1. Holcomb, Susan Simmons ARNP-BC, PhD

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Why do children cough?

A cough is a healthy reflex that helps keep the airways in the throat and chest free from mucus, dust, and dirt. Coughs can be associated with colds, bacteria, or other viral illnesses such as influenza (the flu) and croup, which causes swelling of the voice box and windpipe. Coughs that don't go away may be a sign of more worrisome diseases, such as asthma and pneumonia, and even heart problems.


Is a cough "catching"?

It can be. Colds and the flu can be spread through droplets released into the air when someone coughs or sneezes, so coughing can spread certain illnesses. Teach your child to cough into his elbow or shoulder, rather than coughing into his hand or a tissue (and you should do the same). This way the virus won't get on his hands, where he can spread it to every object he touches.


How can I treat my child's cough?

Try these suggestions to reduce the irritation and swelling that trigger coughing.


Use a saline (saltwater) nasal spray or nose drops, available without a prescription, as often as needed to keep your child's nasal passages moist and reduce swelling. Keeping nasal passages moist will also help him breathe through his nose so he can sleep better at night.


Placing a cool-mist humidifier or vaporizer in your child's room can also keep nasal passages moist. Change the water daily and keep the humidifier clean so it doesn't blow bacteria, viruses, or dust into the air. Follow the directions for cleaning your humidifier or vaporizer.


Topical rubs containing menthol or eucalyptus may help tame a cough and open up nasal passages. Use these products only in children over age 2 and only on unbroken skin. After applying the rub as directed on the label, cover the area with loose clothing to keep your child from getting it on his fingers, then rubbing his eyes or putting his fingers in his mouth. If you don't think he'll keep his hands off the rub, don't use it.


Honey may also help relieve cough in children, but don't give it to a child younger than 1 year. The recommendation for honey is 1/2 teaspoon for children ages 2 to 5; 1 teaspoon for ages 6 to 11; and 2 teaspoons for ages 12 and up, once or twice a day. If you give honey to your child at bedtime, be sure to brush his teeth afterward.


Cough drops or lozenges may help soothe the throat in children age 4 and older. (Younger children may choke on them.) Don't give your child more cough drops or lozenges than is directed on the package.


Elevating the head of the bed or having your child sleep on an incline can help. Place 4-inch (10-cm) blocks under the legs at the head of the bed or, in the case of a crib, place hard books under the mattress. Don't try to elevate his head with pillows because he could suffocate.


Make sure your child drinks plenty of fluids. Drinking more fluids can prevent dehydration, help reduce fever, and loosen congestion.


Don't give your child over-the-counter cough and cold medicines unless your healthcare provider recommends them. They can be dangerous for infants and young children and should never be given to children under age 2. If your healthcare provider says you can give these medicines to an older child, be sure to carefully read and follow the directions on the label. Check the active ingredients and never give two or more medicines if they contain the same active ingredients. Choose products with child-resistant safety caps and use only the measuring devices that came with them. Understand that these medicines aren't a cure; they just treat your child's symptoms.


When should I call my child's healthcare provider?

Most childhood coughs are harmless, but you should contact the healthcare provider immediately if your child:


* has a cough that lasts more than 2 weeks (if he's younger than 3 months, a cough that lasts more than a few hours)


* has trouble breathing or his breathing is faster than usual


* has a blue or dusky color to his lips, face, or tongue


* has a high fever


* makes a whooping sound when he breathes after coughing or has a barking cough


* is coughing up blood


* wheezes when he exhales.