A Cough Accompanied by a Sneeze
Dry, unproductive coughs lasting for weeks with a seasonal pattern is concerning for allergic hyper-responsiveness in many children. These patients may also have recurrent nosebleeds, chronic red eyes, “shiners” from rubbing the eyes, and bouts of sneezing. A simple nasal spray or temporary course of oral medication can help. Not all children need allergy testing: sometimes the parental history, a simple exam, and trial of medication are all that is needed for peace in the house.
The Coughing Cheerleader
Children with acid reflux, voice overuse, or vocal abuse may have scar tissue on the voice or a polyp. These types of coughs can occur at any time of the year in the absence of all other symptoms and can be confirmed with direct visualization of the voice box.
A Wet Cough
A whistling, rapidly breathing, irritable child with a wet productive cough over a few days may be suffering from bronchiolitis, which is an infection of the tiny spaces in the lungs. Children with pneumonia may share similar symptoms and do require medical attention.
The Whoop Cough
When a child (including adolescents!) has a chronic cough for several days that transitions into violent coughing fits, gasps for air, and vomiting, your child may have whooping cough. No longer considered a relic from the Great Depression, whooping cough is encountered now primarily because of lack of herd immunity based on vaccination choices. Occasionally, the immunity in adolescents and adults may also wear off and they may get infected. If you suspect whooping cough, discuss this with doctor immediately.
Overall, parents should be reassured that most coughs are self-limited and go away, but some of the ones listed above require more than just a hug and a warm blanket. Your pediatrician will help with most of these concerns but may need to involve pulmonary doctors and/or ear nose and throat specialists when a cough is more than just a cold.