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Health Information For Parents
Coughs are one of the most common symptoms of childhood illness. A cough can sound awful, but usually isn’t 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.
Sometimes, though, a cough needs a doctor’s care. Understanding the different types of cough can help you know when to handle them at home and when to call your doctor.
The most common types of coughs are:
Barky coughs are usually caused by swelling in the upper airway. Most of the time, a barky cough comes from croup, a swelling of the larynx (voice box) and trachea (windpipe). Younger children have smaller airways that, if swollen, can make it hard to breathe. Kids younger than 3 are most at risk for croup because their airways are so narrow.
A cough from croup can start suddenly, often in the middle of the night. Most kids with croup will also have stridor, which is a noisy, harsh breathing that happens when the child inhales (breathes in).
Whooping cough (pertussis) is 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, they’ll take a deep breath in that makes a “whooping” sound. Other symptoms are a runny nose, sneezing, mild cough, and a low-grade fever.
Whooping cough can happen at any age, but is most severe in infants under 1 year old who did not get the pertussis vaccine, which is part of the DTaP vaccine (diphtheria, tetanus, acellular pertussis). It’s is very contagious, so all kids should get the pertussis shot at 2 months, 4 months, 6 months, 15 months, and 4–6 years of age.
If your child makes a wheezing (whistling) sound when breathing out (exhaling), this could mean that the lower airways in the lungs are swollen. This can happen with asthma or with the viral infection bronchiolitis. Wheezing also can happen if the lower airway is blocked by a foreign object. A child who starts to cough after inhaling something such as food or a small toy should see a doctor.
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.
A child who has a cough, mild fever, and runny nose probably has a common cold. But coughs with a fever of 102°F (39°C) or higher can sometimes be due to pneumonia, especially if a child is weak and breathing fast. In this case, call your doctor immediately.
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 might vomit 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 due to viruses can last weeks, especially if a child has one cold right after another. Asthma, allergies, or a chronic infection in the sinuses or airways also might cause lasting coughs. If your child still has a cough after 3 weeks, call your doctor.
If you’re concerned about your child’s cough, call your doctor. Depending on the type of cough, other symptoms, and how long it’s lasting, the doctor might want to see your child.
Many health care providers now offer telemedicine visits, which can save parents a trip to the office (especially for a nighttime cough). “Video chatting” lets doctors see and hear a child cough, and often this is enough to make a diagnosis or rule out a serious problem. Hearing the cough will help the doctor decide whether (and how) to treat it.
Most coughs are caused by viruses and have to just run their course. Sometimes, this can take up to 2 weeks. Doctors usually don’t prescribe antibiotics because these only work against bacteria.
Unless a cough won’t let your child sleep, cough medicines are not needed. They might help a child stop coughing, but they don’t treat the cause of the cough. If you do use an over-the-counter (OTC) cough medicine, call the doctor to be sure of the correct dose and to make sure it’s safe for your child.
Do not use OTC combination medicines (like “Tylenol Cold”) — they have more than one medicine in them, and kids can have more side effects than adults and are more likely to get an overdose of the medicine.
Cough medicines are not recommended for any children under 6 years old.
To help your coughing child feel better:
Always call your doctor if your child is coughing and:
Coughing is a healthy reflex that helps clear the airways. A severe or lingering cough requires medical treatment, but many coughs are caused by viruses that just need to run their course.
Croup often causes kids to have a loud cough that sounds like a seal barking. Most cases of croup are caused by viruses, are mild, and can be treated at home.
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Kids can get up to eight colds a year – or more. The common cold sends more kids to the doctor than any other illness.
Pertussis is characterized by severe coughing spells that end in a whooping sound when the person breathes in. It can be prevented with the pertussis vaccine, part of the DTaP immunization.
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