Why does my child have a chronic cough?

Why does my child have a chronic cough?

Parents may wonder why their child has a chronic cough if they have been sick with a cold. A chronic cough is defined as a cough that lasts more than 3 weeks continuously. Symptoms of a chronic cough can include coughing regularly, coughing with phlegm, and a rumbling sound in the throat. Some causes of chronic coughing are chronic nasal discharge, which can flow down from the nose to the throat. Asst. Prof. Apassorn Wattanasomsiri, Pediatric Respiratory Medicine Vibhavadi Hospital can help answer any questions parents may have about their child's chronic cough.

What cause chronic cough?

Some parents may be wondering why their children catch colds when they are sick. Coughing continuously for more than three weeks is considered a chronic cough. Symptoms of a chronic cough can include phlegm rumbling in the throat as well as coughing regularly. Part of this is caused by chronic nasal discharge which flows down from the nose to the throat. Groups of children found to have chronic runny nose can include allergic groups with nasal symptoms such as clear mucus in the evening, morning and night, sneezing and itchy eyes. Another cause of chronic runny nose is sinusitis, which is when the enlarged adenoids (lymph nodes behind the nasopharynx) block the flow of the sinus cavity and middle ear tube, leading to frequent ear infections.

How does sinusitis cause a chronic cough?

The sinuses are air cavities with a small outlet into the nose. When a person has a cold or a child has allergies, this exit becomes blocked by the swollen nasal membrane, leading to the buildup of substances in the sinus cavity and inflammation. The child will then display a fever and thick, yellow or green snot that can last for a long time. Since the back of the nostril connects to the throat, the snot can run down the back of the throat. In many cases, parents may not even notice the snot due to its location. This mucus can then cause irritation and coughing.

Children tend to cough more at night or in colder environments because when lying down, mucus and phlegm is more likely to drip down the throat. Cold, dry air also makes the mucus and phlegm sticky, which further exacerbates the issue. Additionally, in these conditions the small hairs in the respiratory tract are not as effective at blowing the mucus and phlegm out, leading to an accumulation of the substances and an increase in coughing.

What should you do when your child coughs?

A doctor should be consulted to determine the exact cause of the cough. If the diagnosis is sinusitis, antibiotics may be prescribed. Nasal decongestants and anti-inflammatory medications are used to treat allergies. However, nasal drops should only be used for a maximum of 4-5 days, as prolonged use can be risky. A safe alternative is to use saline nasal drops to clear the mucus, as mucus buildup is a major factor in coughing.

How is the nasal wash done?

-     For young children, use 1-2 drops of saline, dripping into each nostril while the child is lying on their side. Keeping their face still will allow the salt water to reach the mucus, making it less sticky so it can be removed more easily. If the mucus is particularly thick, a red rubber ball No. 0-1 can be used to help draw it out. To do this, the ball should be inserted into the nostrils about 1-1.5 cm deep. In some cases, it may have to go up to 3-4 cm deep, but this must be done with extreme caution.

-          If your child is older and the snot is not too thick, start by sitting up with the head slightly raised. Put 3-4 drops of a saline solution into each nostril and wait a few minutes before lowering the head to blow the nose. Do this a few times until the nose is clear, then repeat the same process on the other nostril. If the mucus is thick, it is recommended to use a 10 cc syringe (no needle) and slowly inject 5-10 cc of saline solution into each nostril while looking down and having a container to catch the mucus. Do not use too much force when injecting the saline solution. Blow the nose once the mucus has come out. Repeat the process on each side a few more times until the nose is clear. It is recommended to do this at least twice a day, once in the morning and once before bed. If the nose is very congested or runny during the day, the process should be repeated.

Are there any risks associated with nasal irrigation?

Most parents find that nasal suction is more comfortable and helps to clear the nose of their young child, leading to better sleep, less coughing and improved ability to eat milk and food. It is important to remember to perform the suction gently and to keep the face still. Older children should not blow their noses hard, but rather do so several times. If some drops fall into the throat, there is no danger.

What risks are there to allowing a child to have a runny nose and persistent coughing?

In the case of asthma, a relapse is likely and treatment is often ineffective when there is a buildup of sputum in the lungs over a long period of time. This, in addition to the nasal drip down the throat, causes congestion of the nose and the child having to open their mouth to breathe in dry air, leading to dry mouth, dry throat and sore throat, which can lead to an increased risk of otitis media. To help with this, it is recommended to reduce milk and food intake, as well as to get enough sleep despite frequent coughing at night.

Prevention

It is important to remember that taking medication alone may not completely cure a runny nose and cough. Therefore, it is important to teach the child how to properly drain any mucus that remains, to avoid potential chronic coughing issues.

by Asst. Prof. Apassorn Wattanasomsiri, M.D.

Pediatric Respiratory Medicine, Vibhavadi Hospital