Cough in children

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The most common reason for coughing children is cold, but the problems can also be due to, for example, body or asthma. Coughing usually goes away by itself, although it can take several weeks. Sometimes the child needs treatment for what causes the cough or to reduce the discomfort.

Different types of cough

It is common for children to cough. Coughing is part of the body’s defenses and helps the respiratory tract to get rid of irritants. The cough also prevents the wrong things from getting into the lungs. Therefore, the cough should not be unnecessarily suppressed.

Colds and other viral infections are the most common causes of cough in children, but other diseases can also cause cough. Coughs that last for more than four weeks are often due to things other than infections. For example, the cough may be due to asthma.

The cough may also be due to things other than illness. Sudden and violent cough may be due to the baby having something in his throat. Cigarette smoke and other chemical substances in the air can irritate the respiratory tract and cause coughing.

The cough may sound different depending on what is causing it. For example, it can be dry, slimy, scaly, squeaky or peeking. The child can also cough more at different times of the day or at different types of activities. Often the child also has other symptoms, besides the cough. 

When and where should I seek care?

What determines whether you should seek care with your child is not just the cough itself, but how the child is doing otherwise. After a cold, the cough often continues for up to three weeks. If the child is feeling well otherwise, does not have a fever or breathing problems, you usually do not need to seek care.

Seek care at a health care center if the child has a cough and any of these symptoms:

  • The child has a fever for more than four days.
  • The child sometimes has wheezing.
  • The child has had a cough for three weeks which does not seem to subside.

Wait until it becomes every day if it’s a weekend.

If the child has a cough and one or more of the following symptoms, immediately contact a health center or  on-call clinic :

  • The child is very hungry, for example is not as contactable as usual, is uninterested in the surroundings or unable to eat.
  • The child has heavy breathing and sounds wheezing when inhaled.
  • The child is less than six months old and has coughs in connection with the cough.

If closed, seek care at an emergency room.

If it’s in a hurry

Call medical help immediately if any of the following are true:

  • The child is difficult to breathe and has blue lips.
  • The child has difficulty swallowing his saliva and swallows.
  • The child has got something in the airways, which they cannot immediately cough up.

What can I do for myself?

Coughing for a long time can be difficult, both for the child and for the parents. It can be particularly troublesome if the child coughs at night so that sleep is disturbed.

There are several things you can do yourself to relieve your child’s cough in case of a cold.

  • Make sure the child drinks a lot. Give the child what they like best, such as water, scallion, juice or cool tea. Breast-feeding children can breastfeed more often. Drinking makes the mucus less tough and easier to cough up. Hot beverages can feel lighthearted in the throat. Drinking properly has at least as good an effect as expectorant drugs.
  • Children who cough a lot at night may be helped by raising the head end of the bed. The easiest way is to bed with extra pillows. Put the pillows under the mattress and they won’t slip away.
  • The airways become extra dry and irritated if the baby is stuffy in the nose. This is because the child must breathe through the mouth. Then nasal drops at night can make it easier to breathe through the nose. At stores, there are various kinds of nasal drops and nasal spray. Some are decomposing. The kind you want to use depends, among other things, on how old the child is. Follow the instructions on the package carefully.
  • Cool and preferably humid air can help if the child has a body. You can open a window or dress the baby and go out for a while. Raising the baby to the lap can soothe and make it easier for the baby to breathe. The swelling in the trachea usually decreases as the child sits up. Read more about Krupp.
  • Make sure the child does not have to stay in smoky environments as smoke makes the cough worse.
  • Children can get a sore throat from coughing and, for example, having difficulty eating. Then you can give your child prescription pain-relieving medicines. Follow the instructions on the package carefully. If the child is under six months, you should contact the healthcare provider before giving the child any pain-relieving medication. Read more about non-prescription drugs for children here.

Honey is sometimes recommended to suppress a cough. Do not give children under one year honey. It may contain spores of a bacterium that can rarely form a gut in the intestines of children younger than one year.   

Doubtful if prescription drug cough helps

When children have a cough, it is important that they cough up mucus to clear the trachea. Therefore, taking drugs to suppress the cough is not good. Also, to dissolve the mucous no mucus-releasing drugs are needed; it is equally effective to drink a lot so that the mucus is thinned out.

According to several studies, non-prescription cough medicines have no proven effect. But some find that they help. There are non-prescription cough suppressants and expectorants to buy at the pharmacy.

Do not give cough medicine to children under the age of two or to children who have asthma without first asking their doctor for advice.

Causes of cough

Cough can be caused by many diseases.

Viral infections are common

A  cold is an infection caused by viruses. A common problem with colds is cough. In addition to coughing, the child often also has sniff, nasal congestion, sore throat, irritated eyes, and fever, although it does not need to be so high. During the first years of life, children can be pre-cold very often.

Often, the cold begins with an irritating dry cough, often called ret cough. Sometimes the infection causes more mucus to form in the airways and the reticulated cough becomes mucous.

A common cold goes by itself. However, the child can continue to cough for several weeks afterward.

RS viruses cause epidemics every year, mainly during the winter months. Older children usually suffer from problems similar to a common cold. However, children younger than two months, premature infants and children with heart or lung disease may have more severe problems.

The infection starts out as a common cold with sniff, cough, and fever. In the case of a more severe infection, the child gets more cough, more mucus is formed in the airways and the child gets breathing problems with quick, wheezing. For the youngest children, it can be so hard to breathe that they can’t cope with eating or drinking.

Whooping cough

Whooping cough is a contagious disease that most children are vaccinated against. Older children and adults may have whooping cough even though they have been vaccinated or have had whooping cough before.

Whooping cough is a serious illness for children younger than six months. Extra vulnerable are children under three months. This is because children under three months have not been able to get their first vaccine dose. Children between three and six months have received only one or two vaccine doses.

A typical whooping cough starts as a cold with cough and sometimes slight fever. Gradually, the cough gets worse and attacks. After a few weeks, the so-called kicks start. The child then coughs so intensely that it becomes difficult to breathe and can turn blue in the face. Most often, the attack ends with the child coughing or vomiting.

Croup

Some children get a croup in conjunction with colds, but children can also get a croup without first having any cold symptoms. Krupp is because the area below the vocal cords has become swollen due to a viral infection. This makes the air more difficult to pass.

Krupp gives a cough that sounds barking. The child also becomes a horse. When inhaled it can sound squeaky and hissing and sometimes the child has difficulty getting air. Usually, the trouble comes late at night, when the child has been lying down for a while. Krupp is most common in children up to three to four years, but can also occur in older children.

Pneumonia

Children younger than about three years of age get lighter pneumonia than older children. This is because the immune system of younger children is still not fully developed. Pneumonia can be caused by both bacteria and viruses.

Often, pneumonia in children begins as a common cold. Instead of getting better after three to four days, the child gets worse and gets a high fever. Often, but not always, they get more coughing. Breathing gets faster and it can sound stinky when the baby exhales. Sometimes breathing becomes more superficial and cautious.

Asthma and allergies

Coughing that does not pass may be a sign of asthma. If the child has asthma it is difficult to exhale and the exhalation can sometimes sound wheezing. For younger children, usually around one to two years, it can sometimes be so exhausting to breathe that they cannot cope with eating or drinking.

Children who have untreated asthma are more easily chilled. A cold, in turn, make asthma worse. Often the child has no problems during the day, except if they exert themselves physically. However, it is common with a lot of cough at night.

Children who are allergic to fur animals or pollen can sometimes get a protracted cough. Often, the child also has other allergy symptoms, such as nasal congestion, tingling, and itching of the eyes. 

Cough for other reasons

Sometimes coughing can be caused by the child getting something down in the airways. It can be, for example, small parts from toys or beads that are stuffed into the mouth and then inhaled. If the child cannot cough up what has stuck himself, you must try to get it up immediately.

Sometimes small pieces of food can end up in the child’s airways. There they can lie down and cause inflammation with prolonged coughing as a result. Then a doctor may need to pick up what is stuck. It is done under anesthesia. If the inconvenience is not so great, it may suffice for the child to receive anti-inflammatory drugs.  

Some children have extra sensitive trachea and therefore more often get a prolonged cough. For example, they react more easily to chemical substances in the air, such as cigarette smoke. If someone smokes near the child, it can prolong the cough.

Sudden coughing may be caused by the child’s breathing in gas that irritates the respiratory tract or chemicals such as lighter fluid or kerosene. The child then gets a strong cough, and so-called chemical pneumonia can develop within a few hours. It is treated in hospitals. The child may receive oxygen and perhaps cortisone. Sometimes other types of treatments are also needed.

A prolonged cough may also be due to gastroesophageal reflux. Then contents from the stomach to the esophagus leak. Occasionally, the stomach contents may overflow into the airways. It can cause the child to cough. Often, the trouble becomes worse when the children lie down.

Should the child stay at home?

A child who coughs, but who is nervous, fever-free and able to participate in various activities can go to open preschool, preschool or school as usual. But often the cough can get worse if the child runs or is very physically active.

A child who has a fever is tired and unable to stay home until the fever is gone and they feel good again. 

So you can reduce the risk of coughing

The cold virus spreads easily between children and it is difficult to prevent the child from becoming infected.

Here are some tips to reduce the risk of coughing:

  • Wash your hands frequently. It reduces both the risk of self-infection and the spread of infection.
  • Let the kids play outdoors when possible. This means that the children have less close contact with each other, while at the same time infectious agents are not spread as easily outdoors.
  • Children should not be exposed to tobacco smoke. The smoke causes the respiratory tract to become inflamed and it increases the risk of children getting prolonged infections. For children who have asthma, it is extra important that the home is non-smoking.
  • Children who have asthma or are allergic to fur animals should not have fur animals at home.
  • Children younger than six months may be more severely ill from certain infections. Try to avoid having close contact with people with cough, fever or other cold symptoms, if possible.

A child who has asthma or allergies may receive special medicines that are taken preventively at the beginning of a cold. They can make respiratory problems less prolonged.

Prevent children from inserting into the throat

When it comes to toys, there is often a marking that indicates the age for which the toys are intended. Following these recommendations can be a way to reduce the risk of children getting small parts of the trachea.

At bvc or at consumer advisers in your municipality, you can get a small cylinder for free to test if things are too small. The cylinder has a diameter of about three centimeters and is similar to a child’s throat. If the thing you are testing fits into the cylinder, it is dangerous for a small child.

Other small things that are at home can be dangerous if children put them in their mouths. For example, do not let nuts stand where the child can reach them.

Surveys

The doctor finds out more about the child’s cough. For example, you can answer questions about how long the child has been coughing. how the cough sounds, if the child coughs more at any time of day and if they have any other symptoms. The older the child is, the more they can tell themselves. 

The doctor examines the baby’s nose, throat and ears, listens to how the breath sounds and counts how many times the child breathes per minute. The doctor also listens to the baby’s heart and lungs with a stethoscope. Pneumonia, asthma, and body produce different sounds from the lungs.

Samples 

Blood tests may be needed to find out if the child has a viral infection or an infection caused by bacteria. Only bacterial infections can be treated with antibiotics.

Sometimes a bacterial sample may also be needed from the baby’s nose. It can happen that the doctor or nurse brushes with a cotton swab inside the nose.

X-ray 

Sometimes x-rays can be helpful to see if the cough indicates pneumonia. X-rays can also be used to see if the baby has had anything in the airways.

investigations 

In an allergy investigation, you get to answer different questions about what the child is allergic to and what problems they are having. This is often enough for the doctor to diagnose. Sometimes a so-called dot test or an allergy blood test may also need to be taken.

If the doctor suspects that the child has asthma, an asthma study is done. The child who is older than about three years and does not have such major problems is often examined by a doctor at a health care center. Children with more severe problems or younger children may be referred to a child care center. At the reception, there are various examinations that show how the baby’s lungs work.

More about cough

Coughing is not a disease but a symptom. The cough is a protective reflex that starts when something irritates the mucous membranes of the airways. In the mucous membranes, there are nerves that send signals from the brain to different muscles of the abdominal wall and the middle nerve. Then the baby starts to cough. By coughing up the mucus, the child gets rid of what irritates the airways and prevents it from getting into the lungs.

The fact that the cough continues for a while after a cold has passed is due to the fact that the mucous membranes are still sensitive.

If the child has an infection, the mucous membranes of the respiratory tract often swell. The trachea is quite narrow in children under six to seven years and therefore a small swelling can already make the air more difficult to pass. 

Affect and participate in care

You can seek care at any healthcare center you want throughout the country.

Children should be able to participate

There is no age limit for when a child can have an influence over their care. The child’s ability to participate in related to the child’s maturity.

The older the child, the more important it is for them to be involved in their care. In order to be active in the care and to make decisions, it is important that you as an adult and the child understand the information you receive from the care staff. Ask questions if you don’t understand.

You have the option of interpreting assistance if, for example, one of you has a hearing impairment 

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