Decoding your baby's coughDecoding your baby’s cough can be as tricky as describing the “puh-chunk-puh-chunk” sound your car makes to an auto mechanic. In both instances, the unfamiliar noise is a result of something happening on the inside — and it’s generally best to leave “insides” to the professionals. But there is a fine line between prudent caution and unnecessary worry. So how does a parent know whether their baby’s cough is a reason to worry?

Adrienne, a Lynnwood mother of three, remembers her son’s scary coughing spells. “He had trouble breathing and was turning a little blue,” she remembers. After rushing baby Joe to their family provider, the doctor concluded his lungs were clear.

But, trusting her motherly instincts, Adrienne sought another opinion. The second doctor agreed with the first: Joe’s lungs were clear. But in an effort to appease the persistent mother, the doctor agreed to take X-rays. To the surprise of both physicians, this first-time mother had outdiagnosed two medical experts. Baby Joe had pneumonia.

When to get help for your baby's cough

Adrienne was smart to seek medical attention. When a cough is severe and persists to the point that it interferes with nursing, eating or breathing, it is time to see a physician. If you notice that your baby is unable to catch his breath or suspect that he is struggling to get enough air, this is a clear indication that the need for medical help is urgent. One sign that your baby is not breathing well is the loss of color in their lips and fingers — like baby Joe, who Adrienne described as “turning blue.”

According to Dr. David Lemme, a family practitioner at Naval Hospital in Oak Harbor, accurately decoding your baby’s cough takes practice. “The more experience parents have with their children, the more accurately they can assess problems,” he says.

Even inexperienced parents can become attuned to changes in their baby’s cough with the help of some simple reminders of a few biological basics. For starters, the function of a cough is to clear the airway. While this sounds fairly straightforward, it also means that the causes of a cough are many, so diagnosis can be tricky. Nasal congestion, gastro-esophageal reflux, asthma or a trapped Cheerio can all produce irritation of the larynx.

With flu season upon us, parents should also note that a dry cough can be an indication of influenza. The Thurston County Public Health Department advises parents that “most children who are healthy can weather the flu … but that’s not always true for the very young, less than 2 years of age.” A substantial cough occurring after a baby has been exposed to influenza should always be taken seriously.

The good news is that most coughs are not serious. In fact, a simple tickle in the throat can cause coughing.

How to help your baby's cough

If the cough is intermittent and does not impede the baby’s ability to breathe, giving the child something to drink will likely clear the larynx. Similarly, if the cough is caused by post-nasal drainage, suctioning of the baby’s nose may help to alleviate the problem. Another trick parents can use to help sooth coughing is to create a steamy bathroom and then spending 20 minutes playing or reading to their child while they breathe the humid air. Never give a child younger than 3 years old a cough drop!

Even veteran parents can find new cough noises scary. It’s good to trust your gut, and if you have doubts, err on the safe side: Get a professional opinion from a doctor or consulting nurse. Dr. Lemme tells parents that he “would rather see a relatively healthy child brought in for evaluation than have a sick child’s illness ignored.” The consequences of an ignored or misdiagnosed cough can be serious. Lisa Greene, a Bellevue mother of two children diagnosed with cystic fibrosis, knows how important parental instinct can be.

While coughing wasn’t the symptom that brought about the diagnosis of her children, a persistent cough is one indicator of cystic fibrosis. Lisa “knows many families who have children with CF who were misdiagnosed, and unfortunately, by [the time they are correctly diagnosed], children can be very sick and that makes it harder for kids with CF to fully recover and thrive.”

Knowing how to communicate concerns to your medical professionals is even more important than your ability to correctly distinguish a cough. Parents have the greatest successes when they stay calm and deliberate in presenting facts, and listen carefully to the doctor’s questions and suggestions.

While it’s best to leave diagnoses to a medical expert, remember: You are the parent — an expert on your child. No one knows your baby like you do. Take Lisa’s advice and “trust your gut,” but don’t hesitate to talk — and listen — to the medical experts.

Call the doctor if:

Your baby is having difficulty catching his breath.
Your baby looks blue or is losing color in his face and/or lips.
Coughing interferes with nursing or feeding.
Coughing makes your baby weak or faint.
Coughing persists continuously for more than three hours.
Coughing produces blood or discharge.

Katie McPhail is a Seattle-based writer and communications coordinator.

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