Coughs are one of the most common symptoms of childhood illness. Although a cough can sound awful, it's not usually a sign of a serious condition. In fact, coughing is a healthy and important reflex that helps protect the airways in the throat and chest.
But sometimes, your child's cough will warrant a trip to the doctor. Understanding what different types of cough could mean will help you know how to take care of them and when to go to the doctor.
Barky coughs are usually caused by a swelling in the upper part of the airway. Most of the time, a barky cough comes from croup, a swelling of the larynx (voice box) and trachea (windpipe).
Croup usually is the result of a virus, but it can also come from allergies or a change in temperature at night. Younger children have smaller airways that, if swollen, can make it hard to breathe. Kids younger than 3 years old are at the most risk for croup because their windpipes are so narrow.
A cough from croup can start suddenly and in the middle of the night. Often a kid with croup will also have stridor, a noisy, harsh breathing (some doctors describe it as a coarse, musical sound) that occurs when a child breathes in.
Whooping cough is another name for the pertussis, an infection of the airways caused by the bacteria bordetella pertussis. Kids with pertussis will have spells of back to back coughs without breathing in between. At the end of the coughing, the kids will take a deep breath in that makes a "whooping" sound. Other symptoms of pertussis are a runny nose, sneezing, mild cough, and a low fever.
Although pertussis can happen at any age, it's most severe in infants under 1 year old who did not get the pertussis vaccine. Your child should get the pertussis shot at 2 months, 4 months, 6 months, 15 months, and 4-6 years of age. This shot is given as part of the DTaP vaccine (diphtheria, tetanus, acellular pertussis).
Pertussis is very contagious. The bacteria can spread from person to person through tiny drops of fluid in the air coming from the nose or mouth when people sneeze, cough, or laugh. Others can become infected by inhaling the drops or getting the drops on their hands and then touching their mouths or noses.
Cough With Wheezing
If your child makes a wheezing (whistling) sound when breathing out, this could mean that the lower airways are swollen. This can happen with asthma or with a viral infection (bronchiolitis). Also, wheezing sometimes can happen if the lower airway is blocked by a foreign object.
Lots of coughs get worse at night. When your child has a cold, the mucus from the nose and sinuses can drain down the throat and trigger a cough during sleep. This is only a problem if the cough won't let your child sleep.
Asthma also can trigger nighttime coughs because the airways tend to be more sensitive and irritable at night.
Cold air or activity can make coughs worse during the daytime. Try to make sure that nothing in your house — like air freshener, pets, or smoke (especially tobacco smoke) — is making your child cough.
Cough With a Fever
A child who has a cough, mild fever, and runny nose probably has a common cold. But coughs with a fever of 102º Fahrenheit (39º Celsius) or higher can sometimes mean pneumonia, especially if a child is weak and breathing fast. In this case, call your doctor immediately.
Cough With Vomiting
Kids often cough so much that it triggers their gag reflex, making them throw up. Also, a child who has a cough with a cold or an asthma flare-up may throw up if lots of mucus drains into the stomach and causes nausea. Usually, this is not cause for alarm unless the vomiting doesn't stop.
Coughs caused by colds can last weeks, especially if your child has one cold right after another. Asthma, allergies, or a chronic infection in the sinuses or airways might also cause persistent coughs. If the cough lasts for 3 weeks, call your doctor.
When to Call the Doctor
Most childhood coughs are nothing to be worried about. However, call your doctor if your child:
- has trouble breathing or is working hard to breathe
- is breathing more quickly than usual
- has a blue or dusky color to the lips, face, or tongue
- has a high fever (especially if your child is coughing but does NOT have a runny or stuffy nose)
- has any fever and is less than 3 months old
- is an infant (3 months old or younger) who has been coughing for more than a few hours
- makes a "whooping" sound when breathing in after coughing
- is coughing up blood
- has stridor (a noisy or musical sound) when breathing in
- has wheezing when breathing out (unless you already have a home asthma care plan from your doctor)
- is weak or cranky
What Your Doctor Will Do
One of the best ways to diagnose a cough is by listening. Knowing what the cough sounds like will help your doctor decide how to treat your child.
Because most coughs are caused by viruses, doctors usually do not give antibiotics for a cough. If the cough is caused by a virus, it just needs to run its course. A viral infection can last for as long as 2 weeks.
Unless a cough won't let your child sleep, cough medicines are not needed. Cough medicines sometimes help a child stop coughing, but they do not treat the cause of the cough. If you do choose to use an over-the-counter (OTC) cough medicine, call the doctor to be sure of the correct dose.
Do not use OTC combination medicines like "Tylenol Cold" — they have more than one medicine in them, and kids can have more side effects and are more likely to get an overdose of the medicine. Cough medicines are not recommended for children under age 4.
Here are some ways to help your child feel better:
- If your child has asthma, make sure you have an asthma care plan from your doctor. The plan should help you choose the right asthma medicines to give.
- For a "barky" or "croupy" cough, turn on the hot water in the shower in your bathroom and close the door so the room will steam up. Then, sit in the bathroom with your child for about 20 minutes. The steam should help your child breathe more easily. Try reading a book together to pass the time.
- A cool-mist humidifier in your child's bedroom might help with sleep.
- Cool beverages like juice can be soothing. But do not give soda or orange juice, as these can hurt a throat that is sore from coughing.
- You should not give your child (especially a baby or toddler) OTC cough medicine without first checking with your doctor.
- Cough drops are OK for older kids, but kids younger than 3 years old can choke on them. It's better to avoid cough drops unless your doctor says that they're safe for your child.
Reviewed by: Iman Sharif, MD
Date reviewed: November 2008