Cough Follow-Up Guide: What Parents Need to Know

Understanding Your Child's Cough

Coughing is a protective reflex. It helps clear mucus and irritants from your child's airways. Most coughs are caused by viral infections and will resolve on their own with time and supportive care.

Common Types:

  • Dry cough: Typically scratchy, doesn't produce mucus
  • Wet cough: Produces phlegm or mucus
  • Barking cough: Sounds like a seal bark, common in croup for children under 5 years

When to Manage Cough at Home

✅ You can manage your child's cough at home when:
  • Your child can easily fall back to sleep if the cough wakes them up
  • No difficulty breathing/no breathing too fast between coughs
  • Doesn’t have a fever above 102°F for more than 3 days
  • Has not had a cough longer than 3-4 weeks without being seen by a medical provider

How to Treat a Cough at Home

🏠 Home Remedies:
  • Rest: Allow your child to rest and eat as tolerated
  • Hydration: Offer plenty of fluids to keep mucus secretions thin
  • Humidity: Use a cool-mist humidifier or sit in a steamy bathroom
  • Saline nasal spray/drops: Helps clear congestion
    • ⚠️ Suction is best used for toddlers and infants who can't blow their own nose, usually no more than 4-6 times in 24 hrs to avoid irritating the nasal passage too much
  • Positioning: Keep child upright during the day when possible
    • For children older than 2 years: Use two pillows to elevate head—everyone coughs more when lying flat
    • ⚠️ Never use pillows to prop up infants under 1 year due to risk for SIDS
💊 Safe Medications
  • For children over 1 year: ½ to 1 teaspoon honey or drink in warm fluids before bedtime
  • Acetaminophen or Ibuprofen: Only if fever or discomfort is present
  • Vapor rub: Infant version if under two, regular version if over two
  • AVOID over-the-counter cough medications for children under 6 years

When to Contact Us Again

📱 Contact us when:
  • Cough lasting more than 10 days without improvement
  • Symptoms worsen or new symptoms develop
  • Fever persisting beyond 3 days with cough
  • Persistent nighttime cough interfering with sleep
  • Cough associated with wheezing or noisy breathing
  • You're just not sure and need reassurance

When to Visit Your Pediatrician

🩺 Go to an in-person appointment when:
  • Cough lasting more than 4 weeks
  • Fever >3 days with worsening cough
  • Cough with wheezing, chest pain, or labored breathing
  • Barking cough with noisy breathing (stridor—a harsh, high-pitched sound) that doesn't improve with home care
  • Sudden onset cough after a choking episode (concern for foreign body)
  • Persistent, dry cough that could indicate asthma, allergies, or reflux

When to Go Straight to the ER

  • cough leading to vomiting or inability to catch breath
  • stridor (harsh, high pitched sound) when breathing
  • Sudden onset cough after choking (concern for foreign body)
  • severe respiratory distress (rapid breathing, flaring nostrils, pulling in of the ribs/neck muscles when breathing)
  • blue lips or face
  • Coughs can linger after a viral illness and may persist for 2-4 weeks as airways recover
  • Children can develop back-to-back viruses which cause consecutive coughs
  • Seasonal allergies, asthma, or reflux can cause chronic coughs
  • Cough suppressants are not recommended for children under 6 years
  • Most viral coughs will gradually improve with supportive care

If your gut tells you something is wrong, don't hesitate to reach out. Need help? Reconnect with our on-demand team of medical staff available 24/7.

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