Should I call the doctor if my preschooler has a cough?
Call the doctor if your preschooler has a persistent cough,
or if he has a cough and he:
• is breathing more rapidly than usual or looks like he's working harder to breathe
• is wheezing
• has little streaks of blood in the mucus he coughs up
• is running a fever of at least 103 degrees F
• has a chronic illness, such as heart or lung disease
If your child seems to be having serious trouble breathing, call 911.
Can I give my preschooler cough medicine?
No. Even if you think it's just another cold, ask the doctor before giving your toddler an over-the-counter suppressant, expectorant, decongestant, or antihistamine. Most doctors discourage the use of these over-the-counter medications for young children. And the American Academy of Pediatrics (AAP) cautions parents never to use these products for children under the age of 3 without a prescription from the child's doctor.
In fact, because of concern among experts that nonprescription children's cough and cold remedies may be both ineffective and potentially dangerous for children under the age of 6, the government is currently in the process of reviewing these medications. (Many received FDA approval years ago, when standards were lower than they are today.)
What could be causing my child's cough?
There are lots of possible culprits, and in some of these instances you'll want to alert your child's doctor. Here are some of the most common causes of a cough:
The common cold
If your preschooler has a cold, he may have a runny or stuffy nose, sneezing, coughing, watery eyes, a reduced appetite, and maybe a low fever.
Respiratory syncytial virus
Respiratory syncytial virus (RSV) is common in babies and young children. Symptoms resemble those of a cold, with a worsening cough and labored breathing.
RSV usually strikes between November and mid-March, and is sometimes no more troublesome than a cold. But it can lead to more serious respiratory illnesses, such as bronchitis and pneumonia.
Croup
A deep cough that sounds like a bark is the calling card of croup. If your preschooler has croup, he may also have cold symptoms and a fever. The symptoms of croup are often worse at night. As horrible as this cough can sound, in most cases it's not too serious and can be treated at home. Still, you should call your doctor for advice.
Allergies, asthma, and environmental irritants
A child who's allergic to something in his environment (such as cat dander or dust mites) will seem to have a cold that never goes away. Allergies can cause your child to constantly have a runny nose (with clear mucus) or stuffy nose and, because of postnasal drip (mucus running down the back of his sinuses into his throat), a cough. Children with asthma tend to cough a lot, too, especially at night. If your preschooler has asthma he may also have chest congestion, wheezing, and difficulty breathing. And he may have allergies and a family history of allergies or asthma. Another indicator that asthma may be to blame: Your child starts coughing after he's been running around, a condition called exercise-induced asthma.
Another possibility is that an environmental irritant — like cigarette smoke or pollution — rather than an allergen is causing your preschooler to cough. Of course, in this case you'll want to identify and eliminate the problem if possible.
Pneumonia
Most cases of pneumonia, which is an infection in the lungs, start out as a cold. If your child has a cold that seems to be getting worse, a persistent cough, difficulty breathing, a fever, body aches, and chills, call the doctor for an appointment.
Sinusitis
If your preschooler has a cough and a runny nose that has lasted for ten days or more with no signs of improvement — and your doctor has ruled out pneumonia — she may suspect sinusitis. This bacterial infection of the sinus cavities causes a lingering cough because mucus is constantly draining down the back of your child's throat, triggering the cough reflex.
If the doctor determines that your child has sinusitis, she'll prescribe an antibiotic. Once the sinuses are clear again, the cough should stop. Many doctors, however, don't believe children this young can have sinus infections due to their immature sinuses and will take a wait-and-see approach rather than prescribing drugs.
Swallowing or inhaling an object (aspiration)
A cough that has hung on for a week or more without any associated signs of illness (runny nose, fever, lethargy, or body aches) or the clear discharge from the nose that signals allergies may mean that your child has something stuck in his throat or lungs. Aspiration is the term doctors use when someone swallows or inhales a foreign object. This is most common in children who have a fascination with putting objects in their mouth.
"Some of these children come to our attention weeks after the aspiration because they've developed pneumonia," says Richard Scarfone, an emergency room doctor at Children's Hospital of Philadelphia. "They may have inhaled a particle of food or small piece of plastic, which has made its way into the lungs and set up a situation for infection."
If your child's doctor suspects that a foreign body is causing the cough, she'll order a chest X-ray. If the X-ray shows something trapped in the lungs, it will have to be removed surgically. If your child developed pneumonia as result, he'll also be treated with antibiotics.
Whooping cough
Whooping cough, also known as pertussis, has become a lot less common thanks to the DTaP vaccine, but outbreaks still occur, and the disease has been on the rise. More than 25,000 cases were reported in the United States in 2004.
A child with whooping cough typically coughs for 20 or 30 seconds nonstop and then struggles to breathe before the next coughing spell starts.
A child with whooping cough might also have a runny nose; red, watery eyes; and a mild fever, loss of appetite, and diarrhea.
Cystic fibrosis
One of the clearest signs that a child may have inherited cystic fibrosis, a disease that affects about 1 in 3,000 children in the United States, is a constant cough with a thick, hard-to-clear, yellow or green mucus. (Other signs include constipation. salty-tasting skin, and not gaining weight or growing well.)
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