Health and safety

Decoding coughs in kids

To help your child cope with a cough, know the common causes, what each one relates to, and treatments you can try at home. Here’s our guide to decoding coughs in kids. 

A child’s cough can sound terrible and send most parents into panic mode, but it’s not usually a sign of a serious condition. It’s worth remembering that coughing is a healthy and important reflex that helps protect the airways in the throat and chest.

What causes coughs?

Coughs are usually a symptom of an infection, typically the common cold virus. Sometimes, babies develop more worrying coughs. These are:

  • Croup, a viral infection of the voice box and airways.
  • Whooping cough, a bacterial infection of the windpipe and airways. You will be offered a vaccination against whooping cough for your baby.
  • Bronchiolitis, a viral infection of the lungs.
  • Gastroesophageal reflux disease (GERD). Regurgitation of stomach contents and/or acid may trigger a reflex cough and should be considered when the more common causes of cough have been eliminated. This is more common in infants and young children. These young children and infants may not have obvious spitting up of liquids or solids during such episodes; however, they become very distressed during such events.
  • Irritation of the airways. Pollution, primary or secondhand smoke, and an allergen may also produce a persisting cough.
  • Asthma – this can be difficult to diagnose, because symptoms vary from child to child. But a wheezing cough, which may get worse at night, is one of many asthma symptoms. The other may be a cough that is caused by increased physical activity or during play. Treatment for asthma depends on what’s causing it, and may include avoiding triggers like pollution, smoke, or perfumes. Consult your doctor if you think your child has asthma symptoms.
  • Allergies/Sinusitis can cause a lingering cough, as well as an itchy throat, runny nose, watery eyes, sore throat, or rash. Talk to your child’s doctor about allergy tests to find out which allergens cause the problem, and ask for advice on how to avoid that allergen. Allergens can include food, pollen, pet fur, and dust.

Different types of coughs

Knowing and recognising the different types of coughs will help you know how to take care of them and when to go to the doctor.

According to paediatrician and neonatologist Dr Emma Buckley:

  • A dry cough is a cough that does not produce any phlegm, is irritating to the lungs and throat and it may be a sign of a viral infection or cold. These coughs usually last about seven days and if the child is otherwise well, they do not require treatment.
  • A wet cough is a cough that produces phlegm, and depending on the colour, may indicate a bacterial infection. Phlegm that is yellow green or brown usually means that a child has a chest infection or pneumonia. They will usually have a loss of appetite and a temperature.
  • A sudden cough can be an indication of choking on a foreignbody.
  • A cough with a wheezy sound could be a sign of bronchiolitis a viral infection that affects infants or asthma in an older child.
  • A ‘barking’ cough is usually found in children, and may be associated with croup or other viral illness.
  • Croup usually comes on quite suddenly especially in the middle of the night. A cough that causes a ‘whooping’ sound after the cough may be indicative of a serious infection and should be evaluated by a doctor.

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You can help your baby by doing the following:

 

  • Make sure he gets plenty of rest.
  • Offer extra breastfeeds or bottle feeds. Your baby will need plenty of fluids to fight off the infection.
  • Give the correct dose of infant paracetamol or infant ibuprofen. These painkillers will help to bring down your baby’s fever.
  • Breathing in steam may help to relieve your baby’s cough. Try sitting with your baby in the bathroom with the shower on. The warm, steamy air will help to relax his airways. Take care to keep your baby away from the hot water, otherwise he could get burnt.

Treating children

The Irish Medicines Board (IMB) has recommended that over-the-counter cough and cold medicines should not be given to children who are under the age of six. Instead, give your child a warm drink of lemon and honey or a simple cough syrup that contains glycerol or honey. However, honey shouldn’t be given to babies under the age of one, due to the risk of infant botulism.

Preventing baby from getting coughs and colds

Breastfeeding is a great way to protect your baby’s health. It passes your antibodies, chemicals in your blood that fight infections, to your baby. Breastfed babies are better at fending off colds and other infections. You can also protect your baby by trying to keep him away from anyone with a cough or a cold. Or ask them to wash their hands thoroughly before holding your baby. If you or your partner smokes, try to quit, and don’t take your baby to areas where people are smoking. Babies who live with smokers have more colds, and their colds last longer than babies who aren’t exposed to smoke.

Expert advice

A baby or young child should be seen by a doctor for their cough if:

  • They are less than six months and have a temperature more than 38°C as young babies can become unwell very quickly.
  • If their rate of breathing is increased this indicates that they are unwell and struggling to breathe.
  • If they are having spasms of coughing or seem breathless.
  • If they have any change in their colour especially duskiness /blue tinge around mouth.
  • If they have a rash, irritability, or are very quiet and listless.
  • If they are vomiting with the cough and unable to keep fluids down if they are coughing up yellow green or brown phlegm.

Paediatrician and Neonatologist, Dr Emma Buckley – The Children’s Practice

More like this:

Treating vomiting in children
How to prevent whooping cough
Treating baby’s cold

ASK LUCY

Q My son is 18 months old and has just started saying his first words. It is an extremely exciting time in our house and my husband and I are eager to encourage his speaking as much possible. What advice would you give us on how we can foster this without bombarding and confusing him?

AThere is nothing better than hearing your baby begin to talk. All the hard work you have put in over the last two years is coming back tenfold.
Toddlers will vary significantly with ability and speed of which they talk however a guide would be about 50 words by 2 years of age. The most important thing to watch for is that your baby/toddler is cooing and babbling and begins to string sounds together like “Mama/Dada” They should have a wide range of speech sounds and like to imitate you and things they hear.
There are many ways that you can promote Speech and Language development at home:
1. Slowing down your own speech and taking time over conversations with your little one. Every day is a new experience when you are 18 months, nappy changes, bath time, baking a cake brings endless opportunity for you to interact and offer new words for them to hear and repeat. Make eye contact, smile and use exaggerated tones to keep things interesting and fun for your tot.
2. Review the toys that you have on offer to your tot and ensure that they give plenty of open ended play opportunities. Role play is a wonderful way to allow children to take the lead. Kitchens with lots of plates, cups and pots. Fill the pots with dry pasta and allow your child to cook and serve you. Playdoh, painting, gardening and sandpits are also great for allowing your child to take the lead and babble about what they are doing. Read plenty of books together and point and allow them time to answer any questions that you ask.
3. Limit screen time. Overuse of televisions and iPads do not give your child opportunity to interact in a two way manner.
4. Ask your child lots of open ended questions “What’s that?” “Where are we?” Point at things they know the answer to for boosting confidence (Car/ Car, etc.) When they don’t know the answer, explain it to them. Limit baby talk and speak clearly with good pronunciation, remember you are the teacher and they will copy you.
If you are concerned about your child’s speech and language development, be sure to speak with your GP or developmental Health Nurse. They are very skilled at understanding the difference between speech delays and spotting something that may require professional attention.
Enjoy watching their little brains absorb the world around them and listen to what they have to say. It won’t be too long before they won’t stop talking to you, asking “Why Mummy/ Daddy?” every 5 minutes….

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Ask Sarah

Q I’ve heard a lot about the Paleo diet and as I am very interested in reducing the amount of processed foods and grain based meals my family eats, we are considering following this diet. From what I read it seems to be a back-to-basics type of eating. Is a Paleo diet safe for children? My kids are aged seven and nine.

A The Paleo diet is one of the most fashionable diets around at the moment. It is also known as the ‘caveman diet’ and is based on cutting out processed foods, starchy foods like bread and potatoes and eating more meat, vegetables and fruit.
As fad diets go, it is not the worst but there are some good and bad sides to it. Reducing the amount of processed foods we eat is always a good idea and by doing that you will usually reduce the amount of fat, salt and sugar you eat, which is a good thing! The problem with the Paleo diet is that it also cuts out dairy (on the basis that cavemen didn’t drink milk) and this means that the diet is very low in calcium. For this reason it is really not suitable for children who do need a lot of calcium for growing bones. How did cavemen manage without dairy? They ate a lot more food than we do (up to 10,000 calories per day compared to the 2,000 most of us eat). By eating that amount of food they were able to pick up just enough calcium from green vegetables and seeds. To put it in perspective, you would need to eat 16 servings of broccoli a day to get all the calcium you need. This is easier to do if you eat 10,000 calories per day rather than 2,000.
The other problem with the paleo diet is that it is not entirely based in science. Many of the Paleo diets out there say you should not eat wheat, even though we know that cavemen did in fact eat wheat and other grains. These diets also don’t recommend that you eat blubber and the big lumps of fat that were also a large part of the caveman diet!
A final problem is that many Paleo diets encourage people to cut out beans and lentils and to get their protein from meat and fish instead. Many studies over the last few years are clear that eating too much animal protein is linked with more cancer and heart disease. Eating some vegetarian meals based on beans and lentils is a great way to get your protein without always going for meat.
Is this a diet we should follow? I think there is a lot we can learn from the Paleo diets. We could all do with eating less salt, sugar and processed foods and adding in more nuts and seeds as well as more vegetables. However, I think following a strict Paleo diet could lead to low levels of calcium and vitamin D and so it is not suitable for children or teens and adults would need to think about a calcium supplement.