We’ve all been there. You get up to use the bathroom in the middle of the night and as you pass by your child’s room you hear it…coughing. Coughs always send shivers down my spine. Not only because they last so long (kids can have a cough for up to 2 months), but because they can mean so many dangerous things (bronchitis, croup, asthma…). Luckily there is a decoding language to coughs that can tell you if you should be worried or if you should just cuddle them up and weather it out. Read on for your membership to the Cough Decoder Club.
There are two steps in determining the seriousness of a cough. The first step is to assess the accompanying symptoms. Symptoms to watch out for are a fever, lethargy, wheezing, difficulty breathing and vomiting. These terms may sound simple, but when you are hovering over your child trying to detect what is wrong it is easy for your imagination to get the worst of you. “She slept an extra hour, is she lethargic?” Here are some concrete definitions.
- Fever- A real fever is anything 101 degrees F or higher. Anything below that is a low-grade fever which can be caused by many mild irritants, such as teething. The only time a low-grade fever is considered dangerous is when it occurs in infants 6 weeks and younger. If your baby is this young, contact your doctor anytime they have a temperature above 98.6 degrees F.
- Lethargic- Lethargy has little to do with how much your child sleeps. A sick child is going to sleep more because it is the body’s natural defense against illness. Lethargy is determined when your child is awake. It is almost like they are in a comatose state, but they are conscious. If your child lies limp while awake and can’t make eye contact or speak (if they are of speaking age) except to moan then it is time to worry. Anytime a child exhibits lethargic symptoms, they should be seen by a doctor asap.
- Wheezing- You may think your child is wheezing because you hear rattling when they breathe, but a genuine wheeze has an audible whistling sound.
- Difficulty Breathing- Again, you may think that you child is having a hard time breathing because you hear rattling or junk in their throat, but that is not necessarily true. If your child is old enough, they can tell you how their breathing is. Otherwise lay your child on their stomach, with their shirt off. If they are having a hard time, they will breathe in so hard that you can see their ribcage from the back. You can also watch the little indented spot above the breastbone. If it pulls in sharply when they breathe in, they are probably trying harder than usual. Another indication of difficult breathing is if they look worried when they inhale.
- Vomiting- This seems fairly straight forward, and it is–unless you have an infant. I had the scare of my life when my congested infant projectile-vomited on me after he had finished nursing. One frantic drive to urgent care later, I learned that he was fine. Infants who only eat liquids (formula or breastmilk) can have mucus or gas bubbles stuck in their esophagus. When they eat the liquid is not always enough to force the obstruction down, so the milk gets caught in the esophagus as well. When they cough or try to burp soon after a feeding, all of that liquid comes up looking like vomit. There are two ways to tell for sure. The first is if the ejected milk smells fresh. Spit up and vomit have an acidic smell due to the fact that they have mixed with baby’s stomach acid. If your baby’s ”discarded liquid” does not have that acidity, but rather smells like fresh milk then it is not vomit. The other way to check is to note frequency. The UC doctor told me to wait for it to happen on two separate occasions before bringing him in. The reason is because it is rare for milk to get caught in their throat twice in a row, so multiple occurrences would indicate vomiting.
The second step is determining the cough itself. A cough’s sound can tell you a lot about what is causing it. Below are the five most common coughs.
- Croup- Croup sounds scary and it can be in some cases, but not all. This cough is very distinctive. It is loud and brassy and sounds like a seal barking. If your child is having difficulty breathing (see above) or becomes extremely pale take them to the ER. Otherwise contact your pediatrician during normal business hours.
- Whooping Cough- This is a bacterial infection that can be treated with antibiotics. A victim of this cough will experience coughing fits that they cannot stop and it will have the tale-tell “whoop” at the end of each cough when they breathe in. These coughing spells last from 30 seconds to 2 minutes. If your child is having difficulty breathing (see above), cannot tolerate liquids (vomiting), or has an unrelenting fever go to the ER. Otherwise contact your pediatrician during normal business hours.
- Dry Cough-A dry cough is just that, a dry hacking cough. They tend to get worse at night. They may be a symptom of a common cold or asthma.
- Productive or Wet Cough- This cough sounds junky or rattling. It is called a productive cough because you can hear mucus being coughed up out of the lungs. This can be a symptom of an infection, bronchitis or pneumonia.
- Cough with Wheezing-A cough accompanied by a whistling sound when exhaling. Usually a symptom of asthma.
Comments
No comments.