Chronic Cough

Question of the Week

A toddler getting a breathing treatment.
Toddlers should typically use a mask when they get breathing treatments with a nebulizer, not just a mouth piece. Photo by Getty Images

Q. I have a 22-month-old daughter that has had a chronic cough for months. The cough occurs more during sleep than awake times and will sometimes last for up to 1 hour. Our pediatrician has had her on a few medications for cold/flu symptoms and has also had her on albuterol and pulmicort breathing treatments. The breathing treatment were done for 4 to 5 months long at 3 to 4 times a day for both. We saw minor results but still had a cough. We have been to an allergy specialists who has tested her for the "common" food and other allergies and she had no reaction to any of them. As a mother my diagnosis is that she may have over productive saliva glands. She just seems to be choking on her saliva when it accumulates in her throat. Is this a crazy diagnosis or is it possible? Help. Vicki, Gilbert, Arizona

A. It is possible to have a swallowing disorder and to choke or aspirate things as you try to swallow them. I think that you would expect some feeding problems and a frequent daytime cough if that were the case though.

What Can Cause A Chronic Cough

Children with a chronic cough can be difficult to treat, as you have found. Among the top things that doctors think about when a young child is coughing for several weeks or months are:

When treatments for these common conditions haven't worked, it is time to look for other possible causes. 

Evaluating a Chronic Cough

Has she had a chest x-ray? If not, it would likely be a good idea to ask for one.

Does anyone at home smoke? If so, even if they smoke outside, that could be a trigger for a chronic cough.

Has she lost weight?

Is she in daycare?

Has she gone for days or weeks without a cough, only for it to return, or is really every day?

Was she using her asthma medications correctly? Did you use a nebulizer with a mask or an inhaler with a spacer and mask?

Does she choke or cough after eating or drinking or when taking a nap during the day?

A pediatric pulmonologist might be helpful for further management and treatment.

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