Let’s begin by understanding what cough is.
Cough is a protective reflex, hence essential for good health. It is also a symptom of certain diseases. Therefore, it is necessary to seek a doctor’s opinion to know the nature of cough and what is causing it. It should be left to the doctor to find the reason and treat it.
Most of the time, severe, persistent cough in toddlers is caused by viral infections of either the:
1. Upper respiratory tract (URT), or
2. Lower respiratory tract (LRT)
URT infection: This is the most common cause of cough among toddlers. Some of the common URT infections are chronic ethmoiditis, tonsillitis and adenoiditis. Although URT infections affect the child’s quality of life, they are rarely life-threatening. Breathing usually remains within normal limits and the respiratory rate rarely crosses 40 breaths per minute. When cough is present, it is usually dry, although sometimes small quantities of sputum may be present. The child feels relatively comfortable and usually takes normal feeds. But when fever is present, the child may look ill and appear uncomfortable.
LRT infection: This is more serious than URT infections and can be life-threatening. The two most common LRT infections are bronchitis and pneumonia. A child suffering from an LRT infection looks ill. He avoids feeds or may even stop feeding. Breathing appears strained and rate of breathing increases above normal. Coughing usually produces sputum, which may be yellow or green in colour.
In many children, spasmodic cough may be present in cases of LRT infections. The cough is usually dry with symptoms of air hunger, i.e. gasping or difficulty breathing, after a bout of cough. But dry cough in toddlers can also be caused by certain worm infestations as well.
What to do:
1. When a child suffers from recurrent URT infections, parents should consult an ENT specialist. The doctor may check to see if chronic adenoiditis, tonsillitis, or ethmoiditis may be the cause. Chronic ethmoiditis may cause discharge from the nose as well. Toddlers with recurrent URT infections are also prone to glue ears, a condition where fluid fills the middle ear and causes hearing loss.
2. Symptoms such as refusing food, appearing ill with cough that produces sputum is a cause for worry. A child displaying such symptoms should be taken to see a paediatrician to prevent things from getting worse.
3. In cases where URT infections cause spasmodic cough, an ENT specialist should be consulted.
4. Cough caused by worm infestation should be treated with a course of de-worming. Always repeat the de-worming after three weeks for complete eradication.
5. Parents should avoid the common practice of giving cough medicine to children without consulting the doctor, as suppressing a cough may be harmful. But when the cough is severe, cough syrup may be given just to keep it under control. It should also be kept in mind that antibiotics are not useful in viral infections. For that matter, they may have a negative impact. Hence, only antibiotics prescribed by the doctor should be given to the child.
It is important for parents to understand that treatment of symptoms should be the top priority. Here’s what parents can do while waiting for the doctor to see the child:
a. Cold sponges if the fever does not come down with a fever medicine.
b. Give plenty of oral fluids, as the child’s need for fluid increases during fever but their intake decreases. Dryness of throat can also increase cough as well.
c. In case of a child having a runny nose, cleaning should be done using wet wipes. Blowing the nose should be discouraged as it may predispose the child to ear infections.
Remember, home remedies for cough should not be tried for a long time, as a toddler’s condition may worsen in the absence of proper medical care.