Children's Cough: Causes and Treatments

  • Medical Author:
    John Mersch, MD, FAAP

    Dr. Mersch received his Bachelor of Arts degree from the University of California, San Diego, and prior to entering the University Of Southern California School Of Medicine, was a graduate student (attaining PhD candidate status) in Experimental Pathology at USC. He attended internship and residency at Children's Hospital Los Angeles.

  • Medical Editor: David Perlstein, MD, MBA, FAAP
    David Perlstein, MD, MBA, FAAP

    David Perlstein, MD, MBA, FAAP

    Dr. Perlstein received his Medical Degree from the University of Cincinnati and then completed his internship and residency in pediatrics at The New York Hospital, Cornell medical Center in New York City. After serving an additional year as Chief Pediatric Resident, he worked as a private practitioner and then was appointed Director of Ambulatory Pediatrics at St. Barnabas Hospital in the Bronx.

How is the cause of childhood cough diagnosed?

As in most medical evaluations taking a thorough history and conducting a comprehensive physical examination generally leads to a narrow list of diagnostic possibilities. Laboratory studies, X-ray studies and specialized testing by allergists or pulmonary specialists may occasionally be necessary to establish or confirm the cause of childhood cough.

Issues to be evaluated while taking a history of childhood cough include:

  • Duration and intensity of cough,
  • Character of the cough (for example, the "bark" of croup),
  • Events leading up to the cough (for example, possibility of foreign body aspiration),
  • Events which affect cough (for example, physical activity produces increase in cough and shortness of breath in wheezing),
  • Precipitating events associated with cough (for example, GERD symptoms associated with feeding),
  • Progressive worsening of symptoms and development of fever (for example, pneumonia as complication of upper repsiratory infection),
  • Environmental influences (for example, nasal allergy), and
  • Possible emotional component (for example, benign motor tic).

Testing may include:

  • Chest X-ray and/or sinus X-rays,
  • Pulmonary function tests - determines the adequacy of lung inspiration and expiration effort and capability,
  • Allergy testing,
  • Nasal swabs for specific infectious agents (for example, respiratory syncytial virus, pertussis whooping cough),
  • Specialized X-ray studies to help define anatomy (for example, barium swallow), and
  • Endoscopy and bronchoscopy (insertion of a flexible device with camera to evaluate the upper airway.
Medically Reviewed by a Doctor on 3/15/2016

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