How To Help Put A Stop To Your Child’s Never-Ending Cough

If you’ve ever had a sick kid, you know that coughing is one of those things that lingers (sometimes for weeks on end), leaving kids uncomfortable and parents wondering — well — just how to stop a constant cough in a child.

The answer, according to most pediatricians, is a bit more complicated because, as Dr. Michael D. Patrick, Jr., M.D., an emergency medicine physician at Nationwide Children’s Hospital and host of the hospital’s podcast PediaCast explains, “a cough has a job to do; it is an important part of our body's response to infection and to keeping things out of our lungs or bringing things up and expelling things out of our lungs.” For the most part, and generally speaking? “We don't want to get rid of coughs; coughs actually help us get better or prevent things from getting worse.” (A cough, for instance, can keep a cold from turning into pneumonia by keeping that bacteria out of the lungs, he says).

That said, coughs can be bothersome. “Upper respiratory drainage down the back of the throat can cause a tickle that keeps a child coughing and makes it so that they can't rest,” says Dr. Colleen Kraft, M.D., an attending physician at Children’s Hospital Los Angeles.

But docs say it’s time to switch our thinking about coughs in kids away from “how to stop a constant cough in a child” toward “how can I figure out what may be going on — and help keep my child comfortable?”

To answer this, we touched base with three pediatricians at top children’s hospitals around the country.

Determining the type of cough and causes

Coughs come in many different shapes and sizes. There are dry coughs, wet coughs, wheezing coughs, and other types of coughs. But Dr. Katie Lockwood, M.D., an attending physician at Children’s Hospital of Philadelphia Primary Care, Flourtown, notes that you can’t always put too much stock in a “type” of cough, since coughs can change (from, say, dry to wet or wet to dry) over the course of an illness — and aren't always indicative of severity or even what could be causing the cough. That said, here are some common cough types to know about:

• A “dry” cough. Also called a “nonproductive cough,” it doesn’t produce mucus or phlegm. It might feel like a tickle in the throat.
• A “wet” cough. It tends to sound like it's full of mucus, or like you’re coughing something up. “A lot of people think that a wet cough is because there's stuff in the lungs that you're bringing up,” says Patrick. “But it's more likely that it's nasal drainage, landing on the vocal cords, then when you're coughing up through that mucus, you get the ‘wet’ sound.”
• A wheezing cough. A wheezing cough may sound like whistling. You might also notice your child is having a hard time breathing. A wheezing cough is also an exception to the idea of a cough being an important part of your body’s natural immune response, says Patrick, and is a sign to see your doctor — especially if you notice labored breathing.
• A barking cough. It sounds like a bark and can be a sign of a respiratory virus called croup, which impacts your upper airway where your voice box is (creating that harsh quality to the cough). If the barky noise is happening only when your child is coughing, the cough can usually be managed safely at home, says Lockwood, but if they're making any barky noises at rest or in between the coughing or if you hear any abnormal noises or noisy breathing in between coughs, those are “red flags that you should see the doctor,” she says.
• Whooping Cough. A cough that follows a pattern of cough, cough, cough, cough, and then a big breath or having a hard time catching the breath could be a sign of pertussis, a highly contagious respiratory infection, says Patrick. Sometimes it’s even accompanied by vomiting because you're coughing so hard that the cough elicits your gag reflex, he says. Always, it’s a sign to see your doctor.

Treating a persistent cough with medication

A general rule of thumb: “In kids, we don't recommend cough and cold medicines,” says Patrick. That’s because — again, generally speaking — the idea is that a cough will help mucus to trap the virus, keeping bacteria from areas like the lungs.

“So, in general, we try not to suppress the cough, because we want the body to do what it's supposed to do,” adds Lockwood. “And keeping that mucus down in the airway is potentially a risk factor for things like pneumonia.”

Typically, over-the-counter (OTC) cough meds are also “not safe for children under the age of 4,” she says. (You’ll find warnings on the labels.) The Food and Drug Administration (FDA) does not recommend OTC medicines for cough and cold symptoms in children under 2 as they could “cause serious and potentially life-threatening side effects.” The group also notes that they are “not aware” of “any proven benefits” of homeopathic cough and cold medicine for children under 4. The Center for Disease Control and Prevention’s advice echoes that of many experts, that children under 4 should not be given cough or cold medicine unless specifically advised by a doctor.

That said, sometimes your child needs medication. Sometimes, steroid medications are prescribed to help with a cough associated with croup, adds Patrick. And if your child has pertussis, they may need an antibiotic to treat the underlying infection.

So, all in all, generally speaking, skip OTC cough suppressants for kids but know that sometimes, especially in the cases of particular coughs or more serious issues, medications are required — so it’s always a good idea to touch base with your pediatrician if you have questions.

Treating a persistent cough with home remedies

While wondering how to stop a constant cough in a child isn’t always the right approach, often, home remedies to treat a child’s persistent cough can help your child feel better and more comfortable. Here are some that physicians prescribe to their patients:

• Remove nasal secretions. If your child is old enough, teach them to blow their nose frequently, suggests Patrick. For babies, use a nasal aspirator to suck mucus out. Clearing excess mucus out of the nose is a fast way to make breathing more comfortable, especially before eating, breastfeeding, or bottle-feeding young children.
• Use steam or cold. Running a hot shower water and having your child sit in the bathroom allows them to breathe in the warm mist that can help loosen mucus and ease symptoms, says Lockwood. In the case of something like croup, using cold air — say, opening a freezer and having your child breathe in cold air or going on a walk outside in the winter — can be a fast, quick-acting way to cut a cough that just won’t give
• Turn on a cool mist humidifier. A cool mist humidifier near where your child sleeps can help loosen secretions and relieve some of the drainages that happen at the back of the throat, explains Kraft.
• If your child is over age 1, consider honey. You can put honey in a warm liquid such as water or apple juice, or for an older child, decaf tea and use about 1 teaspoon every four to six hours, says Kraft. This will help kids stay hydrated and hopefully loosen secretions. Just remember to avoid honey before age 1 as “infants can't process the botulinum spores that can be found in honey,” says Lockwood.
• Try warm fluids or cold ones. Both warm sips of water or cold — say, a popsicle — for children over 6 months could help break up the drip in the back of the throat and provide comfort, says Kraft.
• Use saline nose drops. Two or three drops in each nostril can help move mucus for a child who is stuffed up, helping them feel more comfortable, says Kraft.
• If your child is over 6, try a cough drop. “Sometimes a cough drop will cut the secretions in the back of the throat and stop that tickle and cough,” says Kraft. Under age 6, she doesn’t recommend this due to the risk of choking.

How do I get my child to stop coughing at night?

Feel like your child’s cough gets worse at night? That makes sense. “A lot of coughs happen from post nasal drip,” says Lockwood. “While lying down, mucus can run back down the throat, which can sometimes lead to coughing.”

Being aggressive about home remedies in the evening (like a cool mist humidifier and honey for children over 12 months) “sets you up for the best possible scenario before bed,” says Lockwood.

“There's actually some research to show that honey works better than cough syrup to reduce some nighttime coughing,” says Kraft.

What to do if a child is continuously coughing after trying OTC and home remedies

If your child has been coughing for a while and changes at home don’t seem to be doing the trick, pediatricians suggest keeping the below pointers in mind:

Know how long coughs last. It’s normal for coughs to linger even after a virus runs its course — sometimes two weeks after a virus, says Patrick. “It just takes a little time for the body's inflammatory system to calm back down after a cold.”

Know when to bring your child to their doctor. “The best way to tell what's causing a cough is listening to the chest and listening to a child breathe, so it's going to be important to see your doctor and get a kid's chest listened to if they have a persistent cough,” says Patrick. Signs that warrant a doctor visit:

• A fever that goes away and then returns, as it could indicate potential pneumonia
• Any wheezing, noisy breathing, struggles with breathing, or a cough with vomiting or bleeding

Ultimately, wanting to stop a constant cough in a child makes sense. But doctors are quick to remind parents that often, coughs are productive — the body’s natural way of clearing away excess mucus and even stopping a more mild issue from becoming a more serious one. There are always exceptions, and it’s good to know when a cough might signal a necessary trip to the pediatrician. Trusting your instincts as a parent, knowing that coughs can linger, and understanding why a cough exists in the first place can all help you help your child feel their best.

Experts:

Katie Lockwood, M.D., MEd, an attending physician at Children’s Hospital of Philadelphia Primary Care, Flourtown.

Michael D. Patrick, Jr., M.D., an emergency medicine physician at Nationwide Children’s Hospital and host of the hospital’s podcast PediaCast.

Colleen Kraft, M.D., MBA, an attending physician at Children’s Hospital Los Angeles.