Thursday, March 27, 2008


Dangerous Condition: Choking

First, there is a very important - and dangerous - reason for coughing: something is stuck in the child's throat or windpipe.

If your child suddenly starts coughing and seems to have real trouble breathing, or starts grabbing their throat, it may mean there is a small object or a piece of hard food, such as a peanut, stuck in the windpipe.

If you suspect that your child is choking, have someone call 911 immediately!

Then, in children over the age of 1 year, you should perform the Heimlich maneuver.
Video: Heimlich maneuver

In babies, perform back blows and chest thrusts.
Photo: Giving back blows and chest thrusts

When to seek medical advice

If you are certain that your child is not choking, you should look to see if other serious symptoms are present.

See the doctor immediately or call 911 if:

  • Your child is less than 1 month old

  • He has an obvious breathing disorder that is not due to a blocked nose

  • He is having coughing spasms and passing out (loss of consciousness)

  • He has started to turn blue around the lips, mouth and fingernails

  • He is coughing up blood

  • He is less active than normal

  • He is having a seizure

  • He is undergoing treatment that reduces a body's immune defense, such as chemotherapy for cancer, and a fever

Make an appointment with your doctor today if:
  • Your child is vomiting or has chest pains

  • You suspect that your child may have asthma or an allergic reaction

  • You suspect that your child has a sinus infection

  • He has had a fever of 100ºF or higher for more than 72 hours

  • He is an infant in between the ages of 1-3 months and has been coughing for more than 72 hours

  • He has been suffering from increasing or persistent coughing for more than 3 weeks

Causes and Types of Cough

Video: The Doctor talks about Coughing

Children cough when the lining of their windpipe becomes irritated. This often happens when a child is sick, or when the body is trying to fight off an illness and makes lots of mucus - or phlegm.

Coughing is an important reflex because it removes the extra mucus and lets air flow more easily through the windpipe and into the lungs, which, in turn, helps the child to breathe.

A child's cough is often worse in the evening (or during the day with naps), especially when the child is lying in bed, because the mucus can collect in the back of the throat. Also, children tend to swallow the mucus, rather than spit it out (as most adults do).

Swallowing it can cause the child to have an upset stomach or to vomit mucus, especially when they have a coughing fit.

Coughing is normally a symptom of an respiratory infection, but it may also be caused by other respiratory diseases (like asthma ).

Children who are coughing will often have other symptoms, such as fever , runny nose or difficulty breathing .

Take note of your child's other symptoms because it can help you figure out the cause of your child's illness.

There are 4 distinct types of cough: a dry cough, a wet cough, a croupy cough, and a whooping cough. It is important to know what type of cough your child has, and what it might mean. Listen to the different types of cough by clicking on the links below, and compare them with your child's cough:

Once you have identified the type of cough your child has, click on the appropriate section to learn about possible causes, when to seek a doctor's advice, or to learn about home treatment.

Dry Cough

A dry, hacking cough is often caused by an infection of the upper respiratory tract (nose and throat), such as a cold or influenza . This type of cough usually gets worse in a warm room or after the child has gone to bed.

However, a dry cough may also be an early sign of an infection of the lower respiratory tract, such as with bronchiolitis , the inflammation of the smallest airways in the lungs, or pneumonia , which is inflammation of the lung tissue itself.

Other causes also include Asthma , which often first appears as a dry nighttime cough, and exposure to cigarette smoke or other similar irritants.

Croup Cough

Croup is a disease, commonly found in young children, that causes a harsh, barking dry cough (audio) , which can sound similar to a seal barking.

Children with croup have a swollen upper trachea (windpipe) which is usually caused by a viral infection. The swelling, which is beneath the vocal cords, causes the barking cough. A child with croup also may make a high-pitched sound (known as stridor) when breathing in.

Click here to hear an example of a child with stridor (audio) .

For more information about Croup and how to treat it, click here.

Wet Cough

A cough sounds "wet" because of fluid (secretions and mucus) found in the lower respiratory tract (windpipe and lungs). Listen to this example of a wet cough (audio).

Common causes of wet cough include infections and asthma. The coughing helps to remove fluid from the lower respiratory tract.

Older children can spit out this mucus, whereas younger children swallow it into their stomachs. Swallowing mucus can cause a child to have an upset stomach, and the mucus can later appear in the child's vomit or stool (poop).

Whooping Cough

If your child is having severe fits of deep, fast coughing, he may have the disease pertussis , also known as whooping cough.

Introduction to Whooping cough

At first, a child with whooping cough will have symptoms similar to an ordinary cold, but gradually his cough will become worse, especially at night. The frequent coughing fits generally have 5 to 15 staccato coughs in rapid succession, and after coughing, the child will breathe deeply, sometimes making a "whooping" sound (audio) .

The rapid coughing can lead to breathing problems and the child can look somewhat blue in the face due to the temporary shortage of oxygen.

If you suspect your child has whooping cough, call your doctor right away.

There is a vaccine available to prevent whooping cough, and children in the US receive it as part of their routine immunizations. However, even with the vaccination, it is still possible for children to develop a mild case of the disease.

Infants who have not been immunized are also be susceptible to infection as are adults and adolescents with low immunity. Non-vaccinated individuals can easily spread the infection to others.

Click here for more information on Whooping Cough and how to treat it.

Home treatment

If your child has a cough, you can try the following treatments:

  1. Give your child plenty to drink. This will prevent the mucus from thickening. Hot liquids or soups will ease the soreness and irritation in the chest and can loosen mucus as well.

  2. Let your child inhale humidified air (or air that has moisture in it). Water vapor can ease and reduce your child's coughing. This can be done in several ways:

    • Use a cool-mist humidifier in your child's bedroom

    • Run a warm shower in the bathroom with the door shut. When the room is filled with steam, sit in the bathroom with your child on your lap for approximately 10 minutes. You can read or sing to him so that he will be relaxed.

    • Hang a damp towel in your child's bedroom.

  3. If your child has a dry cough or a croup cough, let him inhale cool air. Breathing in cool air will reduce the swelling in the respiratory tract which will then suppress the coughing. You can do this in several ways:

    • Open the window so that your child can inhale cool, humid air. You could also take the child outside.

    • Take your child out for a drive with the car windows open.

    • Let the child inhale the vapor from an open refrigerator or freezer.

  4. Avoid exposing a child with a cough to cigarette smoke. This will aggravate the child's discomfort and make the cough worse.

  5. A child with a distinct dry cough should avoid exercise. Older children and youths will often notice their cough gets worse during physical activity.

  6. You can try giving your child over-the-counter cough medicines, but they are not that effective. There are two types of cough medications:

    • Expectorant cough medicines are supposed to help loosen mucus and can be given for a wet cough.

    • Cough-suppressant medicines inhibit the child's cough reflex and should only be administered in the case of a dry cough that affects sleep at nights. They should not be administered for a wet cough, because the cough is needed in order to expel the mucus, nor should they be given to children under 12 months old.

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