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Decoding the Cough in Babies & Toddlers
by Kathleen Roberts

Cough in babies and toddlers can be distressing for any parent. How do you know what your child's cough means? Should you see a doctor? Do you need to worry or just wait it out? All of these are important questions so knowing the answers ahead of time will save you time and possibly unnecessary worrying.

Cough and the Common Cold

You know how annoying it is to have a cold. Imagine how much more so it is for your child. You can take nearly any over-the-counter medicine you want for relief of your symptoms. Your child has very limited choices, especially now that cough medicines have been found to pose a risk to children under six years old.

If your child has a cold, he likely has a dry, hacking cough. There may be a little bit of rattling in his chest due to mucus. He'll also have a runny or stuffy nose, sneezing, watery eyes, reduced appetite and possibly a low-grade fever.

In most cases, a cold will clear up on its own. Just provide your baby with plenty of fluids and rest. It is also helpful to soothe his little nose with saline drops and ease his congestion with a rubber bulb syringe. A cool-mist humidifier can be helpful as well.

In some cases a cold can turn into something a bit more serious. If your child runs a fever of 100 degrees for three days (or a higher fever of 103 for just one day) this could indicate that he has the flu. He may also have an ear or sinus infection. See your doctor if your baby has a fever, if he has yellow discharge from his eyes or if he has a green mucus discharge from his nose for more than two weeks.

If the cough last more than a week, your child refuses fluids, or if the cough causes him to vomit or has blood in the expelled mucus, see your doctor as soon as possible.

Asthma and Bronchitis

The cough you'll notice with asthma and bronchitis is very similar. It may be accompanied by wheezing and noisy breathing as airways tighten. People of all ages can get bronchitis but in infants, bronchiolitis is usually the problem.

Asthma can cause coughing, especially at night. An asthma attack needs to be treated immediately with medicines that your doctor will prescribe. These can include prescriptions that will stop an attack as well as other medicine that will help prevent an attack. If you suspect that your baby is having an asthma attack and you do not have any medications for her, call 911 or get to an emergency room as quickly as you can

If your family has a history of asthma, there is nothing you can do to prevent your baby from developing it too. However, you can delay the development and help prevent attacks. Avoiding possible triggers goes a long way toward prevention. If your child has allergies you should consider seeing an allergist for help. Eliminate allergy triggers such as smoke (from cigarettes and the fireplace), dust mites, animal hair and mold. Air pollution and over-exertion can also trigger an attack.

Bronchiolitis is typically caused by a virus called the Respiratory Syncytial Virus, or RSV. Because this is a virus, antibiotics are of no help. However, it can be dangerous so always see your doctor in order for the condition to be evaluated and monitored.

Cough from bronchiolitis is similar to asthma but it usually includes fever and loss of appetite. As with a cold, the best treatment is rest, fluids and a cool-mist humidifier that is cleaned daily.

Croup

Croup is a very common childhood ailment that is often contagious. It is easy to recognize by the characteristic cough. Your child will sound like a seal barking. Other symptoms can include a low fever, high-pitched wheezing when breathing and possibly labored breathing.

Usually croup will clear up on its own in a week or so. Many parents find that cool air eases their baby's symptoms. Use a cool-mist humidifier or take your baby outside on a cool evening for a few minutes. Some parents will even slightly open the window in their child's room at night. Another method that can help is to run the shower until the bathroom gets steamy. Sit with your baby in the steam-filled bathroom for 15 to 20 minutes allowing him to sit upright while he breathes in the steam.

See a doctor or call 911 immediately if your baby struggles to breathe while he is sleeping or if he starts to turn blue. Severe cases of croup may need to be treated in the hospital with oxygen. Less severe cases may be treated with mild steroids. Consult your doctor before giving your child any fever-reducing medicine such as acetaminophen or ibuprofen. Don't be surprised if your child gets croup repeatedly. Some children just seem to be prone to it and tend to get it often.

The Flu

The cough that may accompany the flu is similar to when you child has a cold—a dry cough. The difference is that your child will likely have a fever, vomiting and possibly diarrhea. Like a cold, the flu is also similarly treated with fluids and rest.

If your baby refused fluids, runs a high fever of 100 degrees for three days or 103 degrees for a day, or if she is struggling to breathe seek medical help immediately. She can get dehydrated easily and she may have more serious problems.

GERD

Gastroesophageal Reflux Disease, or GERD, is actually fairly common in infants. Usually it isn’t serious and often they outgrow it within a year. However, there are cases that can be more severe. Symptoms include frequent cough, frequent hiccups, spitting up, poor appetite, poor sleep and irritability during feedings.

Often some simple changes can help your baby deal with GERD. Try keeping him sitting upright during feedings and don't forget to burp him. You can also elevate the head of his crib to help his food stay where it belongs when he is sleeping. Smaller feedings given more frequently can also help.

Call your doctor if you see that your child is losing weight or if he has problems swallowing. A sore throat, respiratory problems such as bronchiolitis, or sinus or ear infections are also reasons to see a doctor.

Whooping Cough

Pertussis, or whooping cough, is a very serious illness. It has been increasing in frequency since the 1980s and has been found to be transmitted to babies from their parents, who show no symptoms, in many cases.

It is characterized by loud, frequent, violent coughing spasms. Other symptoms include the tongue sticking out, bulging eyes and discoloration of the face. If your child exhibits symptoms of whooping cough, call 911 immediately. Oxygen will be needed during the coughing spasms. Your doctor may prescribe erythromycin to the entire family and you can expect it to take several months to recover.

There are many different types of coughs, some serious and some not as serious. Educate yourself so you can recognize the need for medical attention if the need should arise.