, your child may develop stridor, a harsh, high-pitched sound every time she inhales — similar to the noise kids make after a long crying jag.
Likely culprit: Croup, a contagious viral infection that causes the throat and windpipe to swell and narrow. It typically affects kids between 6 months and 3 years of age. (Older children and adults have wider windpipes, so swelling is less likely to affect breathing.)
What to do: Sit with your child in a steamy bathroom for five minutes; the humidity will help move mucus from her lungs and calm her cough. At night, bundle her up in warm pajamas, open her window and run a humidifier; the cold, moist air may reduce airway swelling. Call your doctor right away if her cough worsens or she's having trouble breathing. She may need medicine to reduce inflammation. Croup often runs its course in three to seven days.

COUGH CLUES: A wet cough without wheezing or fast breathing, day or night.
Other symptoms: Sneezing, runny nose, watery eyes and a mild fever (usually under 101.5 degrees Fahrenheit).
Likely culprit: The common cold, a viral infection of the nose, sinuses, throat and large airways of the lungs. Coughing usually lasts the entire length of the cold (about seven to 10 days) but can linger twice as long, with mild improvement each day.
What to do: Keep your child's nasal passages as clear as possible; congestion and postnasal drip worsen his cough. For babies and toddlers who can't blow their nose yet, use nasal saline drops and a bulb aspirator to suction a runny nose. An over-the-counter nasal decongestant may help children over age 2; ask your pediatrician for a recommendation. If your child's cough and stuffy nose persist for more than 10 days without improving, see your doctor. Your little one could have sinusitis (a bacterial infection often brought on by a cold) or another problem, such as asthma, allergies, pneumonia or enlarged adenoids, which can inhibit breathing.

COUGH CLUES: Dry, hacking coughing fits — as many as 25 coughs in a single breath. When your child inhales sharply, she makes a whooping sound.
Other symptoms: Before the cough starts, your child has a week of cold-like symptoms, possibly with a mild fever. In babies, mucus may bubble from the nostrils. In severe cases, a baby may have convulsions.
Likely culprit: Whooping cough, or pertussis, a highly contagious bacterial infection of the throat, windpipe and lungs. Children who haven't been immunized are most vulnerable. Babies routinely get shots at 2, 4 and 6 months, and boosters between 12 and 18 months and again between 4 and 6 years. Immunity wanes with age, so adults may carry pertussis and pass it on to a child.
What to do: Call a doctor if the cough worsens after a week. Babies usually are hospitalized to control the cough and have mucus suctioned from the throat. It's treated with antibiotics; the cough can last months.

COUGH CLUES: A phlegmy or wheezy cough often accompanied by fast or shallow breathing.
Other symptoms: Your child starts out with cold symptoms and may develop a fever up to 103 degrees. He's lethargic, and he wheezes when he exhales.
Likely culprit: Bronchiolitis, an infection of the lungs' tiny lower airways, called bronchioles. It is usually caused by respiratory syncytial virus (RSV) and most often occurs from late fall to early spring. Not to be confused with bronchitis, bronchiolitis is common. "Almost all kids will get a bout of it by age 3," says Susanna McColley, M.D., division head of pulmonary medicine at Children's Memorial Hospital in Chicago.
What to do: Call your pediatrician right away if your little one is struggling to breathe or is too irritable to eat or drink. Put a cool-mist humidifier in his room to help loosen mucus, and be sure he drinks plenty of fluids. Infants sometimes need to be hospitalized.

COUGH CLUES: A mildly hoarse, throaty cough that comes in frequent spells and can be wet or dry.
Other symptoms: Your child feels listless and complains that his throat is scratchy and sore, his head hurts, and the muscles in his back and legs ache. He also may have a runny nose, fever and nausea.
Likely culprit: Flu, a viral respiratory illness that's most common November through April.
What to do: Call your doctor if your child has a fever above 101.5 degrees, is throwing up, has diarrhea, or is uninterested in eating or drinking (your doctor will recommend steps to prevent dehydration). Give your child plenty of fluids, and use a humidifier to loosen congestion in his airways. Also, to ward off future bouts of the flu, ask your pediatrician about getting your child an annual flu shot in late fall. Experts recommend the vaccine particularly for babies 6 to 23 months of age, who are most susceptible to complications associated with the flu.

COUGH CLUES: A wheezy, crackly, persistent cough after your child eats. It worsens when she lies down.
Other symptoms: She may feel a burning sensation or may vomit or belch when swallowing. A baby might be fussy or be labeled colicky. Toddlers may develop wheezing and picky eating habits.
Likely culprit: GERD (gastroesophageal reflux disease), caused by a weak or immature band of muscle between the esophagus and stomach that lets acid flow back up. Sometimes the irritating juices enter the lungs, causing a cough.
What to do: See your doctor if the cough lasts longer than two weeks. He may recommend keeping your baby upright for at least 30 minutes after feedings and elevating the head of her mattress. Prescription medicine also can control GERD symptoms.

COUGH CLUES: A persistent cough, often wheezy or whistling, lasting longer than 10 days; it's worse at night, after exercise or after exposure to pollen, smoke.
Other symptoms: Your child is wheezing or has labored, rapid breathing.
Likely culprit: Asthma, a chronic condition in which small airways in the lungs swell, narrow, become clogged with mucus, and spasm, making breathing difficult. "Children with asthma, in essence, have sensitive lungs," says Mark Widome, a Parents adviser and author of Ask Dr. Mark.
What to do: In mild cases, a cough may be the only symptom. See a doctor for an accurate diagnosis. A family history of allergy, asthma or eczema can increase your child's odds of getting the disease.

Coughing actually can be good for kids: It helps loosen and clear phlegm from the respiratory tract. So before you give your child an over-the-counter medication, check out this info from Parents.

Cough Suppressant
Does it work? If your child's cough is keeping her up at night, a suppressant — which inhibits the cough reflex in the throat and windpipes — may help her sleep. Always ask your pediatrician before giving it to your child.

What you must know: Inhibiting a cough — especially a mucousy, lower-respiratory one — can actually exacerbate or prolong an illness. In addition, suppressants can cause drowsiness or overexcitement in some children.

Does it work? Not really. Studies have found that these products—which claim to thin mucus so it can be coughed up more easily — aren't really helpful.

What you must know: Many doctors recommend giving water instead.

Multi-Symptom Cold Reliever
Does it work? Yes and no. While it can help a child who is suffering from various symptoms (such as a cough, fever and sore throat) feel better, many doctors warn against giving children formulas that contain so many drugs, because there's a danger of overdosing if you combine them with another remedy, such as acetaminophen.

What you must know: They can cause side effects ranging from sleeplessness (common with antihistamines) to irritability (typical of decongestants) and hyperactivity.

Cough Drops
Do they work? Yes. They increase saliva production, which can soothe your child's throat and loosen his cough.

What you must know: Don't give them to children under age 4. Like hard candy, lozenges pose a choking hazard.

Acetaminophen and Ibuprofen
Do they work? Yes. Both lower fever and control pain; ibuprofen lasts longer.

What you must know: Ibuprofen can cause stomachaches or vomiting; it shouldn't be given to children under 6 months of age without a doctor's OK. In addition, check the ingredients of any other medications you give your child to make sure they don't also contain acetaminophen or ibuprofen.

If your child's been battling a cold or the flu for days — and his cough just isn't getting any better — he could have pneumonia. Here's what you need to know about this scary illness.

It's very common. About 4% of children under age 5 get pneumonia each year, and it's a common reason kids are hospitalized.

It sometimes follows another illness. Most of the time, a child's body can successfully fight off a cold or the flu. But in the case of pneumonia, the virus — or in some cases, bacteria — has managed to make its way into the lungs. Once there, the germs inflame the lung tissue and cause the air sacs to fill up with fluid and pus, making it more difficult for oxygen to get into the bloodstream.

Symptoms are similar to those of a cold. Look out for a lingering cough, fever, chills, wheezing, and labored or rapid breathing. In addition, watch to see if your child's nostrils flare — or if the skin between his ribs caves in — when he breathes. If you suspect your child has pneumonia, contact your doctor immediately.

All that coughing can leave your child with a sore, scratchy throat. Help him feel better fast, Parents says, with these Mom-tested tricks:

  • Push fluids. Keep your child's throat and mucous membranes moist — and help prevent dehydration — by encouraging her to drink lots of water, diluted fruit juices, ginger ale and electrolyte solutions.
  • Give a little cold comfort. Frozen desserts such as ice pops, sherbet and sorbet are a tasty way to numb an irritated throat.
  • Serve chicken soup. Studies show chicken soup contains anti-inflammatory substances that may ease cold and flu symptoms. The warmth also will soothe a sore throat with every swallow.
  • Gargle with salt water. If your child is 4 or older, have her gargle several times a day with a saline solution — 1 teaspoon of salt dissolved in 1/2 cup of warm water — to reduce inflammation.
  • Use a damp cloth. If your child's cough is accompanied by a fever, try laying a cool, damp cloth across his forehead and using another one to stroke downward on his arms and legs to dissipate the heat. (Stroking upward generates heat.)
  • Elevate her head. Keeping your child's head elevated as she sleeps will prevent mucus from clogging her nasal passages, which can aggravate a cough. If your child is older than 2, give her an extra pillow or have her sleep on her side or tummy. For a baby, place a pillow below the crib mattress to prop up the area where her head rests. (Never put a pillow directly in a baby's crib, because it can cause suffocation.)
  • Try a humidifier. A cool-mist humidifier can help keep your child's mucous membranes moist as he sleeps. Clean it daily to prevent bacteria or mold buildup.
  • Take care of her nose. A cough often goes hand in hand with an icky runny nose. Help soothe sensitive skin and prevent infection by applying petroleum jelly or an antibiotic ointment to your child's upper lip and around her nose.


Copyright©: 2005 Meredith Corporation.