Cough until you puke

cough and cold

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.

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 teaspoon 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 (Dtap in infants and young kids and Tdap in tweens), 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, ideally at a location that routinely cares for children.

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

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Author: DrStuppy

I am a pediatrician and mother of two teens. I have a passion for sharing health related information.

3 thoughts on “Cough until you puke”

  1. My daughter, who had been fully vaccinated, had a bad cough that left her gagging afterwards. I took her in, they said maybe a sinus infection. After another 4 days and research , I asked for the pertussis test which came back positive. She was diagnosed too late to be helped by treatment (though we were all treated anyway). Her cough, though not frequent, is still terrible weeks later, and may be for weeks to come. Parents and doctors need to know that you can get whooping cough even if you’ve been vaccinated.

    1. It’s important to tell the doctor every symptom, even if you don’t think it’s related. I remember one visit with a fully vaccinated kiddo who looked pretty healthy. Actually running-around-the-room toddler healthy. We talked about cough symptoms and I did my exam (which was normal) but it wasn’t until the very end of the visit that the parent mentioned being frustrated about the vomiting after coughing that made me think pertussis. He was positive, but I almost didn’t check because he looked like he had a mild cold. Whooping cough can be deceptively normal appearing between coughing fits. Despite knowing this, it can be easy to miss if you don’t see a fit.

    2. Yes, it’s possible to get whooping cough despite the vaccine. Especially if it’s been more than a couple of years since the vaccine, as in most teens and adults.

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