Cough 'til you puke...

This is the time of year it seems everyone's coughing. I've heard from more than one worried parent that their child coughs to the point of vomiting. In the medical world, we call this post-tussive emesis.

Post = after, tussive = cough, emesis = vomit

Kids tend to have a very active gag reflex, so they sometimes gag themselves and vomit with cough. This can be good, since it gets the mucus out of the back of the throat. You can try to teach older kids to hack and spit it out, cough and spit it out, gargle with salt water, and rinse mucus out of the nose.

Of course it's not fun to vomit after coughing because everything in the stomach comes up and makes a huge mess. Sometimes the vomit comes out of the nose, which can burn from the stomach acid. And vomiting can be very scary to kids.

Are there serious concerns when kids vomit from coughing? 

Yes. In medical school I learned that when kids cough to the point of vomiting we should consider whooping cough, pneumonia and asthma. In reality, I find that many kids with regular cough and colds can gag from cough, but I always consider the more serious options.

What should I do if my child vomits from a cough?

First, keep your cool. If a parent starts to get flustered, it makes the child more worried, which never helps.

Make sure your child's breathing is okay. Obviously he is coughing, but between coughs if the breathing rate is too fast or labored, he should be evaluated ASAP.

Rinse out your child's mouth (and nose if needed- saline drops or rinses work well for this). Vomit is just nasty tasting and can burn in the nose.

Treat the cough. If your child has asthma, give a breathing treatment or their rescue inhaler. If your child is over a year of age, you can use honey to help a cough. A tsp usually does the trick. Humidify the air with a vaporizer or humidifier. For more treatments see Cough Medicine: Which one's best.

When should my child be seen?

If your infant is under a year of age or your child has not had the whooping cough vaccines, he should be evaluated. Some babies with whooping cough stop breathing so many are hospitalized to monitor for complications. 

After a single episode of vomiting if your child's breathing is comfortable, just continue to manage at home.

If your child develops difficulty breathing or dehydration, he should be seen as soon as possible.

If your child continues to vomit after coughing but is comfortable between episodes, he should be seen during normal business hours at his regular doctor's office.