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Why Is My Child Coughing?



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children cough endlessly everywhere

that's a fact it's one of the commonest

reasons for children to be brought to my

outpatient clinic or to the emergency

department for that matter I'm going to

talk to you a bit about what's normal in

childhood cough what's abnormal and what

are the key features that should make

you seek help the things that I

described towards the end of this talk

are incredibly rare I'm not here to

scare you I'm here to reassure you that

what your child is doing is probably

normal what's the normal cough healthy

ten year olds will have around 11 bouts

of coughing in a normal 24-hour period

that's healthy young children will have

up to 12 colds in a year

when children get a cold they will cough

for two to three weeks with that in mind

you can imagine that it's difficult to

find a point when they're not coughing

and that's normal so how do you treat a

normal bog standard cough well the first

question is do you need to most children

with a cold will cough for one two maybe

three weeks and then they'll be fine and

actually that cough will be part of the

way in which they clear the chest of any

secretions that are causing irritation

if your child is coughing to the extent

that they're getting no sleep that

they're in pain or significant

discomfort or they're vomiting all the

time you may want to do something to

relieve those coughing symptoms and at

that point it's reasonable to give them

an over-the-counter cough syrup you need

to recognize that these aren't going to

make your child better any sooner they

may make them feel a bit more

comfortable

the other thing paracetamol ibuprofen

again over-the-counter can relieve some

of the pain associated with coughing so

that's a normal cough what's abnormal

what should get your spidey sense is

tingling well thankfully the most common

causes of an abnormal cough are still

not too worrying your child may have a

bit of gastro esophageal reflux

that's when stomach acid comes up from

the stomach up to the upper Airways and

irritates the Airways of the vocal cords

and Nixon cough particularly at night or

an exercise and actually sounds a lot

like asthma persistent bacterial

bronchitis is a name for a low-level

bacterial infection which

is your child to have a a wet cough that

just doesn't go away even between colds

there's also a quite unusual cause for a

persistent cough we call it habit or

psychogenic cough and it curves in a

context where children look very well

and yet they cough and cough and cough

what's odd about this cough is that it's

much more prominent in the daytime and

they hardly ever cough at night they

cough an awful lot more in front of

their parents particularly say what

parents are worried or in front of a

pediatrician but they won't really cough

when they're having fun

quite often they went off at the weekend

and they won't coffee for nurses

watching the key thing is if a habit or

psychogenic cough has been identified

don't worry

the answer is common difference

reassurance don't talk about it don't

notice it it will go away so let's talk

about asthma so asthma is a condition

where we have reversible narrowing of

the Airways what that means for your

child is wheezing and coughing quite

often a response to a virus or exercise

and the cough is particularly prominent

at night thankfully most children with

asthma are readily controlled on inhaled

steroids or a blue inhaler you'll have

seen these before and the key thing is

if it is asked though it gets better

with these treatments so we've talked

about abnormal cough what then are the

key red flag features that should make

you seek an urgent pediatric opinion

we've talked about a wet cough that

doesn't go away but if you add to that a

child that has also had severe breathing

difficulty maybe at birth has had a

runny nose since birth and maybe gets

recurrent chest infections these may be

a sign of immune deficiency so a

weakness in the immune system or more

rarely a condition called PCD or primary

ciliary dyskinesia where the hair cells

that line the upper and lower

respiratory tract don't walk the mucus

out effectively now I guess the final

red flag you'd like to look out for is a

child whose cough is worse with eating

and drinking or perhaps doesn't like to

eat and drink maybe the child who vomits

a lot and has done

severely since they were born this child

may possibly have cough related to

aspiration that's passage of food and

drink into the lungs

perhaps through an abnormal connection

between the breathing tubes and the

feeding tubes something we call either a

fistula or a laryngeal cleft or perhaps

due to severe guest residual reflux so

at this point I think it's probably

helpful to go back to where we started

children coughs what they do it's normal

it's even healthy if you have doubts

based on anything that I've said that's

why you have a GP that's why we have

pediatricians so thank you for watching

I hope that that's been informative

please do subscribe to the YouTube

channel for more content on this and

other childhood subjects and we'll see

you soon