Your baby has a cough. When should parents worry?

Key takeaways

• Most baby and toddler coughs are caused by common viral infections and improve with supportive care.
• Trouble breathing, dehydration or unusual lethargy are signs parents should seek medical care right away.
• RSV often worsens around days 4 to 5 before children start to improve.
• Babies under age 1 should not take cough medicine, but that doesn’t mean there’s nothing you can do.
  

Your baby’s cough can send your anxiety soaring, especially if it starts in the middle of the night. Is it just a cold? Could it be RSV? Should you head to the ER?

During peak respiratory season in metro Detroit, these are common questions in pediatric offices. Michelle Faber, MD, a pediatrician with Henry Ford Health, shares what parents should watch for and when it’s time to worry.

What causes most coughs in babies and toddlers?

“No matter what time of year it is, the most common cause of cough is illness, most of which is viral,” Dr. Faber says.

That includes colds, flu, RSV and COVID. Bacterial infections like pneumonia and pertussis, also known as whooping cough, are concerns pediatricians watch for, but they are far less common than viral respiratory infections.

Croup is another frequent concern in younger children. Dr. Faber explains that croup is not a separate illness. It is inflammation and swelling of the upper airway usually caused by a virus. Because babies and toddlers have narrower airways, that swelling can create the classic barking cough.

How can I tell if my baby’s cough is serious?

If your child has a runny nose, a fever that comes down with medication and is drinking fluids, sleeping and acting like their normal self, that is generally reassuring.

But certain symptoms should prompt urgent evaluation.

Parents should seek care right away if their baby is struggling to breathe, has ribs pulling in with each breath, has flaring nostrils, is wheezing, is coughing to the point of vomiting and cannot keep fluids down, has fewer than three wet diapers in 24 hours or has blue lips or skin.

“If a child just isn’t acting like themselves and is difficult to engage, that’s a child I’m more worried about,” Dr. Faber says.

What should parents know about RSV?

RSV often starts with mild symptoms for the first couple of days. Unlike many other viruses where children are sickest at the beginning, RSV tends to worsen around day 4 or 5 before starting to improve closer to day 7. That mid-illness peak can catch families off guard.

In infants, especially those born prematurely, RSV can cause significant respiratory distress and in rare cases apnea, meaning they stop breathing.

There is now an RSV immunization available for babies during their first RSV season, as well as a vaccine given during the third trimester of pregnancy to help protect newborns.

“It really is meant to prevent hospitalization and death,” Dr. Faber says. In Michigan, pediatric guidance follows the American Academy of Pediatrics recommendations.

What can I safely give my baby for a cough?

For babies under 1 year old, there are no recommended or proven effective cough medicines. That can feel frustrating, but supportive care can make a difference.

Dr. Faber recommends nasal saline drops with suction, using a cool mist humidifier in your child’s room and slightly elevating the mattress to reduce postnasal drip. A warm bath or shower before bed can also help loosen mucus.

For children over 1 year old, a small amount of honey may help soothe the throat. Honey should never be given to infants under 1 due to the risk of botulism.

Over-the-counter cough medicines are not recommended for children under 6 and have not been shown to be effective.

How long is too long for a cough?

It is common for a cough to linger for up to a month after a cold or even pneumonia. But if your child is still coughing beyond four weeks, it is important to see your pediatrician to rule out asthma, reflux or other underlying causes.

And when in doubt, Dr. Faber reminds parents, it is always okay to ask.

“It’s your job to worry and my job to tell you if you need to,” she says.
This content is sponsored by Henry Ford Health. Learn more at Expert Answers to Your Kids’ Health Questions.

from Metro Parent https://ift.tt/hNpwfW7