Cough

Symptom Definition

  • A cough is the sound made when the cough reflex suddenly expels air and secretions from the lungs.
  • A coughing spasm is > 5 minutes of continuous coughing.
  • Main cause: part of a cold, a viral infection of the large airway (viral bronchitis)
  • Other common causes: croup, asthma, allergic cough

See More Appropriate Topic

  • If barky cough and hoarseness, see CROUP
  • If previous diagnosis of asthma, see ASTHMA ATTACK
  • If wheezing but no previous diagnosis of asthma, see WHEEZING

Call 911 Now (your child may need an ambulance) If

  • Severe difficulty breathing (struggling for each breath, unable to speak or cry because of difficulty breathing, making grunting noises with each breath)
  • Child has passed out with coughing spasms
  • Lips are bluish when not coughing

Call Your Doctor Now (night or day) If

  • Your child looks or acts very sick
  • Your child choked on a small object that could be caught in the throat
  • Difficulty breathing (< 1 year old) not relieved by cleaning the nose.
  • Difficulty breathing (> 1 year old) present when not coughing
  • Lips have turned bluish during coughing
  • Child is aged up to 12 weeks with fever > 100.4°F (38°C) rectally
  • Severe chest pain, coughed up blood or wheezing

Call Your Doctor Within 24 Hours (between 9 and 4) If

  • You think your child needs to be seen
  • Continuous (nonstop) coughing
  • Age < 1 month old with any cough
  • Age 1 to 3 months with a cough for > 3 days
  • Earache or sinus pain/pressure is also present
  • Fever present > 3 days
  • Chest pain present even when not coughing

Call Your Doctor During Weekday Office Hours If

  • You have other questions or concerns
  • Coughing has kept your child home from school for 3 or more days.
  • Symptoms of nasal allergy are also present
  • Cough has been present > 3 weeks

Parent Care at Home If

  • Cough with no complications and you don't think your child needs to be seen

Home Care Advice for Cough

  1. Cough Medicine for Mild Coughs: Before the age of 1 use clear fluids (eg, water apple juice) to treat the cough.  After age 1, use 1/2 to 1 tsp of honey (or corn syrup) as needed as a homemade cough medicine. It can thin the secretions and loosen the cough. After age 4, use cough drops.
  2. Cough Suppressant for Severe Coughs: For coughs that interfere with sleep, school or work, use dextromethorphan (DM). See dosage chart. Do not use under 1 year old.
  3. Coughing Spasms: For coughing spasms, give warm fluids (apple juice). Expose to warm mist (e.g. foggy bathroom) Reason: both relax the airway and loosen up the phlegm (Avoid juice if < 4 months old).  Children > 4 years can suck on hard candy or cough drops (Reason: to coat the irritated throat). Also, have the child try not to talk or cough at these times.
  4. Vomiting: For vomiting that occurs with hard coughing, reduce the amount given per feeding (e.g. in infants, give 2 oz. less formula) (Reason: cough-induced vomiting is more common with a full stomach).
  5. Humidifier: If the air is dry, use a humidifier (Reason: dry air makes coughs worse).
  6. Fever Medicine: For fever > 102°F (39°C), give acetaminophen or ibuprofen.
  7. Avoid Tobacco Smoke: Active or passive smoking makes coughs much worse.
  8. Contagiousness: Your child can return to day care or school after the fever is gone and your child feels well enough to participate in normal activities. For practical purposes, the spread of coughs and colds cannot be prevented.
  9. Expected Course: Viral bronchitis causes a cough for 2 to 3 weeks. Sometimes the child coughs up lots of phlegm (mucus). The mucus can normally be gray, yellow or green. Antibiotics are not helpful. Coughing up mucus is very important for protecting the lungs from pneumonia.
  10. Call Your Doctor If
    • Difficulty breathing occurs
    • Wheezing occurs
    • Cough lasts > 3 weeks
    • Your child becomes worse or develops any of the "Call Your Doctor Now" symptoms