Springdale Mason Pediatrics

Cough - Symptom (Age 6-21)


  • A cough is the sound made when the cough reflex clears the lungs. It helps protect the lungs from infections.
  • A coughing fit or spell is over 5 minutes of nonstop coughing
  • Coughs can be dry (no mucus) or wet (with mucus)

Call or Return If

  • Trouble breathing occurs
  • Wheezing occurs
  • Cough lasts more than 3 weeks
  • You think your child needs to be seen
  • Your child becomes worse

About This Topic


  • Viral bronchitis. Most coughs are part of a cold that includes the lower airway. The bronchi are the lower part of the airway that go to the lungs. Bronchitis in children is always caused by a virus.
  • Many viruses can cause a cough. This includes cold viruses, influenza, croup and bronchiolitis (RSV) viruses.
  • Bacteria do not cause bronchitis in healthy children.
  • Chronic bronchitis in adults is caused by smoking.
  • More serious causes: whooping cough, pneumonia and airway foreign body.
  • Asthma. Asthma is the most common cause of chronic coughs in children. In adults, it's smoking.
  • Allergic Cough. Some children get a cough from breathing in an allergic substance. Examples are pollens or cats. Allergic coughs can be controlled with allergy medicines, such as Benadryl.

Phlegm or Sputum

  • Mucus or phlegm can be white, grey, yellow or green.
  • Yellow or green phlegm is a normal part of the healing of viral bronchitis.
  • This means the lining of the windpipe was damaged by the virus. It's part of the phlegm your child coughs up.
  • Antibiotics are not helpful for the yellow or green phlegm seen with colds.

Trouble Breathing: How to Tell

  • Trouble breathing is a reason to see a doctor right away. Respiratory distress is the medical name for trouble breathing.
  • Here are symptoms to worry about:
  • Struggling for each breath or shortness of breath
  • Tight breathing so that your child can barely speak or cry
  • Ribs are pulling in with each breath (called retractions)
  • Breathing has become noisy (such as wheezes)

Prevention of Spread to Others

  • Cover the nose and mouth with a tissue when coughing or sneezing.
  • Wash hands often. After coughing or sneezing are important times.

After Care Advice

  • Coughs are a normal part of a cold. Viral bronchitis is the most common cause of a new cough in children.
  • Coughing up mucus is very important. It helps protect the lungs from pneumonia.
  • A cough can be a good thing. We don't want to fully turn off your child's ability to cough.
  • Here is some care advice that should help.
Homemade Cough Medicines:
  • Goal: Decrease the irritation or tickle in the throat that causes a dry cough.
  • Use HONEY 1 teaspoon (5 ml) as needed. It's the best homemade cough medicine. It can thin the secretions and loosen the cough. If you don't have any honey, you can use corn syrup.
  • Use COUGH DROPS or throat drops to decrease the tickle in the throat. If you don't have any, you can use hard candy.
Drug Store Cough Medicines (DM):
  • Non-prescription cough medicines are not advised. Reason: No proven benefit for children. (FDA)
  • Honey has been shown to work better for coughs. OTC cough syrups containing honey are also available. They are not more effective than plain honey and cost much more.
  • If you decide to buy a cough medicine, choose one with dextromethorphan (DM). It's present in most non-prescription cough syrups.
  • When to Use DM: Give only for severe coughs that interfere with sleep or school. Give every 6 to 8 hours as needed.
Coughing Fits or Spells:
  • Breathe warm mist (such as with shower running in a closed bathroom).
  • Give warm clear fluids to drink. Examples are apple juice and lemonade.
  • Reason: Both relax the airway and loosen up any phlegm.
  • For vomiting that occurs with hard coughing, give smaller amounts per feeding.
  • Reason: Vomiting from coughing is more common with a full stomach.
  • Try to get your child to drink lots of fluids.
  • Goal: Keep your child well hydrated.
  • It loosens up any phlegm in the lungs. Then it's easier to cough up.
  • If the air in your home is dry, use a humidifier. Reason: Dry air makes coughs worse.
  • For fevers above 102° F (39° C), give acetaminophen (such as Tylenol) or ibuprofen. Note: Lower fevers are important for fighting infections.
  • For ALL fevers: Keep your child well hydrated. Give lots of cold fluids.
Antibiotics Not Needed:
  • Antibiotics are not helpful for viral infections.
  • They can only kill bacteria.
Avoid Tobacco Smoke:
  • Tobacco smoke makes coughs much worse.
What to Expect:
  • Viral coughs usually last for 2 to 3 weeks.
  • Sometimes, your child will cough up lots of phlegm (mucus). The mucus can normally be gray, yellow or green.
Return to School:
  • Your child can go back to school after the fever is gone.
  • Your child should also feel well enough to join in normal activities.

Author: Barton Schmitt MD, FAAP
Copyright 2000-2021 Schmitt Pediatric Guidelines LLC
Disclaimer: This health information is for educational purposes only. You the reader assume full responsibility for how you choose to use it.
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