Coughing is a normal protective reaction to irritation of the throat or lungs. In babies under 6 months, coughs are unusual and can be a sign of a serious lung infection if the child is also unwell. In older children, the vast majority of coughs are due to minor infections of the throat or upper airways, such as colds. A runny nose can cause a cough, particularly at night as fluid drips down the back of the throat and causes irritation. A cough at night, even if it is not accompanied by wheezing, can be a symptom of asthma, and you should consult your doctor if you are concerned.
Warning
Danger signs Call an ambulance if your child is coughing and he or she develops any of the following symptoms:
Abnormal drowsiness
Blue-tinged lips or tongue
Inability to speak or make sounds
1Did your child's cough start suddenly within the last few minutes or hours?
Possible cause Your child may be choking on an inhaled foreign body.
Action While waiting for help to arrive, follow the first-aid measures for choking. Once in hospital, your child will be examined and any foreign body will be removed. This may involve your child having a general anaesthetic.
13Call your doctor now
Possible cause Your child may have inhaled a foreign body, such as a bead. The object may have lodged in an airway, causing severe irritation.
Action Your doctor will examine your child and may arrange for a chest X-ray. If a foreign body is lodged in an airway, your child may need to go into hospital for the object to be removed, possibly under general anaesthesia.
14Call your doctor now
Possible causes Bronchiolitis, a viral infection of the small airways in the lungs, or pneumonia, infection of the air spaces in the lungs, are possibilities.
Action Your doctor will examine your child and may arrange for him or her to have an X-ray or go to hospital for tests and monitoring. Treatment may include giving oxygen and antibiotics.
15
Possible causes Noisy or rapid breathing in a child may be the result of a potentially serious lung problem.
Possible cause Coughing under these circumstances is likely to be due to asthma. Consult your doctor.
Action Your doctor will examine your child and may assess his or her breathing (seeMeasuring peak flow rate). If the results indicate that your child has asthma, the doctor may initially prescribe bronchodilator drugs. These may be given via a pressurized inhaler. Small children will need a face mask to help them inhale the drugs effectively.
17
Possible cause Even though your child has been immunized, a mild attack of whooping cough (pertussis), an infectious disease that causes bouts of coughing, may be the cause. The infection is much less serious in children who have been immunized than in those who have not. Consult your doctor.
Action Your doctor will probably prescribe antibiotics for your child to reduce the chance of him or her passing the infection on to others. Coughing may persist for several weeks, but symptoms are rarely severe enough for the child to need hospital admission.
18See your doctor within 24 hours
Possible cause Your child may have whooping cough (pertussis), an infectious disease that causes bouts of severe, uncontrollable coughing.
Action Your doctor will probably prescribe antibiotics to reduce the chance of your child passing the infection on to others. If the condition is severe, your doctor may send your child to hospital for treatment. Episodes of coughing may persist for several months. Severe cases of whooping cough, which are more likely in children aged under 1 year, may result in permanent damage to the lungs.
19
Possible causes Your child may have enlarged tonsils or adenoids, which can block the airway. Consult your doctor.
Action Your doctor will examine your child and may arrange for hearing tests or refer your child to a specialist. In some cases, removal of the tonsils and/or adenoids is advised, although symptoms often improve as the child grows up. Adenoids rarely cause a problem in children over 8 years.
20
Possible cause Perennial allergic rhinitis may be the cause. In this condition, an allergic reaction to substances such as house dust, animal fur, or mould spores causes symptoms all year round.
Action If you think you know the trigger for your child's allergy, try to limit his or her contact with it. Antihistamines, which are available over the counter, may provide relief. If these do not help, consult your doctor, who may prescribe alternative drug treatment.
21
Possible causes A common cold or other viral infection is a possibility. However, if a rash also develops, your child may have measles. This is especially likely if he or she has not been vaccinated against measles.
Possible cause and action A smoky atmosphere and smoking itself will irritate a child's throat and lungs, causing a persistent cough. If your child has begun to smoke, you should persuade him or her to stop. The longer he or she smokes, the more difficult it will be to give up. If family members continue to smoke, they should avoid smoking in the home.
23
Consult your doctor if you are unable to make a diagnosis from this chart.
Self-Help Relieving a cough
Relieving a coughing fit in a young child Sit your child on your lap and gently pat his or her back in order to loosen any sputum.
If your child has a troublesome cough, you may find one or more of the following measures helpful in providing relief:
Give your child plenty of warm drinks.
Moisten the air in your child's room by hanging a wet towel in front of a radiator, placing a bowl of water in the room, or by using a humidifier.
An older child may cough less during the night if he or she sleeps propped up on two or three pillows.
Family Doctor Health Advisor is for information purposes only, and is designed as a general reference and catalyst to seeking further information.
The RACGP is not engaged in providing medical or other advice or services, and is not responsible for the results of any actions taken by any person on the basis of any information in this publication, or for any error in, or omission from, this publication.
Publication Date: 31 March 2009 Authorised By: RACGP
