What does that cough mean?
A cough is one of those common things we tend to worry about as parents. You might be wondering, is it normal? What does that sound mean? Or has it gone on for too long? Let’s take a look at the different types of coughs, what they might mean and what you can do about it. So the next time you’re inevitably woken by a cough in the night, you can feel confident in knowing what steps to take next.
How’s it spread:
The main cause of a cough is generally a respiratory infection (there are a few exceptions, but that’s not the focus of today’s post). Kids can catch between 6-12 of these a year.. Yikes! They’re usually caused by a virus which means antibiotics won’t fix it. Coughs typically pass on their own, but unfortunately can occasionally linger for a good couple of weeks. This is typically normal and is often referred to as a post-viral cough.
If the cold is caused by a virus, the best prevention techniques we can use are:
Washing our hands
Not sharing eating utensils or water bottles
Cleaning surfaces, toys and high touch surfaces regularly
Encouraging your child to sneeze into a tissue then throw it in the trash
Types of coughs and what they might mean:
Dry or unproductive cough: An unproductive cough means the cough doesn’t bring up phlegm or mucous. It can be a sign the airway is irritated and inflamed. It might sound hacking, tickly, or raspy. Causes can range from allergies, a viral or bacterial infection or sometimes inhalation of a foreign body.
Wet or productive cough: This type of cough brings up phlegm and mucous. The phlegm can be located anywhere including the throat, nose, or airways. It may sound rattling, wet or congested. It’s most often caused by a virus or bacteria and is commonly seen in bronchitis and pneumonia.
Barking cough: A barking cough can indicate swelling in the upper airways and is associated with croup. If your child has croup, they may have a hoarse voice and sound a bit like a barking seal. The illness is caused by a virus and typically the cough gets worse at night. If you suspect your child has croup, it’s a good idea to take them to be assessed as sometimes the swelling may need a course of steroids.
Night time cough: There can be a few different reasons why a cough is more pronounced at night. The culprit is often a post nasal drip which is where excess mucous from the nose and throat drips down the back of the airway, causing irritation and triggering a cough. Another cause can be cooler air. At night the temperature drops which can lead to airway irritation and coughing. Although less common, asthma is something to consider with a night time cough, if you’re worried don’t hesitate to pop into your doctors office for a check.
Wheezing cough: A wheezing cough sounds like a high pitched whistling noise on exhalation. It can mean the airways are narrowed and inflamed and is a typical sign of asthma, however can also be triggered by allergies or a respiratory infection. If your child is often wheezy (especially when they run around) it might be a good idea to take them for a review with your doctor.
Home care:
If your little one is otherwise well and has no other concerning symptoms then it’s okay to care for them at home. With an acute cough (short term) there aren’t any recommended medications to treat it. The best approach is supportive care to keep your child comfortable.
Should we use cough medicines? In your local pharmacy you’ll likely see a lot of over the counter cough syrups aimed at kids. Current advice is to steer clear of these due to their lack of evidence and side effects. In fact, a number of cough medicines have recently been recalled because of their side effects. They can cause sedation and slowed breathing and are one of the biggest causes of accidental poisoning which is scary and definitely something to avoid.
So what can we use? If the cause is an upper respiratory tract infection, aka the common cold, then studies suggest honey as a useful treatment to soothe a throat and cough.
Honey: How much? 1-2 teaspoons before bed, it can be mixed with milk, water or given on its own. What type: plain table honey has been found to be just as effective as manukau to relieve a cough. For who: Honey is only recommended in children over the age of 1 due to the risk of botulism.
Nasal saline: Saline (either drops or spray) is a good way to help your child clear their congestion. The idea here is to reduce the likelihood of post nasal drip and airway irritation.
Hydration: Yes, that old chestnut - keeping your kids well hydrated will definitely help to keep them more comfortable. Hydration helps to loosen and thin the mucosal secretions, which allows your little one to clear their airway more easily when they cough.
Elevate your child's head: This is only relevant for older children whom aren’t at risk of SIDs. Elevating the head means the risk of post nasal drip is reduced leading to a reduction in coughing.
When to see a doctor:
If you’re worried or your child seems unwell, then it’s always good to take them to a doctor for a checkup. If you’re child has any of these symptoms, it’s best to visit a doctor that same day:
High fever
Not drinking as they usually would and less wet nappies
Is under the age of 3 months
Has a barking cough
You’re concerned something isn’t right
The cough has lasted more than a couple of weeks
When to call an ambulance:
If your child is having trouble breathing or showing signs of respiratory distress that’s considered an emergency and you need to call an ambulance.
Listening to your child's cough can be a good indicator of what's going on for them internally. Although it’s never your job to diagnose what's wrong, it's nice to have these little nuggets of health information somewhere in your head so you have an indication of what step to take next. Most coughs are caused by a minor illness and usually resolve on their own. However it's good to be vigilant and seek medical advice if your child's cough continues, changes, worsens or is accompanied by other worrying symptoms. As a parent, you know your child best and with these little bites of information, your instincts will guide you in seeking the right care at the right time for your child.
References:(2006). Cough in children: Definitions and clinical evaluation. Medical Journal of Australia, 184(8), 398-403. https://www.mja.com.au/system/files/issues/184_08_170406/cha10981_fm.pdf
Smith SM, Schroeder K, Fahey T. Over‐the‐counter (OTC) medications for acute cough in children and adults in community settings. Cochrane Database of Systematic Reviews 2014, Issue 11. Art. No.: CD001831. DOI: 10.1002/14651858.CD001831.pub5. Accessed 21 June 2023.
Cohen, H. A., Rozen, J., Kristal, H., Yaks, Y., Berkovitch, M., Uziel, Y., Kozer, E., Pomeranz, A., & Efrat, H. (2012). Effect of Honey on Nocturnal Cough and Sleep Quality: A Double-blind, Randomized, Placebo-Controlled Study. Pediatrics: Official Journal of the American Academy of Pediatrics, 130(3), 465-471. https://doi.org/10.1542/peds.2011-3075
The Royal Children's Hospital Melbourne (2020, August 1). Cough. Retrieved June 21, 2023, from https://www.rch.org.au/kidsinfo/fact_sheets/cough/#:~:text=Cough%20is%20a%20very%20common%20problem%20for%20children%2C%20and%20is,will%20not%20respond%20to%20antibiotics.