Cough
Cough in Children – What Parents Should Know
Cough is one of the most common symptoms of illness in childhood. Although it can be unpleasant and exhausting, in most cases it is a natural defense mechanism of the body, helping to clear mucus, dust, or viruses from the airways.
1. Dry vs. Wet Cough – What's the Difference?
Dry Cough:
• The child coughs "empty," without mucus.
• It often appears at the beginning of a viral illness, when the larynx is irritated, or after exposure to cold or dry air.
• It may sound barking or irritating – especially at night.
Wet Cough (Productive):
• The child coughs up mucus – it sounds "deeper."
• It typically appears during or after a cold, as the airways are being cleared.
• The cough may be more intense in the morning after waking.
➡️ Note: After a cold or viral infection, cough may persist for 2–3 weeks without indicating a serious problem.
2. When Should Parents Be Concerned?
Contact your doctor immediately if:
• The child is having difficulty breathing (struggling for breath = using accessory breathing muscles – intercostals, pulling in at the jugulum (the soft hollow just above the breastbone), or showing signs of cyanosis – bluish lips, fingertips, or face),
• Wheezing (whistling sounds) occurs during breathing,
• The child has a high fever lasting more than 3 days,
• The cough lasts longer than 3 weeks,
• The child is choking, vomiting from coughing, or is extremely fatigued,
• The cough started suddenly – e.g., after inhaling a small object (risk of aspiration!),
• There is blood or thick purulent mucus in the cough.
3. How Can Parents Help at Home?
• Ensure plenty of fluids – this helps thin the mucus.
• Humidify the air – ideally with a humidifier or wet towels on the radiator.
• Regular airing out and access to fresh air.
• Nasal hygiene – regular nose cleaning (e.g., with saline spray and nasal aspirator).
• Herbal teas – e.g., linden or thyme for wet cough, marshmallow root for dry cough.
• Home remedies – e.g., onion syrup, warm chest compresses (made with curd, thyme, lavender, honey – consult your doctor) - see here for compresses guide.
• Monitor (I may ask you): does cold (after a walk or airing the room) or warmth (warm room) worsen or improve the cough? Is your child thirstier than usual? What kind of drinks help (cold/warm/lukewarm)? Is the cough painful? Does it worsen when lying down?
4. What About Cough Medicines?
• Do not give your child antitussives or expectorants (cough suppressants or mucus-thinning medications) without medical advice.
• WARNING! Children under 6 years old should not be given any synthetic cough medicines (e.g., Stoptussin, Robitussin, Paxeladine, Mucosolvan, Solmucol, ACC).
• Prefer herbal preparations (e.g., Bronchipret + Kaloba, DR. WEISS Stopkašel, or TEREZIA Nekašli – choose one after consulting a pharmacist). For exhausting, spasmodic coughs, lozenges with Iceland moss can be helpful.
• In some cases, these medications may be inappropriate or even harmful – e.g., suppressing a wet cough with dry cough medication can interfere with airway cleansing.
5. When Can/Can't a Child with Cough Attend School or Daycare?
• A child with a mild cough, no fever, and feeling well may attend school or daycare after consulting with a doctor. However, I personally prefer that the child returns only when completely cough-free, as that's a sign of fully regenerated respiratory mucosa. Sending a still-coughing child back increases the risk of a more serious secondary infection in the bronchi or lungs.
• If the child has a fever, worsened general condition, or the cough interferes with daily functioning, they should rest at home.
Conclusion:
Cough may be unpleasant, but in most cases, it's no cause for panic. Pay attention to your child's overall condition, observe the duration and nature of the cough, and when in doubt, don't hesitate to consult your doctor.