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Parent Care by Dr. Bart Schmitt,
Disclaimer
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New Users See Instructions
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A cough is the sound made when the cough reflex suddenly expels air and secretions from the lungs.
A coughing spasm is > 5 minutes of continuous coughing.
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Cause:
Most are part of a cold, a viral infection of the large airway (viral bronchitis). Other common causes: croup, bronchiolitis, asthma, allergic cough.
SPUTUM OR PHLEGM
- Yellow or green phlegm is a normal part of the healing process of viral bronchitis.
- This means the lining of the trachea was damaged by the viral infection and is being coughed up as new mucosa replaces it.
- Bacteria do not cause bronchitis in healthy children. Antibiotics are not indicated for the yellow or green phlegm seen with colds.
- The main treatment of a productive cough is to facilitate it with good fluid intake, a humidifier (if the air is dry) and warm chicken broth or apple juice for coughing spasms (if over age 1).
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See More Appropriate Topic (instead of this one):
- If previous diagnosis of asthma, see Asthma Attack
- If barky cough and hoarseness, see Croup
- If wheezing but no previous diagnosis of asthma, see Wheezing
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When to Call for Cough
Call 911 Now If:
Severe difficulty breathing (struggling for each breath, unable to speak or cry because of difficulty breathing, making grunting noises with each breath)
Child has passed out with coughing spasms
Lips are bluish when not coughing
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Call Us Now If:
- Your child looks or acts very sick
- Choked on a small object that could be caught in the throat
- Difficulty breathing (< 1 year old) not relieved by cleaning the nose
- Difficulty breathing (> 1 year old) present when not coughing
- Lips have turned bluish during coughing
- Birth to 12 weeks with fever > 100.4°F (38°C) rectally
- Fever > 105°F (40.6°C) at any age
- Severe chest pain, coughed up blood or wheezing
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Call Us Within 24 Hours If:
- You think your child needs to be seen
- Continuous (nonstop) coughing
- Age < 1 month old with any cough
- Age 1 to 3 months with a cough for > 3 days
- Earache or sinus pain/pressure is also present
- Fever present > 3 days
- Chest pain present even when not coughing
Call Us During Weekday Office Hours If:
- You have other questions or concerns
- Coughing has kept home from school for 3 or more days
- Symptoms of nasal allergy are also present
- Cough has been present > 3 weeks
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Home Care
(Read "When to Call..." first):
Cough Medicine for Mild Coughs: After age 1 year, use corn syrup 1/2 to 1 tsp as needed as a homemade cough medicine. It can thin the secretions and loosen the cough. After age 4, use cough drops.
Cough Suppressant for Severe Coughs: For coughs that interfere with sleep, school or work, use dextromethorphan (DM) which is present in most cough syrups. Do not use under 1 year old.
Coughing Spasms: For coughing spasms, give warm fluids (e.g. apple juice). Expose to warm mist (e.g. foggy bathroom). (Reason: both relax the airway and loosen up the phlegm). (Avoid juice if < 4 months old). Children > 4 years can suck on hard candy or cough drops. (Reason: to coat the irritated throat). Also, try not to talk or cough at these times.
Vomiting: For vomiting that occurs with hard coughing, reduce the amount given per feeding (e.g. in infants, give 2 oz. less formula). (Reason: cough-induced vomiting is more common with a full stomach).
Humidifier: If the air is dry, use a humidifier. (Reason: dry air makes coughs worse).
Fever Medicine: For fever > 102 F (39o C), give acetaminophen (e.g. Tylenol) or ibuprofen.
Avoid Tobacco Smoke: Active or passive smoking makes coughs much worse.
Contagiousness: Your child can return to day care or school after the fever is gone and your child feels well enough to participate in normal activities. For practical purposes, the spread of coughs and colds cannot be prevented.
Expected Course: Viral bronchitis causes a cough for 2 to 3 weeks. Sometimes the child coughs up lots of phlegm (mucus). The mucus can normally be gray, yellow or green. Antibiotics are not helpful. Coughing up mucus is very important for protecting the lungs from pneumonia. We want to encourage a productive cough, not turn it off.
Call Your Doctor If: - Difficulty breathing occurs
- Wheezing occurs
- Cough lasts > 3 weeks
- Your child becomes worse or develops any of the "Call Your Doctor…" symptoms
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