Managing a Child’s Cough and When to Be Concerned

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Normal cough vs chronic cough

Cough is a protective reflex to clear secretions and particles from the airways. Coughs affects about 30% of children at any given time with majority occurring due to respiratory tract infections. Children less than 4 years have about 5-8 upper respiratory tract infections per year while children > 10 years of age have 2-5 respiratory tract infections per year. Coughs are expected to resolve in 1-3 weeks following most respiratory illnesses and managing a child’s a cough generally isn’t too difficult. Any cough lasting for > 4 weeks is abnormal and needs further evaluation.

What can cause a chronic cough? 

Infections

Allergic conditions such as asthma, hay fever

Inhaled foreign body

Enlarged adenoids and tonsils

Chronic infective lung conditions such as chronic bronchitis, cystic fibrosis, Immune deficiencies etc.

Recurrent aspiration from reflux, neurological causes, airway abnormalities and so on.

Cardiac causes

Irritants, psychogenic cough, medications

Things to look out for:

There is usually no need to panic if your child is coughing more than usual. But there are things to look out for which can help you figure out the causes. It’s also important to pay attention to the type of cough and watch for other symptoms.

Onset, duration

Wet or dry cough

Cough free periods

Barking, wheezing

Breathing or feeding difficulties

Triggers and relievers

Associated symptoms

Disappearance during sleep

Response to treatment

How to manage the cough: 

Managing a child’s cough depends on the type of cough it is, how distressing it is to the child and how concerning other factors seem to you.

For a dry cough; Wait and watch. 70 per cent of dry coughs will resolve on their own.

Avoid irritants. These include strong perfumes and sprays, cigarette smoke, dust and more.

Treat  the underlying cause of the cough, such as hay fever, asthma, sinus infections, reflux, bronchitis and more.

Further investigations and referral are needed when a cough is moist for up to and more than 4 weeks. It’s also needed when the cough stops responding to treatment, or when the child is having feeding difficulties and/or noisy breathing.

This article was written by Dr Ramaa Puvvadi. 

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