Coughing in children: Insights from a pediatric pulmonologist
Tina Santiago-Rodriguez ( - August 18, 2015 - 3:33am

Most, if not all, parents know that when a child has a cough, it can be quite a worrisome thing. One can especially be bothered by it if you are not aware of what to expect and what to look out for.

To help parents out there identify specific signs and symptoms of their children’s cough, I asked Dr. Mark Herbert Rosario, a pediatric pulmonologist, a few questions. Below are the questions and Dr. Rosario’s corresponding answers:

Tina: How can a mother know when her child has a cough? Are there specific signs and symptoms to look out for?

Dr. Rosario: A child’s cough can mean different things and it is probably the most common complaint to doctors. Coughing is aimed at the removal of mucus and other materials, like a lodged piece of food or phlegm, from the airways.

Stimuli that cause coughing may originate from the central nervous system, such as [in the case of a] psychogenic cough; or most commonly, they may be from the respiratory system, located either in the major airways or in the lining of the lungs.

It can also be provoked by a non-respiratory cause, such as irritation of the diaphragm, throat, or even the ears. So a mother should observe carefully what type of cough her child has — whether it is dry, hacking, or barking/brassy; and whether it is productive (presence of phlegm) by sound and appearance.

Specific signs and symptoms which warrant a visit to your doctor includes the following:

  • Your child has difficulty catching his breath
  • Your child looks blue or is losing color in his face and/or lips.
  • Your child’s cough interferes with nursing or feeding.
  • Your child’s cough makes him weak or faint.
  • Your child’s cough persists continuously for more than three hours.
  • Your child’s cough produces blood or discharge.

Tina: How do you differentiate among a cough due to the following conditions:allergies, flu, pneumonia, asthma?

Dr. Rosario: Differentiating a cough due to conditions like flu, pneumonia, asthma, or allergies entails a detailed history and a good physical exam of the child.

The common cold or flu usually brings out a dry hacking cough. This usually is associated with a stuffy or runny nose, sore throat and/or fever.

On the other hand, pneumonia, which could be from a viral or bacterial infection, gives you a wet and phlegmy type of cough. Other associated symptoms would be fever (usually high), fast breathing, loss of appetite, fatigue, and cyanosis (baby turns blue).

Asthma would present a cough accompanied by wheezing or noisy breathing. This type of coughing is usually worse during nighttime or may follow after exercise or weather changes. Associated symptoms would be similar to the common cold. They may also have a slight fever or itchy and runny nose.

Coughing due to allergies is tricky to diagnose because they have the same associated symptoms with the common cold. They usually present with a dry cough like the flu but the main difference is that they tend to be more persistent.

Other associated symptoms to establish allergies are the presence of allergies in the family, frequent sneezing usually early in the morning, continuously stuffy or runny nose, and frequent skin rashes or redness.

Tina: What should parents do if their child has a cough?

Dr. Rosario: Parents should always be mindful of their child’s cough. When a cough is severe and persists to the point that it interferes with nursing, eating or breathing, it is time to see their doctor.

A child’s cough need not trigger excess panic in parents and other caregivers. Many times, a cough can be treated with simple home remedies like honey, coupled with good, nutritious food, increased fluid intake, and plenty of rest. Of course, if ever you are in doubt, it is still best to consult your pediatrician.

Do you have questions related to health and family that you’d like answered? Leave me a message on Facebook ( or contact me here if you do, and I’ll try to get them answered by qualified experts!

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