Every child gets a cough from time to time; there’s really no escaping them. It’s completely normal for children to catch several colds a year, especially if they are in daycare or go to school, and common allergies can cause a cough too.
Most of the time, it’s nothing to worry about. Most of the time, some rest, plenty of fluids, honey (for children over a year old) and some patience and TLC do the trick. But sometimes, it’s important to call the doctor. Here’s when you should worry about a cough:
1. Your child is having trouble breathing.
Signs of this include:
- Breathing quickly
- “Sucking in” around the ribs or front of the neck
- Having trouble talking or crying
- Not wanting to eat or drink
- Acting much sleepier than usual
- Looking pale or blue
2. Your child is having trouble swallowing.
This could be a sign that your child is coughing because something is blocking his throat. If your child won’t swallow or is drooling much more than usual, that could be an emergency.
3. There is a high fever (102 degrees or higher) or any fever that lasts more than 3-5 days.
Most of the time this isn’t a big deal, just a virus, but it’s good to check in with your doctor — especially if your child is acting really cranky or sleepy or the cough seems particularly bad to you — to be sure there isn’t a more serious infection going on.
4. The cough is constant.
Coughing here and there is fine, but a nonstop cough can be a sign of trouble.
5. You hear a wheeze with the cough.
It’s not easy to tell if a child is actually wheezing without a stethoscope, and sometimes when children have a lot of phlegm it can sound like they are wheezing when they are not. But it’s always better to be on the safe side.
6. The cough sounds barky, like a dog or seal.
This can be a sign of croup or another problem with the upper airway. Most kids with croup do just fine, but it’s a good idea to check in with your doctor for advice and to see if a visit to the office would be a good idea.
7. Your child coughs with exercise.
This can happen with the common cold, but it can also be a sign of asthma as well as heart or lung disease. You should let your doctor know, and bring your child in to be checked out.
8. The cough keeps your child up at night.
This can happen with a bad cold or anything that causes a bad post-nasal drip, but a call to the doctor is a good idea, if only to get advice that might help everyone sleep a bit better.
9. The cough has lasted more than two or three weeks.
Most of the time this is just a lingering cold, or — as often happens during cold and flu season — it’s actually a new cold on top of the old one. But a call to the office, and possibly a visit with the doctor, is a good idea to be sure there isn’t something else going on.
10. There is something about the cough that worries you, even though none of the above applies.
Pediatricians trust a parent’s instincts. You know your child better than anyone; if something doesn’t seem right, I want to know. Just as importantly, even if it isn’t anything serious, we don’t want you to worry — especially if we can allay those worries with a phone call or visit.
About the blogger: Dr. Claire McCarthy is a primary care pediatrician at Boston Children’s Hospital, an assistant professor of pediatrics at Harvard Medical School, a senior editor for Harvard Health Publications and an official spokesperson for the American Academy of Pediatrics.