Cough comes in many varieties. Loud, soft, wet, dry, staccato, barking, rumbling, high pitched, low pitched, constant, or intermittent. Most parents want to stop a cough quickly because the sound is disturbing and there is an assumption that cough is always a bad thing. In fact cough can be the body's defense against viral cold mucus settling into the chest and that is a cough that should not be eliminated. Sometimes a cough is very disturbing to the child - some cannot sleep, others throw up from the force of the cough, still others are in pain while coughing, and these are the times parents need advice to handle the situation. If your child has little or no fever (over 101F rectally is defined as fever) and she is over 2 months of age and is feeding well and mostly happy, a cough associated with a cold and runny nose or congestion is not one to "treat". This type of cough is the result of mucus dripping into the airway and chest and being expelled by the body's reflex action in order to protect itself. Let the cough be in this situation. If instead your child has high fever and a cough is painful it is time for that doctor visit. If a cough is worse at night, but not too disturbing to your child during the daytime, and there is no really high fever or misery (other than the lack of sleep) you may try to give your child a cough suppressant and a decongestant or anti histamine before bed (try these OTC medicines out during the daytime first to be sure your child doesn't have the unusual but annoying paradoxical reaction of agitation and sleeplessness from antihistamines - also check the dose carefully by knowing your child's weight). It is also helpful to "steam" your child before sleep by frequent short trips into the bathroom with the hot shower flowing to steam up the room. Do not stay longer than 5 minutes and keep the door ajar for the infant age group. Check with the pediatrician in the under 6 month old since too much steam can also be hard on the newborn lungs. Increase your child's fluids so that the mucus is well hydrated and easier to manage and elevate the child's mattress a bit so the flow of mucus is with gravity instead of pooling in the back of the throat when she lies down and making her cough constantly. A cough that is loud, wet, loose and rumbling is almost always a "good" cough particularly if the child is not feverish or in pain. Coughs that are unusual, muffled, wheezy or painful should definitely be "heard" by the doctor. Remember that most coughs bother our adult ears more than they bother our child and don't over react. Patience and fluids are usually all that is needed.

Some coughs are associated with seasonal allergies and not with classic cold symptoms. In some children, every fall or Spring brings with it an annoying and constant hacking cough. This is often the result of an irritant such as pollen, getting to the airways of an allergic type child and may even be the only symptom of a variant of asthma called "cough-variant asthma" or "reactive airways disease". There are inhaled medications that can be of great relief for these children and can be given even to toddlers in a passive mist form. Talk to your doctor about this since this cough is a sign of airway narrowing and although it is rarely dangerous it is very disturbing to the body and needs attention. Don't settle for keeping your child away from the great outdoors - all kids deserve to play outside and they can if we help them get comfortable. Cough and cold medicine will not do the trick here although some antihistamines might help a little at the expense of unwanted sedation. Not what children need.

There are coughs that come with more serious infections such as pneumonia, and of course this child will look quite ill, have high fever in almost every instance, and will need to be seen by the pediatrician for diagnosis and treatment, usually with antibiotics. An x-ray may be necessary. Don't worry about having given a cough medicine before going to the doctor - it doesn't matter - what the doctor is looking for can be found with or without the cough actually being present.

Description

The forceful expulsion of air produced by irritation of receptors in the airway. Often cough is repetitive and may have particular characteristic qualities such as dry or wet or barking or staccato. Some coughs are productive in that sputum is produced during the cough process. Others are so forceful that small blood vessels can rupture, resulting in bleeding. Cough can be the result of infection, allergy, tumor, asthma, smoke inhalation, and even nervous tension. The approach to treatment depends on the cause.

How it is spread?

Only coughs that are the result of infection can be transmitted to others. The infection spreads because the force of the cough distributes particles carrying the infection into the surrounding air and these particles are inhaled by others nearby leading to the next infection. Teaching children to cover their mouths when coughing and to stay at home until a cough is either resolved or has been identified as noninfectious is the best way to prevent spread. Good hand washing is also important since sput um can be spread from mouth to hand to hand to mouth.

Normal Course of Illness

Cough that is caused by infection will usually abate once the infection is controlled either with antibiotics in the case of bacterial infections or by the body's own immune defenses in the case of viruses. Some infections however can leave behind a persistent cough for many weeks that although not contagious can be quite disturbing. Coughs caused by allergens and inhalants generally resolve when the irritant is removed. Coughs of asthma resolve when the underlying asthma is treated. Asthmatics are particularly prone to coughing when exposed to allergens or smoke, as well as when exposed to infectious cough particles.

Treatment

The treatment of cough depends on the cause. Any cough can be suppressed with the use of strong narcotic medications however this is rarely needed and may even contribute to more serious developments such as pneumonia if the cough reflex is eliminated. Some coughs can be quieted with the use of coating agents that reduce the sensitivity of the cough receptors in the airway. Tea with honey is an example of this technique. If cough is caused by broncho spasm , as in the asthmatic cough, only the use of bronchodilators, sometimes with the addition of steroids can put an end to the cough. Bacterial causes of cough requires identification of the organism and the correct choice of antimicrobial agent (antibiotic).

When to seek help

When a cough does not stop and results in loss of sleep or appetite, a doctor's examination is warranted. Any cough associated with a high fever should be evaluated, sometimes requiring a chest x-ray to aid in diagnosis.