Coughing is a common issue seen in the adolescent age group (children between 10-19 years of age). It could be due to various reasons such as an allergic reaction, pollution, and change in season, or any other infection. When any foreign material (also known as an allergen) enters the respiratory system, it produces a cough in order to get rid of it. Though coughing is a normal defense mechanism of your body, it can cause severe discomfort in children and hinder their normal/day-to-day activities. 

Coughing serves as a method for your child to clear his/her airways, get rid of mucous (a normal, slippery, and stringy fluid in the nose), or phlegm (mucous which is thicker than normal), or a lodged piece of food.

Children can have either dry (without mucous) or wet cough (with mucous). A wet cough is caused as a result of a bacterial infection that results in the production of mucous. 

While coughing is not a serious health problem, if your child’s cough lasts for more than 3 weeks (known as chronic cough), it can lead to certain respiratory problems. To treat or manage cough at the earliest, it is important to understand the various causes of cough in children, its symptoms, and diagnosis.

Common Causes of Cough in Children

1. Asthma (a condition in which your airways narrow, swell, and may produce extra mucous). Most children with asthma have cough as a symptom that is made worse by viral infections. Cough due to asthma mainly aggravates in the night in children and is associated with a wheeze (whistling noise while breathing, which occurs due to air being forced through a narrower passageway).

2. Postnasal drip, caused by allergic rhinitis (also known as hay fever) or a sinus infection (sinusitis) can produce chronic cough in children. 

The walls of your child’s nasal passages are coated with mucous membranes, which contain tiny hair-like cells that are responsible for the movement of mucous towards their throat.

When your child is down with a cold or an allergy, the membranes lining his/her nasal passages become swollen, inflamed and irritated. As a result, these inflamed tissues begin to produce more mucous, to flush out the allergen (any substance that is eaten or inhaled, such as dust, pollen, bacteria, virus, or pet dander) that causes the irritation. This build-up of mucous that drains down from your child’s nose into the throat is known as postnasal drip. 

3. Stomach and esophageal conditions. Sometimes, your child may cough when fluids and contents from the stomach move back up into his/her throat. This is called "reflux" and may occur silently. Your child may develop a hoarse voice and/or feel choking as a symptom. 

4. Viral infections (commonly in the form of a fever). After having a viral respiratory infection (caused by the spread of viruses), your child can have a cough that lasts for weeks. 

5. Bacterial infections. Bacteria sometimes can infect the lower airways and cause irritation and cough. 

6. Foreign bodies, such as toys and food, can be accidentally inhaled at any age, but most commonly occurs at ages two to four years. It can cause a cough for many weeks to months until the body is removed. 

7. Environmental irritants like exposure to tobacco smoke and other pollutants (smoke and exhaust from wood burning, air pollution and exhaust from vehicles) can lead to a cough.

Symptoms of Coughing

  • Having watery or dry eyes

  • Having a dry or a sore throat

  • Wheezing

  • Difficulty in breathing or talking

  • Nausea or vomiting

  • Trouble swallowing

  • Turning red or purple when coughing

  • Feeling sick or fatigued

  • Coughing blood in some cases

  • Having a temperature above 100.4° F 

Diagnosis of Cough in Children

  • If your child does not have severe symptoms, then no lab testing is required.

  • In case your child has a chronic cough, then an x-ray of his/her chest is required. 

  • In case your child has drooling (saliva flowing outside of your child’s mouth unintentionally), fever, and anxiety, an ENT specialist will immediately evaluate his/her epiglottis (a leaf-shaped flap of cartilage located behind your child’s tongue) for any lesions or diseases.

  • If your child has inhaled a foreign body, a chest CT (computerized tomography) scan might be needed. 

Treatment of Cough in Children

If your child has a daytime cough due to a viral respiratory infection, it doesn't need any specific treatment – it will go away on its own.

In case of a chronic cough, over-the-counter (OTC) mucous thinning agents such as cough suppressant medications can be prescribed by your paediatrician.

If you think your child may have asthma, make an appointment with a pulmonologist/allergist to get a correct diagnosis and to treat the disease.

Complications of Cough in Children

Very few children with cough experience complications. Usually, the complications are mild and easily treatable. Your child may become very sick, have rashes, accompanied by diarrhoea and vomiting.

Management and Prevention of Cough in Children

Cough can be prevented in children with various tips and home remedies. A few of them include:

1. Increase the general immunity of your child. Your child’s general immunity (complex biological systems that defend your child’s body from foreign substances) plays a major role in keeping his/her body free from diseases. If your child frequently falls ill, that means your child’s immunity is low. Proper diet and physical exercises can help in getting it back and keep your children away from infections that may cause a cough and cold. 

2. Vaccinate your child for whooping cough or diphtheria. 

  • Whooping cough, also known as pertussis, is a highly contagious respiratory infection that can be very serious, especially for newborns and young infants. It spreads through the air by infectious droplets and can cause severe coughing fits in infants and children.

  • Diphtheria is a serious bacterial infection that usually affects the mucous membranes of your child’s nose and throat that can block his/her airways. It spreads through infected respiratory droplets or through contaminated objects.

The DTaP vaccine is developed to protect your child against three serious diseases - Diphtheria, Pertussis and Tetanus (a disease that causes muscle stiffness and spasms in your child). 

Getting your child vaccinated at infancy will protect him/her from contracting these diseases and preventing a chronic cough. In case you have missed out on this vaccination for your child, talk to your paediatrician about the next steps. 

3. A face mask will protect your child from environmental pollutants. Due to increasing pollutants and other suspended particulate matter in the air, cough and allergies are more common in metro cities. If you live in a highly polluted area or in an area surrounded by construction or industrial activity, it is advisable for your child to wear a face mask, while stepping out. A charcoal coated face mask can also be given to children if they are allergic to dust. 

Discuss with your paediatrician as to which type of face mask will be best suited to protect your child from cough.

4. Avoid pollutants. Though it might be impossible, it is a good idea for your child to stay indoors during high pollution time, like in the afternoons and during the winter season to avoid frequent episodes of cough. Growing plants in your locality can help in reducing pollution. Use humidifiers and air purifiers at home to keep your house free from allergens found in the air. 

5. Give your child ginger and honey tea. Ginger and honey tea is an age-old home remedy to soothe your child’s irritated throat, which occurs due to excessive coughing. Boil about 20-40 grams of sliced ginger in water for nearly 5 minutes and then add honey. 

The anti inflammatory compounds in ginger will relax membranes in your child’s airways, which reduces coughing. Honey has antibacterial properties that help in moistening your child’s throat and preventing cough. 

6. Let your child take enough rest. Taking enough rest is essential for your child’s quick recovery. If he/she has excessive coughing, remember to elevate your child’s head with 2-3 pillows at night, to keep the head above his/her heart. Lying flat on the back can increase mucous buildup in your child and trigger a cough, especially during the night. An elevated position will reduce mucous buildup and relieve discomfort.

These are some self-practicing steps that you can go for if the intensity of your child’s cough is low, but if it worsens, you need to consult your peadiatrician for proper medications. Also, don’t ignore a prolonged cough, even if it is mild in intensity, as it can be a symptom of an underlying disease. 

Disclaimer: This article is written by the Practitioner for informational and educational purposes only. The content presented on this page should not be considered as a substitute for medical expertise. Please "DO NOT SELF-MEDICATE" and seek professional help regarding any health conditions or concerns. Practo will not be responsible for any act or omission arising from the interpretation of the content present on this page.