Cough is a reflex action of the respiratory tract that is used to clear the upper airways.1 In contrast, chronic cough is a cough that remains unexplained after basic clinical assessment.2
Chronic cough is a cough which lasts for more than three weeks and is a common reason for referral to secondary care.2
What causes chronic cough in infants?
Chronic cough in infants can be related to several environmental or pathogenic triggers.1 Environmental factors include exposure to cigarette smoke, and exposure to environmental pollution.1 Diseases that cause chronic cough include asthma, bronchitis, gastro-oesophageal reflux disease, postnasal drip syndrome or rhinosinusitis.1
Chronic cough as a symptom of Cow’s Milk Protein Allergy
Up to 30% of infants with Cow’s Milk Protein Allergy (CMPA) will present with a respiratory symptom such as chronic cough.3 CMPA can be suspected in infants who display immediate symptoms of cough following the ingestion of cow’s milk protein.4,5
The majority of infants affected with CMPA have at least two symptoms affecting at least two different organ systems6,7 If, in addition to a respiratory symptoms such as chronic cough, your patient shows any of the signs and symptoms that can be related to CMPA5 (see below), you can use the CoMiSS® tool8 to score the combination of their symptoms and assess the likelihood of CMPA.
Signs and symptoms related to CMPA5
· Gastrointestinal/Digestive: Colic, vomiting, reflux, regurgitation, anorexia, diarrhea, constipation
· Respiratory: Sneezing, wheezing, runny nose
· Skin: Atopic dermatitis, urticaria, angioedema
· General: Failure to thrive, anaphylaxis, insomnia, inconsolable crying