Coughing is a reflex that helps clear the airway of secretions, dust, and irritants. While most childhood coughs stem from common colds or respiratory viral infections and improve on their own, a cough can also signal a more serious underlying condition. According to Master, Doctor Le Anh Trong, from the Pediatrics Department at Tam Anh General Hospital Hanoi, parents should seek medical attention if their child's cough presents with the following signs.

Cough with difficulty breathing

Difficulty breathing in children may manifest as rapid breathing, labored breathing, flaring nostrils, chest indrawing below the rib cage, or a sunken sternum upon inhalation. Infants might feed intermittently, refuse to feed, be unusually fussy, or appear more fatigued than normal.

Parents should count their child's breaths when the child is calm and not crying. Normal respiratory rates vary by age and require professional assessment alongside other symptoms. Doctors will specifically evaluate whether the child experiences difficulty exhaling or inhaling to aid in diagnosis and treatment.

Bluish lips, blue fingertips, intermittent breathing pauses, weak breathing, or difficulty waking are emergency signs. Families must take the child to the nearest medical facility immediately and avoid self-treatment at home.

A doctor examines a child's respiratory system. Photo: Tam Anh General Hospital.

Wheezing or abnormal breathing sounds

Wheezing is a high-pitched whistling sound, often noticeable during exhalation, indicating narrowed small airways. This condition can occur with bronchiolitis, bronchial asthma, or other respiratory illnesses. Children typically present with coughing, rapid breathing, poor feeding, or fatigue.

Not all noisy breathing signifies wheezing. Infants with nasal congestion may make snorting sounds. A distinct whistling sound during inhalation might indicate upper airway narrowing. Parents can record their child's breathing while calm for the doctor's reference. However, video recordings do not replace a direct medical examination.

If a child is eating or playing with small objects and suddenly experiences choking coughs, difficulty breathing, inability to cry or speak, and bluish discoloration, it could be due to an airway foreign body. This is an emergency requiring proper first aid and immediate transport to a medical facility.

Cough with fever, lethargy, or refusal to feed

Fever accompanying a cough is common in respiratory infections. The severity depends on the temperature, the child's age, and overall condition.

Newborns may not exhibit symptoms as clearly as older children. Signs such as reduced feeding, refusal to feed, frequent vomiting, lethargy, difficulty waking, unusual fussiness, or decreased urination frequency warrant attention.

Infants under three months old with a fever of 38 degrees Celsius or higher require prompt medical evaluation. For older children, parents should seek medical attention if the fever is high, recurrent, or accompanied by difficulty breathing, seizures, rash, chest pain, or increasing fatigue.

Cough causing vomiting and dehydration

Children may vomit after a strong cough due to an irritated throat reflex. If this occurs only a few times, and the child remains alert, eats, drinks, and urinates normally afterward, parents can continue monitoring. However, frequent vomiting, inability to drink fluids, dry lips, tearless crying, sunken eyes, reduced urination, or no urination for several hours may indicate dehydration and require medical consultation.

Recurrent coughing at night or after meals, accompanied by heartburn, chest pain, or spitting up, often relates to gastroesophageal reflux. Doctors need to take a thorough medical history and rule out respiratory causes before making a diagnosis.

Prolonged cough

Children should be examined if a cough does not improve, persists for many weeks, recurs frequently, worsens at night, appears during physical activity, or affects eating and sleeping. These symptoms could indicate bronchial asthma, chronic respiratory inflammation, allergies, or other underlying causes that need identification.

Coughing blood or chest pain

Coughing blood, even a small amount, requires investigation. While blood might originate from damaged nasal or throat membranes after a forceful cough, it can also be associated with respiratory illnesses.

Chest pain during coughing sometimes results from continuous contraction of chest wall muscles. However, if a child experiences severe pain, difficulty breathing, lethargy, or sudden onset of pain, families should not continue monitoring at home.

If a child coughs but remains alert, feeds well, breathes normally, and shows no warning signs, parents can ensure rest, adequate hydration, appropriate nasal saline irrigation, and monitor their condition.

Doctor Trong advises against self-administering antibiotics, cough suppressants, expectorants, or old prescriptions to children. Some over-the-counter cough and cold medications can cause serious side effects in young children. Antibiotics are ineffective against viral illnesses and should only be used when prescribed by a doctor.

Van Anh