When my kids start to cough, my wife, my mom, my mother-in-law start to panic and push me to do something about it. Aiya, it's only a cough, why panic? But that's just because I have the necessary knowledge to discern between a dangerous cough and a benign (non dangerous) cough. So in this blog, I will share with you some points on how to handle your child who is coughing.
Why do kids cough?
Cough is important because it is the body’s way of clearing foreign objects and secretions from the respiratory tract. The cough itself is a symptom of an underlying disease and not the disease itself. Now, don't fall into the trap of assuming that treating a cough means giving cough syrups! If only life were so simple! The most important thing about treating a cough is to know the cause. Some coughs need to be treated with antibiotics, others may need to be treated with puffers (medication that is inhaled).
What are the common causes of cough in children?
A useful way to think about coughs is to divide them into into long term (more than 3 weeks) and short term coughs (less than 3 weeks)
Short term coughs
These are usually caused by infections or allergies. The infection may be isolated to the upper airways (ie the throat) or lower airways (the lungs). If the child is coughing and has a fever, it is advisable to bring her to the doctor to exclude pneumonia (lung infection). A child with a sore throat and a fever will need to be seen by a doctor.
Long term coughs
Some of the common conditions that can cause a long term cough are Asthma, Post Nasal Drip (this is when the mucous from the nose drips down to the throat and the child coughs to get rid of it) and Gastro-oesophageal reflux disease (When the stomach contents goes back up the food pipe.
When is a cough harmful?
The cough itself is not harmful. The important thing is to find out the cause of the cough. Conditions such as pneumonia and asthma which may have harmful complications if not treated early.
What tests should be done.
For any cough lasting more than 3 weeks, a Chest X-ray is advised to rule out important or uncommon causes for the cough like pneumonia, TB, developmental problems, inhaled foreign bodies and other diseases. Once the chest X-ray is shown to be normal, the most likely remaining causes of a long term cough are post-nasal drip syndrome, asthma and reflux disease.
Allergic Rhinitis/Post nasal drip syndrome
These children typically wake up coughing in the morning to clear the throat. They may frequently be having a runny nose but without a fever. You should approach your doctor who may assess the child and prescribe preventive medications.
These children may have an audible wheeze and be very short of breath after exercising. They may also wake up coughing in the middle of the night with an incessant cough. Asthma affects one in five children in Singapore so it is quite a common condition. When properly treated, the child should be able to function like any normal child.
You should be suspicious of Asthma if
- There is a family history of Asthma
- The child has eczema (sensitive skin) or allergic rhinitis (sensitive nose)
- Cough incessantly in the middle of the night
- Gets very short of breath when excercising
Gastro-esophageal Reflux Disease
The child may complain of abdominal discomfort and may have reflux of milk after feeds. A trial of anti reflux medication for 2 weeks may alleviate the symptoms of cough.
The 100 Day Cough
There is a common saying amongst Singaporeans about the 100 day cough. This is a cough that follows a throat infection which may last up to 8 weeks. The important thing to note is that you should only conclude that the cough is a 100 day cough when all the other important causes of the cough has been eliminated.
OK, I hope that is enough information for the meantime. This is in no way complete and you may want to refer to these articles for more information:
Your Child's Cough
Patient information on Asthma
Always check with your doctor if you are in any doubt!