Respiratory infections and cough in children

Why a cough may persist

Secretions and irritation of the airways can cause a cough even after the fever has gone. The cough helps clear them and should not be suppressed automatically. In many cases it settles gradually over several weeks.

For the pediatrician it matters whether the cough is dry or wet, whether it occurs every day, during feeding, at night or with running. New viral episodes may overlap, but a cough that persists every day, especially beyond 4 weeks, requires a fuller assessment. Worrying symptoms call for an earlier check.

Signs that call for a prompt consultation

A cough that starts suddenly during eating or play with small objects raises suspicion of a foreign body. Do not explain it as a virus without assessment. Rapid breathing, drawing in of the chest between the ribs, poor feeding, a fever that returns after improvement or worsening require a prompt consultation.

How causes are distinguished

The pediatrician assesses breathing and examines the lungs, throat and ears. The color of secretions or a red throat, on their own, do not prove a bacterial infection. When streptococcal pharyngitis is suspected, testing is decided according to age and clinical signs.

In a child in good condition with a short cough and no warning signs, tests and chest X-ray are usually not needed. When the cough is prolonged or the examination is abnormal, further examinations may be recommended. A chest X-ray, if indicated, is performed at the appropriate service.

When antibiotics have a role

Antibiotics do not shorten the common viral illness and do not stop the cough immediately. They are recommended when the bacterial diagnosis and the clinical condition justify them. Unnecessary use can cause diarrhea and allergic reactions and favor bacterial resistance.

Do not use leftover antibiotic from another episode and do not share a prescription between children. When treatment has been prescribed, follow the regimen and the reassessment date. Lack of improvement calls for reconsidering the diagnosis, not automatically adding another antibiotic.

Frequently asked questions from parents

How often is it normal for a child to catch a cold? Young children, especially in nursery or kindergarten, may have 6 to 10 colds a year. This is part of the development of immunity. Attention is needed for very severe or prolonged episodes, those with persistent fever or those affecting growth.

Why does the cough get worse at night? Lying down makes it easier for secretions to drain from the nose into the throat and irritate the airways. Raising the head slightly, air that is not dry and a nose cleared with saline help. A night cough that recurs every day needs assessment.

Are antibiotics given for pharyngitis? Only when a bacterial infection, for example streptococcus, is suspected or proven, and according to the doctor’s assessment. Most sore throats are viral and do not benefit from an antibiotic. Do not ask for an antibiotic without assessment and do not use leftovers.

Do cough syrups help? Combination cough and cold preparations are not recommended in young children without professional advice, because the benefit is limited and there is a risk of side effects. Fluids, nasal cleaning and rest are fundamental.

When should a chest X-ray be done? Not for every cough. An X-ray may be requested when pneumonia, a foreign body or another cause is suspected and when the examination shows relevant signs. It is performed at the appropriate service and the result is interpreted together with the child, not in isolation.

Can I send my child to nursery with a cough? If there is fever, difficulty breathing or the child feels very unwell, they stay at home. A mild cough without fever and with a good condition often does not prevent attendance, but contacts should be limited according to the institution’s guidance.

What you can do at home

Offer fluids and care for the nose with saline solution as advised. Keep the environment free of tobacco smoke and irritating vapors. Do not use steam from boiling water, because of the risk of burns.

Combination preparations for cough and cold should not be started without professional advice, especially in young children. Honey is not given to infants under 1 year. Inhalers and corticosteroids have specific indications and are not a general treatment for every cough.

Care at Tirana Polyclinic: We offer pediatric consultation and interpretation of results performed at or outside the clinic. Further examinations are determined by symptoms and findings, with referral for specialized assessment when needed.