Paroxysmal Cough

What Is a Cough?

Coughing is an important reflex, which happens when you try to clear your airways.
Coughing is most often a sign of a cold.
A coughing fit is a non-stop cough lasting for 5 minutes or more.
The cough may be dry (no sputum) or wet (white, yellow or green sputum).

Reasons for Cough

Colds or viral bronchitis - bacteria do not cause bronchitis in healthy children.
Bacterial infections of the lungs - e.g. pneumonia
Sinus infection - coughing can occur when a discharge at the back of the throat irritates the airways or when the pressure inside the sinus causes a cough reflex.
Allergic cough - develops when you inhale allergic substances or are allergic to something.
Asthma - asthma with stridor is a common cause of chronic cough. 25% of children with asthma only have a cough without stridor.
Cough caused by air pollution - develops when the airways are irritated. The most common cause is tobacco smoke.
Exercise-induced cough - made worse by running, especially when breathing in cold air.
Coughing from serious causes - bronchiolitis, whooping cough or if a foreign body gets into the airways.

Difficulty breathing is a reason to take your child to the doctor.

The Following Signs Indicate Difficulty Breathing:

Shortness of breath or extra effort in breathing
Difficulty speaking or crying while breathing
Concave ribs during breathing (retractions)
Noisy breathing (e.g. wheezing)
Barking cough, change in the timbre of the voice
Rapid breathing
Lividity of the lips or face

Sputum

Yellow or green sputum is expected at the start of viral bronchitis. Sputum expectoration means the virus has damaged the mucous membrane in the tracheal wall. Antibiotics are not always necessary to treat yellow or green sputum that appears after a cold.

Seek Medical Attention Immediately In the Following Situations

Sinus infection - coughing can occur when a discharge at the back of the throat irritates the airways or when the pressure inside the sinus causes a cough reflex.
The child has stopped breathing.
Lips or face has turned blue.
You think your child has a life-threatening condition.
The child has swallowed a foreign body.
The ribs retract during each breath (retraction).
You hear a hoarse sound when the child inhales (stridor).
Uncontrollable bouts of coughing occur.
A whistling sound is heard when the child exhales.
The child is breathing fast.
Cannot breathe deeply because of pain in the chest area
Severe chest pain is expressed.
The child is coughing up blood
Lack of clear consciousness while awake.
Weak immune system (sickle cell anemia, AIDS, cancer, taking steroids).
High-risk child (cystic fibrosis or other chronic diseases).
Under 12 weeks of age and with a high fever.
Temperatures up to 40°.
Not looking well.

Contact Your Family Doctor in the Following Situations

The baby is less than six months old
Ear pain or discharge from the ear
Nasal sinus pain
Fever for more than three days
Chest pain when the child is not coughing
Coughing triggers three or more episodes of vomiting
The child does not attend a children's institution for three or more days due to a cough
Allergy symptoms (runny nose, itchy eyes) occur together with cough.
A runny nose lasts 14 days or more
The cough lasts three weeks or more.

What Should We Know About Cough?

Most coughing is a sign of a cold.
Coughing up sputum is very important as it protects the lungs from developing inflammation.
Eliminating the ability to cough is not recommended.

Anti-Cough Medicines

Over-the-counter cough medicines are not recommended. They have not been proven helpful and should not be used in children under four years of age.

Coughing Fits - Warm Steam and Fluids

Breathing in warm steam, e.g. in a bathroom
Warm drink
Do not use a warm drink for children under three months of age.
For children aged 3 to 12 months, give a warm drink of 30 ml 4 times a day.
Give a warm drink in large quantities for children over one year of age.

Vomiting Caused By a Severe Cough

If vomiting has developed during coughing, feed in small portions and more often.
Cough-induced vomiting is more likely to occur when the stomach is full.

Encourage Your Child to Drink Fluids

Drinking fluids will prevent dehydration.
Liquids help to loosen sputum and make it easier to cough it up.
It also helps to reduce nasal secretions.
If the air in the room is too dry, humidify it. Dry air makes coughing worse.

Returning to a Children’s Institution

It is okay to take the child back to the children’s institution once the fever and coughing have stopped.

What to Expect?

Cough due to viral bronchitis lasts for 2-3 weeks.
In viral bronchitis, the sputum may be colored, but this does not require antibiotic treatment.
Bacterial infections require antibiotic treatment.
A chest X-ray in the first days of illness is not necessary in most cases.