Will This Freaking Cough *Ever* Go Away? We Asked Doctors What’s Up

If your entire household has been hacking away for the entirety of this year's cold and flu season, you're not alone. TODAY co-hosts Hoda Kotb and Savannah Guthrie called it "kennel cough," while Sheinelle Jones dubbed it "the sound of the season." This hideous coughing symphony is sweeping the nation, and it's seemingly taking zero prisoners.

But what's the deal, and how do you know when it's time to go to a doctor? And in the interim, how the eff do you find relief (or help your little one feel better)? Two pediatricians are here to help.

"Tell me whyyyyy…." - the Backstreet Boys and also you

First, it's not just you: Even doctors agree that currently circulating respiratory viruses — including colds, flu, COVID, and RSV, plus bacterial infections like strep throat, pneumonia, and whooping cough — are contributing to coughs that hang around for weeks, if not months on end. Combine it with increased travel around the holidays, as Purvi Parikh, MD, an allergist and immunologist at NYU Langone, points out, and it's a recipe for disaster.

With all these bugs floating around (and all of us moving around), it's entirely possible that your household can be hit back-to-back, so it feels like the bodies are taking an absolute beating these days.

And while Rachel Dawkins, MD FAAP, the medical director at Johns Hopkins All Children's Hospital Care Network, says, "It's absolutely normal to see a lot of respiratory infections this time of year," Parikh notes that low vaccination rates are contributing to a rise in vaccine-preventable illnesses, such as the recent measles outbreak that spread from a children's hospital to a daycare facility in Philadelphia. Psssst… this is where we reiterate the importance of keeping your family up-to-date on all available vaccines.

But as you know, vaccines alone won't shield your fam from everything. (And it's awful that masks have become politicized, because they really do help minimize exposure to icky sh*t in the air.) So when the plague takes up residence in your home and refuses to leave, what is a parent to do?

"While a prolonged cough is incredibly annoying and frustrating, it's important to understand that not all coughs are created equal," says board-certified pediatrician Kristen Cook, MD. "The duration of a cough can actually help your physician determine the cause of that cough."

Cook notes that there are three types of cough:

• Acute: less than three weeks
• Subacute: three to eight weeks
• Chronic: longer than eight weeks

"Both subacute and chronic coughs are considered lingering coughs," she says.

Once it reaches the subacute phase, Cook says it's considered post-viral (or post-infectious) cough syndrome. "Here's what happens: A virus infects the human body, replicates, and triggers an immune response that causes a slew of annoying symptoms, such as nasal congestion, runny nose, sore throat, fever, and cough. Once the human body recovers from a viral upper respiratory tract infection (and all other symptoms resolve), a cough may stick around for up to eight weeks."

Beyond eight weeks, it's considered chronic. "The main causes of a chronic cough include post-nasal drip, inflammatory airway conditions, and acid reflux disease," Cook adds. "Less commonly, infections such as whooping cough and tuberculosis can also cause a chronic cough." More on these in a minute.

"Do you have to let it linger?" — The Cranberries and also you

No matter the cause of the inflammation and irritation in your throat, nose, and chest, there's a solid chance it'll take ample time to clear up, even though you're long past contagious. Joy. And given the recent news that the main ingredient in many OTC meds is, well, useless, what are your options?

More bad news, per Cook: "Unfortunately, there are no effective treatments for post-viral cough syndrome," aka that subacute cough. "Cough and cold medicine is not safe for kids under 5," adds Dawkins.

But all hope is not lost. "Humidified air can be very helpful, especially in a child with nose or chest congestion," says Dawkins. "If you don't have a humidifier, you can steam up the bathroom and sit in the warm, steamy air with your baby. In little babies (less than a year), you can use a bulb suction to remove snot from the nose — especially before eating and before bed. In kids older than a year, a spoonful of honey can be helpful. Most over-the-counter 'natural' cough syrups are just flavored honey," she notes.

If the cough has become chronic, you'll likely want to check in with your family doctor to determine the exact cause and any course of treatment that will help. "Post-nasal drip involves an overabundance of mucus draining from the nose into the throat," explains Cook. "This process will trigger the cough reflex. Symptoms include a chronic cough, frequent throat-clearing, sore throat, and even bad breath." It's typically caused by allergies, infections, a deviated septum, and acid reflux disease, and Cook adds that a trial of "an antihistamine such as cetirizine" may be helpful for post-nasal drip.

"Acid reflux disease involves stomach acid that recurrently flows into the esophagus," says Cook. "This can cause significant irritation, which leads to a dry-sounding cough that is often worse at night or after eating. Heartburn and hoarseness are also common symptoms of acid reflux disease. Typically, treatment involves taking a daily medication such as Prilosec or Prevacid."

Inflammatory airway conditions such as asthma and reactive airway disease can contribute to chronic cough too, says Cook, with Parikh adding that increased time spent at home during the pandemic might be leading to new or worsening indoor allergy or asthma symptoms, even if you never experienced them before.

"These conditions tend to cause a dry-sounding cough that is worse at night, a cough that is worse with physical activity, wheezing, shortness of breath, and difficulty breathing," Cook notes. "Allergies, infections, cold air, strong scents, smoke, and humidity can all trigger an inflammatory airway condition." Your doc might prescribe meds like albuterol, inhaled steroids, or oral steroids for these conditions.

The TL;DR

Even though a lingering cough is very annoying, Dawkins says it's "rarely dangerous — cough is actually the way the body naturally protects the lungs. I would worry if a child is having respiratory distress," she adds. "Parents may notice the sides of the nose flaring in and out, the muscles between the ribs sucking in, or the belly muscles being used consistently to help the child breathe. In addition, if you hear the child wheezing or making a whistling sound while breathing, you should contact your pediatrician."

Parikh recommends calling your family doctor if the cough includes phlegm that is colored or bloody, or if it's accompanied by high fevers, altered mental status, and/or trouble breathing and talking in complete sentences.

No matter what, Dawkins says, "As pediatricians we are always happy to take a listen to a child when you are concerned." Go forth and prosper, Mama. Nothing lasts forever, including those lung-launching coughs taking your family down one hack at a time.