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A Lesson on Toddlers and the Cough Reflex

Some time back, when Gavin was sick, he had a coughing bout while Daddy was taking him out of the shower.  Since the cough sounded very “phlegmy”, Daddy suggested he spit out the phlegm.  Although most of us would rather spit out the phlegm rather than swallow it, I’m sure any experienced parent would know that kids, as a general rule, will usually swallow the phlegm.  Considering that kids don’t know how to spit properly, it is questionable whether it is necessary to advise a child to spit out the phlegm.

When Gavin tried to spit out the phlegm, he accidentally threw up all over Daddy and himself and the both of them had to have another shower.  Whether it was because he was covered in vomit, the fact that he needed another shower, or the dreadful sensation of having thrown up, Gavin began howling.  All in all, it was a traumatic, messy, smelly and somewhat nauseating (you would feel nauseated too if you had to smell it) experience.

Suffice to say that we learned on that evening that when it comes to our toddler, it is never a wise idea to encourage him to spit out his phlegm because it usually entails vomiting.  I can’t say whether this rule holds true for other toddlers since Gavin has an excessively sensitive gag reflex (being able to puke on command when forced to eat anything he doesn’t like and puking whenever he cries too hard).

So although the preferred option is to spit out the phlegm, given that it isn’t going to harm him to swallow it (unless he has pneumonia, in which case spitting out the phlegm is mandatory), I figure allowing Gavin to swallow it isn’t really that bad.

You would think that Daddy would have learned from that lesson, but no.  Last night, a rather groggy Gavin woke up coughing.  Wise old Daddy encouraged Gavin to spit out.  He didn’t seem like he was going to comply because he kept swallowing it.  Daddy ran to the bathroom to get a bowl which he handed to me to further encourage Gavin to spit out but before I can get the bowl anywhere near his mouth – let alone get him into a sitting position so he can actually spit into the bowl – a volcanic eruption of vomit spews from his mouth right up at my face and all over the bed.

Nice one, Daddy.  The next time you decide to encourage your son to spit up his phlegm please make sure you’re holding him over the toilet bowl.

Gavin, of course, started howling, which woke up his little brother who then started howling.  When I picked Gareth up, he threw up on me – was it the smell of Gavin’s vomit on me or was it just because I’m such a vomit magnet?  Between all the howling and commotion, we somehow managed to change the sheets, my clothes, shower Gavin and myself, and change Gareth’s clothes in the middle of the night.

So here’s what I’ve learned:

  • according to my lecturer in dental school, young children don’t know how to spit out (hence the reason why we avoid given them too much toothpaste or toothpaste with concentrated fluoride because they end up swallowing most of it).
  • according to, children under five do not spit up phlegm, and young children and babies may vomit it up (which is what Gavin used to do when he was little but has long stopped doing so).
  • if you have a toddler like Gavin, it’s probably pointless to ask him to spit out the phlegm, unless you want to spend the next fifteen minutes dealing with a howling toddler and a smelly mess of puke.
  • the only time I know when you really should spit out the phlegm is when you have pneumonia (like I did when I was in third year Uni), otherwise, it is probably more pleasant although not mandatory to spit it out.

Published by Shen-Li

SHEN-LI LEE is the author of “Brainchild: Secrets to Unlocking Your Child’s Potential”. She is also the founder of (a website on parenting, education, child development) and (a website on Right Brain Education, cognitive development, and maximising potentials). In her spare time, she blogs on Forty, Fit & Fed, and Back to Basics.

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