TYPES OF COUGH IN CHILDREN: HOW TO IDENTIFY AND RELIEVE IT

Cough is a defense mechanism that the body has, to expel secretions and foreign bodies from the respiratory tract. With the descent of the thermometers comes the season of viruses, mucus and coughs, and although in most cases the cough is a symptom of a banal picture, the truth is that parents worry a lot and children can especially find it upset.

Therefore, we want to offer you a complete guide on cough in children, its characteristics, the types of cough that exist and what we can do to relieve it.

What is the cough?

Cough is a defense mechanism that It aims to expel mucus from the airways, in order to keep them clean and clear. It is therefore a "protective reflex" of the body, and one of the most frequent causes in pediatric consultations.

Phases of cough

The cough has a complex mechanism that consists of four phases:

Inspiratory Phase: inspiration and closure of the glottis
Contraction phase of the respiratory muscles against the closed glottis
Compression phase: muscle contraction raises alveolar and bronchiolar pressures
Expulsion phase sudden air and secretions

Types of cough and treatments

Although the most common is that cough in children is caused by upper respiratory infections (colds), there are many other causes that pediatricians identify depending on the type of cough, although there may also be the case of nonspecific cough that is not associated with any known cause.

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For diagnose the reason that causes cough, the doctor analyzes how it is, what characteristics it presents, how it sounds, in what situations it occurs and when it started. All this, together with the physical examination of the patient and his medical history, will indicate the disease or pathology present.

Dry cough

Dry cough does not move secretions and it has its origin in the inflammation of the respiratory tract. It is a very annoying and ineffective cough, and usually usually occurs at the beginning of colds, when there is still no mucus.

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As it is not a productive cough, it can be treated with syrups (under medical prescription) or natural remedies that help to mitigate it, since it is very annoying for the child and at night it can prevent his rest.

But there are also other causes of dry cough that should be assessed by the doctor:

Choking and / or foreign body aspiration: before a choking or aspiration of a foreign body that is lodged in a bronchus, there are pictures of cough with stridor. In these cases, it is very important to go immediately to the hospital emergency department.
Asthma: When the cough is persistent and is accompanied by fatigue and wheezing, it can be a symptom of asthma. It must be evaluated urgently by the doctor.
Environmental factors: the cough is produced by external factors present in the environment and which are irritating, such as tobacco smoke, pollution, chimneys, stoves, environmental allergies (animal hair, pollen ...) ... Exposure to these types of environments must be avoided , and in case the child has an allergy follow the medical instructions.

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Nervous or psychogenic cough: This type of cough is not due to any respiratory disease but is presented in situations of stress or in a more or less conscious way to get attention.

The main characteristic of this type of dry cough is that disappears at night or when the child is distracted, and usually occurs more frequently in older children or adolescents. This diagnosis is reached after having ruled out any other type of causes or diseases.

Cough hoarse or "dog"

It is a type of strong and painful cough, with "canned" sound or that simulates the barking of a dog. It is due to inflammation of the larynx (laryngitis) and usually occurs suddenly, accompanied by a closed stridor when taking air.

Is a very alarming cough for parents and it is even likely that the child is overwhelmed with the situation.

One of the remedies that usually works is to shelter the child well and take it out to the street to breathe cold air. This will help deflate the ropes and significantly improve cough. However, it is recommended that the pediatrician assess the situation and in case of respiratory distress or that the symptoms do not give up you must go to the hospital urgently.

Productive cough or soft cough

It is the typical cough of colds that helps move the mucus and take it out. Sometimes it can cause vomiting in the child because of the phlegm that comes to his mouth or swallows.

It is a very useful and necessary cough, and cutting it with treatments or syrups that are not prescribed by the pediatrician could be harmful, since the mucus would be retained causing greater airway obstruction.

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Other causes of cough in children

For chronic rhinitis: the cough is caused by irritation caused by secretions that descend from the nose or sinuses. As we read in the report of "Persistent Cough" of the AEP:

"The typical pattern is the preschooler who omits with repeated high tract infections that lead to adeno-tonsillar hypertrophy, otitis and even obstructive symptoms during sleep. In older children, the presence of persistent rhinitis or hypertrophy of turbinates should make us think about the presence of atopy "

By gastroesophageal reflux: Occasionally, chronic cough can be a symptom of reflux, even when there are no other digestive symptoms associated with this pathology. In this case, the cough occurs due to throat irritation caused by stomach acids.
Swallowing disorders: various neuromuscular pathologies, palatal fissure, or cord paralysis also cause persistent cough.

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Coughing or convulsing cough: is the type of cough that happens suddenly. It could be the cause of some object that the child has aspirated, or if it happens within the framework of a disease it can be a sign of pertussis, which can become very serious in infants and young children.

Cough treatment

As we have commented, cough is a symptom not a disease, so once the cause is identified, the doctor will treat the disease in question, and with it the cough will disappear.

But the dry cough caused by throat irritation during the catarrhal processes it can be especially annoying for the child, especially at night, so in these cases the pediatrician could indicate the administration of cough syrups or natural remedies.

In any case, we must consider the following:

Cough syrups are contraindicated under two years because they can cause seizures, tachycardia, decreased levels of consciousness and even death. For this reason, the US drug agency (FDA) recommends not using these syrups in children under four years, and especially not in children under two years.

In addition, as indicated by the Spanish Agency for Medicines and Health Products (AEMPS), syrups that carry codeine They should not be used in children under 12 years of age or in women who are breastfeeding.

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Natural medicine: offer honey to children older than one year, cut an onion into pieces and place it near the bed, use humidifiers in a very timely manner if the environment of the house is very dry (and if the pediatrician recommends it, because sometimes it can harm instead of benefiting), offering frequent fluids, and doing nasal washes with physiological saline can help fight cough.

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When to consult with the pediatrician

It is advisable to take the child to the pediatrician before any catarrhal or persistent cough (more than three weeks), but above all we must pay special attention to the following symptoms, which could indicate an urgent medical evaluation:

Cough with difficulty breathing: the ribs are marked and the sternum sinks, pitos or stridor are heard when breathing, very fast breathing, fatigue when breathing ...
Cough accompanied by prolonged fever
Cough attacks with changes in the color of the lips and / or skin (bluish / cyanotic)
Suspicion of foreign body aspiration

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