It's normal for colds and infections to result in a cough, but if your toddler's cough persists, it may be the symptom of another medical condition. It's not common for a cough to get worse while you're eating, and if your toddler's does, the most likely causes require medical attention, so be sure to consult your pediatrician.
Coughing is the body's way of getting mucus or a foreign material up and out of the lungs and airways. Infections like bronchitis or sinusitis, allergies, postnasal drip, or a viral illness are frequent causes. Coughs that get worse while eating, or that occur primarily during eating, may be due to gastroesophageal reflux disease, dysphagia or asthma.
Gastroesophageal reflux disease, or GERD, occurs when stomach contents, such as food and acid, move out of the stomach, into the esophagus and sometimes all the way up into the mouth. Reflux in a toddler happens when the muscle that normally contracts to hold contents in the stomach becomes weak or relaxes at the wrong time. One of the most common symptoms of GERD is a frequent or persistent cough due to irritation in the esophagus or the windpipe. A cough from GERD might get worse when your toddler eats because, as food fills the stomach, it creates pressure that pushes against the muscle and causes reflux. The chance of reflux increases with chocolate, peppermint and high-fat foods because they make the valve stay open longer.
The broadest definition of dysphagia is difficulty eating, but the problem can be anywhere in the process. Your toddler may have a hard time picking up food and getting it into her mouth, or might not close her mouth to hold the food in. The difficulty could be with sucking, chewing, swallowing, or moving food down the throat and into the stomach. Coughing, especially coughing that gets worse during meals, is one symptom of dysphagia. Other symptoms include irritability during feeding, refusing food or drinks, difficulty coordinating breathing with eating, or gagging. Dysphagia puts your toddler at risk of poor nutrition, dehydration and upper respiratory infections.
Different conditions can trigger an asthma attack, but some of the most common triggers are exercise, GERD, cigarette smoke, allergies, stress and cold air. Whatever the trigger, the immune system responds and causes inflamed and swollen airways, contraction of muscles around the airways and increased mucus production. The result is difficulty breathing and a cough. Toddlers may develop cough-variant asthma, which is asthma where a chronic cough is the only symptom. If your toddler's trigger is a food allergy, the coughing can get worse when he eats.