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.
What Are the Different Types of Coughs?
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.
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
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.
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.
How Are Types of Coughs Diagnosed?
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.
How Are Coughs Treated?
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.
How Can I Help My Child Feel Better?
To help your coughing child feel better:
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.
Sometimes, brief exposure to cool air outdoors can relieve the cough. Make sure
to dress your child appropriately for the outdoor weather and try this for 10–15 minutes.
Cool beverages like juice can be soothing and it is important to keep your child
hydrated. 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.
If your child has asthma, make sure you have an asthma
action plan from your doctor. The plan should help you choose the right asthma
medicines to give.
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.
When Should I Call the Doctor?
Always call your doctor if your child is coughing and:
has trouble breathing or is working hard to breathe
is breathing faster 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 younger than 3 months old
is younger than 3 months old and 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 your doctor already gave you an asthma
is weak, cranky, or irritable
is dehydrated; signs include
dizziness, drowsiness, a dry or sticky mouth, sunken eyes, crying with little or no
tears, or peeing less often (or having fewer wet diapers)