Find An Allergist / Immunologist   |   Pollen Counts   |   Journal of Allergy and Clinical Immunology   |   Annual Meeting    Site Map   Contact   Home    Search
Patients & Consumers Online Tools Find an Allergist / Immunologist Pollen Counts Diseases 101 Drug Guide Featured Resources » AAAAI Tips Brochures Topic of the Month Information Request Form Donate Now Constituencies » Patients & Consumers Contact Search by Condition (A-Z) Request a Speaker Smoke Free Homes Referral Guidelines Breakthroughs in Bioscience Other Resources En Español Just for Kids Seniors		Allergy & Asthma Advocate: Summer 2006 Cough in Children By Richard L. Wasserman, MD, PhD, FAAAAI Cough is the most common respiratory symptom for which patients seek medical attention. Cough protects the body by removing mucus and irritating particles from the respiratory tract. Coughing is a useful function and does not always mean there is a problem with your child. Normal children can cough 1 to 34 times a day and have coughing episodes lasting up to a couple of weeks. Coughing at night, after going to sleep, is frequently abnormal and may indicate the need for medical attention. Causes of cough in children include: Cough due to viral upper respiratory tract infection Coughs associated with nasal symptoms, with or without fever, are usually due to viral upper respiratory tract infections. This is the most common cause of cough in children. Healthy children can have up to eight viral respiratory infections with cough every year. This acute cough is usually due to postnasal drip (see below) and direct airway irritation by the virus. Medications may or may not be needed or helpful. Post-viral cough Children without asthma, allergies or sinusitis can have a cough after viral respiratory infection lasting for weeks. There is no specific therapy for this cough and it does eventually resolve. Cough suppressant medications can be tried but they are not often helpful. Nasal and sinus disease causing cough Nasal and sinus problems may cause drainage resulting in cough that can persist. Usually, other symptoms such as nasal congestion and runny nose are present, but sometimes the only symptom is cough. Allergic rhinitis (hay fever) is often the cause and tests for allergies may be helpful. Cough due to drainage is often worse around bedtime and on awakening. Irrigating or rinsing the nose when there are nasal symptoms is safe and often helpful for cough due to drainage. Cough as a symptom of asthma In children, cough is a very common symptom of asthma; with or without wheezing and shortness of breath. In some children, cough is the only symptom noticed by the child or parent. Typically, cough due to asthma worsens with viral infections, particularly at night, and by exercise, cold air and changes in weather. Cough due to asthma is treated with the same inhaled and oral medications used in all patients with asthma. Stomach and esophageal causes of cough In some children, chronic cough is due to GERD, a problem with the stomach and esophagus (food tube). This may be associated with complaints of chest or upper abdominal pain. Children often have trouble describing the discomfort. Sometimes, a hoarse voice or choking is an associated symptom of GERD. This cough occurs most frequently when lying down. In young infants, reflux and swallowing problems are a common cause of persistent cough, particularly when it occurs after eating. Other causes of cough include: Inhaled foreign body Small foreign bodies, such as a piece of a plastic toy or part of a peanut, hot dog or a hard candy can be accidentally inhaled, causing cough that can persist for weeks to months. The foreign body may or may not appear on an x-ray. "Habit" cough This is a persistent cough that has no physical cause. It occurs most commonly in children, adolescents and young adults. It occasionally persists after a simple viral respiratory infection. The cough typically is dry and repetitive or is a “honking” cough that usually worries parents and teachers much more than the child. Habit cough is absent at night after the child goes to sleep. Irritant cough Exposure to environmental tobacco smoke and other pollutants (smoke and exhaust from wood burning, air pollution and exhaust from vehicles) is associated with increased cough in healthy children and may worsen the cough associated with asthma or rhinitis. These substances should be avoided, particularly in children with asthma or rhinitis. Treatment Often, simple daytime cough after viral respiratory infections requires no specific treatment and typically resolves in one or two weeks. Call your doctor immediately if your child has shortness of breath or difficulty breathing. Effective treatments are available for most of the causes of cough described above. If your child’s cough is persistent or severe, contact your allergist/immunologist or primary care physician. The best way to approach cough is, find the cause and treat it! <back>
		© 1996-2008 · All Rights Reserved · American Academy of Allergy Asthma & Immunology