Cough is one of the common complaints in toddlers (children who are one to three years old). Coughing is a way the body prevents the entry of harmful substances into the airways. It helps clear secretions from the airways, making breathing more comfortable. However, seeing your little one struggling with a cough can give you anxiety. Toddlers, unlike older children and adults, cannot be given most over-the-counter medications without consulting the doctor. These medications may even paradoxically harm the little one. Since coughing is the body’s protective reflex, giving cough suppressants may also not be a good idea unless advised by a doctor.
The treatment of cough is guided by several factors, namely,
- The nature of the cough (whether it is barky, associated with a whoop, dry or associated with mucus production)
- The timing of the cough (whether it is more in the morning or at night or stays the same throughout the day)
- Whether there is any associated fever with the cough
- Whether the cough is associated with vomiting
- Whether the cough is aggravated by eating or any other factors
- Whether the cough is associated with noisy (wheezing) or labored breathing
- Presence of other symptoms, such as runny nose, itchy eyes, sneezing, chills, aches and difficulty sleeping
Most children with cough recover on their own with supportive care at home. Most coughs go away in a week or two. Since most coughs are caused by a viral infection, doctors generally do not give antibiotics. Medications are not needed for most toddlers. Cough medications are specifically not recommended for toddlers or any child under six years of age.
Since many medications may not be safe for a toddler, consulting your doctor on the phone or via telemedicine may help. To help your child comfortably recover from a cough, you may
- Ensure that your child gets enough rest.
- Give plenty of fluids to your child. These include water, homemade vegetable and fruit juices, electrolyte solutions, warm soups and broths. Avoid giving soda and orange juice because they may irritate your toddler’s sore throat.
- Run a cool mist humidifier in your child's room, especially at night. This will make breathing easier and help them get restful sleep.
- To provide relief from a “dry” or “barky” cough, turn on the hot water in the shower and close the door to steam up the room. Sit with your toddler in the bathroom for 15 to 20 minutes to allow steam to relieve your child’s symptoms. You may read a book to your child or play with them during this time.
- Give your toddler over-the-counter pain and fever medications, such as acetaminophen or ibuprofen, according to the instructions on the package or your doctor’s instructions. Do not give ibuprofen to an infant younger than six months old. A warm bath or a heating pad may also help relieve aches and pains.
- Do not give your toddler any over-the-counter combination medicines (such as "Tylenol Cold") unless your doctor says so.
- Completely avoid giving aspirin to a child who is 19 years old or younger unless advised by your child’s doctor. Giving aspirin to individuals who are 19 years old or younger can cause a rare, but potentially fatal condition called Reye syndrome.
- Use a saline nasal spray if there is nasal congestion. Saline nasal sprays are available over the counter and are safe for use. Do not give any decongestant nasal sprays unless advised by your doctor.
- Keep your child away from smoke, including tobacco smoke.
- Do not give hard candy or cough drops to relieve sore throat in children younger than six years of age because they are potential choking hazards.
- If your child has been diagnosed with asthma, get the doctor’s advice to manage symptoms at home. Always keep their medications handy.
- You may take your child outdoors for some fresh air because this may provide some relief. Dress them appropriately for the outdoor weather. Make sure they do not overdo physical activities. A 10- to 15-minute slow walk or sitting in the fresh air may be good for them.
Contact your doctor if your child develops any serious symptoms, such as
- Trouble breathing or breathing faster than usual
- Fever of 103°F or more or a fever of 101°F or more lasting for more than a day
- Excess lethargy or floppiness
- Excessive coughing or coughing up a lot of mucus
- Inability to take feeds or fluids
- Pain in the ear, chest or abdomen
- Progressive worsening of any symptom
- Your toddler makes a "whooping" sound when breathing in after coughing
- Your toddler makes a noisy sound (stridor) while breathing in
- Presence of bluish or greyish discoloration of the lips, nails, nose or face
- Presence of any signs of dehydration, such as drowsiness, a dry or sticky mouth, sunken eyes, crying with little or no tears or peeing less often (or having fewer wet diapers)
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St. Louis Children's Hospital: "Cough." https://www.stlouischildrens.org/health-resources/symptom-checker/cough
Children's Hospital Los Angeles: "Decoding Your Baby's Cough." https://www.chla.org/blog/health-and-safety-tips/decoding-your-babys-cough