December 23, 2008,
K.H. asks from Dover, DE on December 21, 2008
How Do You Know a Good Cough from a Bad Cough?
As a mother, I am constantly at this dilema when it comes to my girls getting sick. I hate to drag them into the docs for a simple cold, with a cough that will go away on its own with time and rest. But whenever I hear them cough, I am always confused about when their cough is actually more than that, and they should be seen. Of course, I know the barky cough is not good, and should be seen...but is there another way that other mothers know (and I seem to have missed out on) when their child needs to be seen due to a "bad" cough, a sign that it is something more?
D.K. answers from Washington DC on December 21, 2008
As the other mom mentioned, the cough isn't the only symptom to watch of course, but as far as coughing goes, here's the best advice I can give you.
I would say that a barky cough (like you said) a wheezy cough (restricted airways), and a cough with a rattle deep in the chest (pneumonia) should be heard by a doctor. Also a cough with that little pain sound at the end as that could signify a sore throat which in turn could be strep or any number of other things.
Normal cold coughs (at least in my experience) progress in the following manner:
1. Dry, tickly occasional cough (usually accompanied by a runny nose which is often the cause of the cough in the first place, known as a post-nasal drip)
2. Dry, raspy uncontrollable cough (caused by irritated cillia in the throat from stage 1)
3. Deeper and a little wetter but still unproductive cough (exacerbated by laying down at this point)
4. Frequent, uncontrollable, wet and productive (meaning you can hear the mucus loosening up during the cough, but the mucus is still in the upper respiratory region, lower in the lungs is potentially bad and is a call a doctor should make)
5. Productive coughs tapering off in frequency and violence signifying the end of the cold.
Also, if you happen to see any of the mucus, keep in mind that clear is good, any other color could signify an infection, especially dark yellows, greens and browns.
I hope this helps you feel a little more confident about knowing when to go to the doctor and when not to. Of course, the best thing you can do is to listen to your inner voice. Every mom has one. No one knows your children like you do and if something seems very wrong, you'll know.
Best of luck through the rest of cold and flu season.
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K.W. answers from Washington DC on December 21, 2008
Try focusing on the "big picture", not just the one symptom. What I mean is ask yourself some of the following questions-
Is she running a fever? How long has she had the cough? Does she seem short of breath or seem to be breathing really fast, even when just sitting still? Is she still playful and generally content or is she lethargic? Is the cough so bad that it's interfering with sleep? Is she eating and drinking? Peeing regularly? Answering questions like these can often give you a pretty good idea of whether or not it's time to call a doctor.
Keep in mind that a cough is usually the last symptom to completely go away. If your child has asthma or some other type of respiratory condition, you may need to call a dr. sooner because a cough is often the first sign of a potential problem. I know from personal experience that we, as parents, are often more bothered by our children's sickeness than they are. When in doubt, call your pediatrician or speak to his advice nurse and tell them your child's symptoms before making an appointment. Sometimes they can give you a home remedy and tell you what danger signs to watch for. Hope this helps!
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A.B. answers from Washington DC on December 23, 2008
With children you cannot dismiss symptoms like cough, fever, aches, rashes, because there are some more serious illnesses that have similar symptoms to that of the average cold. Recently, both of my children came down with a severe upper respiratory infection, which I "sourced" about because the cough was really scary. We did have to treat it aggressively, because in my daughter's case (age 4), it quickly turned to pneumonia, with a lingering cough that is only now clearing up. My son still has a croupy cough, but it is getting better. At first, though, I worried and called the doctor's office. They decided not to adjust his meds, as he was already on an aggressive plan, and now I see progress. So, see a pediatrician when you're not quite sure. I hate making unnecessary trips like most busy parents, but I'd hate it more if the condition was serious and I kept trying home remedies and my children suffered needlessly. Most pediatricians understand. I've made my share of needless trips, but there have been an equal number of serious illness and it really was hit-or-miss. Children are often not that great at communciating just how serious the pain is, either, so I vote for seeing the doc to determine the severity. There are some insurances that acknowledge that the childhood years are serious and do not charge a copay for every single trip to ped's office until age 13. You can also use a pain indicator system to determine how much in distress is your child. Using five paper plates, make faces on each one with different expressions: 1 being happy, 5 being miserable and in tears. Hold up various faces and ask your child to point to the one that represents his pain. If he points to number 4 (out of 5), you can make that a family policy to get child to pediatrician. If he points to 2, wait another day with home treatments and see how the child progresses. Point to 3, call the doctor's office and seek counsel over the phone and let them tell you if you should bring him in. 5? Trip to ER might be needed. I forgot to write that both of my children were diagnosed as asthmatic after so many trips with a barking cough. Had I dismissed each episode as a typical cold, we would have missed the pattern and they'd have more trouble with colds. I think the rule of thumb is when you notice symptoms interfering with normal activity and child's overall behavior is changing, you need help. Eg., child coughs but continues playing, ok. Child coughs, stops eating, but still plays and drinks fluids and progresses by day 3, ok. Child has barking cough, becomes listless and cannot sleep due to cough, even without fever, help is needed.
R.H. answers from Norfolk on December 22, 2008
you don't really need to bring them to the doctor for a cough it's when it's more than a cough. Doctors never like you to give Cough suppressant to children. Coughing is a thing the body does to clear it's air pipe. If they can't do that they have no other way to clear it and can drown on the mucus in the pipe. Adults spit out the mucus. Children and babies don't know how. The only time they say it's ok to give a cough suppressant is if the coughing is productive. Meaning it's dry. You can hear it when it's dry. If this kind of cough keeps them from sleeping than you should prob. bring them to the doctor if med. doesn't help.
The only real reason i bring to the doctor is for a temp OR if i don't think they can breath for the most part.