What is a cough?
A cough is usually a reflex response to an irritant — from a virus, to pollen, to cigarette smoke. Coughs are a way for the body to protect itself. They prevent irritants from getting deep into the lungs and help open our airways to exchange oxygen and carbon dioxide. For example, if you swallow water the wrong way, you’re going to cough it up.
How do you diagnose what’s causing the cough?
First, we ask some basic questions. How long has the cough been happening and how often? What triggers it? Does the cough last just a couple of seconds or does it take minutes to recover? What makes it better? All of the information gives us hints to determine the cause of the cough.
With technology available, I also encourage parents to record the cough. Bringing a recording to your physician or the emergency department is very helpful, so we can observe any concerning signs of respiratory distress based on what we’re seeing on the video or hear on an audio recording.
Then we do a physical exam with a stethoscope to listen for sounds in the chest wall, neck, or the nose. This helps differentiate the cough between an upper respiratory cause versus a lower respiratory condition.
Some causes of cough can be detected with specific tests. Certain conditions like COVID, the flu, RSV, or strep can be checked in the office or emergency room if there is a high likelihood of these illnesses. Other conditions, like asthma, may require special exams like a pulmonary function tests.
How long do coughs usually last?
It depends on what’s causing of the cough. Most colds take three to five days to peak, but the symptoms can last up to two weeks — so coughing for 10 to 14 days for a common cold is not unusual, especially in pediatrics.
With other conditions, like pneumonia, the cough may last a month after the main part of the illness is over. If the cough is lasting beyond the expected time, your provider may ask the child to come in more often to be monitored.
How long is a child contagious?
It depends on the virus. In most cases, the first five to seven days of a cold is when your child is contagious. Fever can be an indicator of the contagious period. The likelihood of spreading the virus decreases after a week. Your doctor can give specific advice based on the virus.
When should children see a doctor about a cough?
We always think about whether the cough interferes with daily activity. So for children, daily activity means going to school, sleeping, playing, or eating. If it interferes with any of those, that is a reason to see a physician. If the child has a cough and a fever that lasts more than five days, then those are signs to see a doctor too.
Another concern is respiratory distress. If the cough causes your child to breath faster than normal, or parents are noticing the breathing is visible underneath the rib cage or in the neck bone, or the nostrils are flaring to breathe — those are signs that the body is working too hard. Many children can breathe 30 breaths per minute. For an adult, that would be way too fast. The older you are, the slower your normal breathing rate is. So if a child is breathing faster than normal, that would be reason to seek medical attention.