Does someone in your family have a cough right now? Better question: Who doesn’t? This time of year, classrooms resound with choruses of coughing children, whose parents likely wrestled, hours earlier, about whether or not to send them to school that day.
Trying to figure out the source and severity of a cough can be one of parenting’s great mysteries. I have three big coughers here 
at our house: When a cold comes on, they never seem much afflicted by sore throats or even stuffy noses, but rather a constant, nagging, occasionally gag-inducing cough which makes it sound as if they are much sicker than they actually are. I’ve tried just about every cough medicine on the market to combat it, with little success (and a whole lot of middle-of-the-night crying, usually more about “wild cherry flavor”—is there a more vile substance known to man?—than the cough itself).
Our favorite pediatricians and site advisory board members, Julie Kardos, M.D. and Naline Lai, M.D., verified that they get as many questions about coughing as just about anything else. So the other day, they provided straight, no nonsense answers to the five big questions we all seem to have about coughs. Give it a read; it just might save you a trip to the doctor’s office. (Or, more likely, the drug store…read on.)
Q. When is a cough “normal,” and when does it warrant a trip to the doctor’s office?
A. Kids get, on average, 10 viruses a year, mostly in the winter. And most get coughs with those colds viruses. It’s normal for a cough to last two weeks, even after a child is feeling better.
If a cough progressively worsens, or comes with a fever after your child has had other cold symptoms, that could be a sign of a bacterial infection, and you should definitely see the doctor. Ditto if there’s any sign of breathing trouble with a cough. (Do the “lift the shirt test”: lift up your child’s shirt, and if his stomach is moving a lot, or his ribs are sticking out as he breathes, that’s a red flag.) If a cough last more than two weeks, call his doctor, since he could have other issues such as a sinus infection, acid reflux or something anatomic pressing on his lungs.
Q. What if my child seems to cough like crazy every time they have a cold?
A. Some kids have a type of asthma that’s triggered by upper respiratory infections, and they cough a ton just when they’re sick. For these kids, doctors can prescribe specific asthma medications, which can help control the cough caused by a cold.
Q. Does cough medicine work?
A. Cough suppressants don’t work. There are no convincing studies in children to suggest otherwise. If the cough is due to allergies—this is often diagnosed when a child coughs only in certain places, like just at home or school or around certain animals—Benadryl (diphenhydramine) can be helpful. If the cough is caused by a bacterial infection, treating that infection with antibiotics will help cure the cough.
Q. Is there any harm to trying to suppress a cough?
A. Cough by itself isn’t evil at all. It’s the body’s way of getting rid of mucous. When people come to our office and they have nice clear lungs and are coughing up a storm, we say, “great!” A productive cough can make a child less likely to get pneumonia. Babies tend to get more complications from flu and other respiratory infections because they don’t have the strength to cough and mucous settles into the lungs and causes a bacterial infection.
Q. Still, coughs can keep kids up at night. Are there ways to make a child more comfortable?
A. If a child is over a year, you can try a teaspoon or two of honey every few hours and before bed. A humidifier and drinking a lot of fluids during the day keeps the throat moist too, which can help. If they’re elementary school age, you can give them cough drops during the day for the same effect. If the cough sounds like a barking seal, it could be croup, which is just an inflammation of the vocal cords due to a cold (the grown-up equivalent is laryngitis). Opening a window and letting your child breathe fresh, cold air can help control a “croupy” cough. (For more on croup, tune in to this Two Peds in a Pod podcast.)
But the biggest thing to remember is that a cough often bothers parents more than kids. If your child is coughing but sleeping through it, there may not be anything more you need to do than wait patiently for the cold to run its course.
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