What your child's cough is telling you

There are many reasons children develop a cough, and it can be difficult for parents to determine what is causing the cough and when to see the pediatrician.

Typically, a child's cough is nothing to worry about. Parents can expect their children to get several colds each year, especially during the fall and winter. But there are times when it is important to call your child's doctor.

Nazima Zakhidova, M.D., Pediatrician at Children's Health℠, shared some general advice to help parents know when to seek medical care for their child's cough.

"As a general rule, if your child has a cough that is getting progressively worse and/or lasting longer than a week without improvement, it's a good idea to have them seen by a medical professional,” says Dr. Zakhidova.

What are the different types of coughs in infants or young children?

Children may experience many different types of coughs, including:

• Barking cough, where a child's cough sounds deep, like a bark from a seal or dog.

• Whooping cough, where your child has short, violent coughs sometimes followed by an intake of breath that sounds like a whoop.

• Coughing and wheezing. Wheezing is a high-pitched whistling sound when a person breathes.

• Dry cough, where your child coughs and does not produce any phlegm or mucus.

• Productive or wet cough, when a child coughs and produces mucus or phlegm.

• Persistent cough, which is a cough that lasts for more than 3 weeks and may worsen in severity.

Why can't my child stop coughing at night?

A child's cough may become worse at night because mucus from their nose and sinuses may drip down their throat when they lie down, also called a postnasal drip. Postnasal drip, which can be seen with viral colds and allergies, can irritate their throat and make them cough more at night. Propping up your child's head with an extra pillow or two may help reduce their cough at night. Elevating their head can help congestion drain and ease a cough related to postnasal drip. This is only recommended for children over 2 years old.

Coughing at night can also be a sign of asthma. Call your pediatrician if your child is coughing at night and it is not accompanied by a runny nose or congestion.

What's causing my child's cough?

Here are eight common causes of a child's cough and signs it's time to see a pediatrician.

Cold

The common cold often produces a wet cough that sounds like it is coming from the chest and is producing mucus or phlegm. This is called a “productive” cough. Most colds get better with hydration and rest. Cough and cold medications are not routinely recommended for children.

Call your pediatrician if: Your child's voice becomes hoarse and has a barking, productive cough.

Allergies

Symptoms of Seasonal allergies include itchy, watery eyes, runny nose, cough, congestion, sneezing and sometimes a sore throat. Allergies do not usually cause fatigue, body aches or a fever. Seasonal allergies don't typically affect children under 2 years old.

Call your pediatrician if: Your child's allergy symptoms worsen or persist after more than two weeks. Your child's doctor may recommend or prescribe allergy medications depending on your child's age and symptoms. If your child is already taking medication for seasonal allergies and their symptoms persist, contact your pediatrician.

RSV

Respiratory syncytial virus, commonly known as RSV, is a virus that has similar symptoms to the common cold, but it can be serious and even life-threatening in babies.

Call your pediatrician if: Your child has labored breathing that is hard and fast. You may notice your child's chest sinking in between and below the ribs with each breath. If you see any of these symptoms, contact your child's doctor immediately.

Bronchiolitis

Bronchiolitis happens when mucus builds up in tiny airways that lead to the lungs, called bronchioles. This makes it hard to breathe. RSV is the most common cause of bronchiolitis, but other viruses may also cause it. Bronchiolitis is mainly seen in children 2 years old and younger and causes wheezing and difficulty breathing.

Call your pediatrician if: A dry cough evolves into clicking, bubbling or rattling when your child inhales. If your child is having labored breathing, call your pediatrician.

Pneumonia

Pneumonia is a viral or bacterial infection of the lungs. It causes the air sacs, or alveoli, of the lungs to get inflamed and sometimes fill up with fluid or pus. Children with pneumonia may have milder symptoms than adults. Pneumonia symptoms may include worsening cough with phlegm, high fever, fatigue, shortness of breath, and/or decrease in appetite.

Call your pediatrician if: Your child has a persistent or worsening cough with high fever and/or rapid or difficult breathing.

Asthma

Asthma is the most common chronic disease of childhood, affecting almost one in 10 children – including more than 156,000 in North Texas, according to the Beyond ABC report. Asthma attacks can come and go and can be triggered by a number of factors, including respiratory illnesses, exercise, cold air, laughing, rough play and exposure to environmental factors, such as cigarette smoke and/or air pollution.

Call your pediatrician if: Your child's cough is accompanied by wheezing, which is a high-pitched, whistle-like sound heard typically when exhaling.

Croup

Croup occurs when the upper airway (vocal cords and windpipe) swells, which makes it difficult to breathe. Croup typically occurs in fall and winter and affects boys more than girls. A child can have croup at any age, but it happens more often in children under the age of 5. See more signs of croup.

Call your pediatrician if: Call your pediatrician if your child is less than 2 years old and appears to be struggling with stridor, a squeaking or whistling noise when they breathe in and out. In rare cases, swelling in your child's airway can be dangerous. You should seek immediate medical attention if your child is struggling to breathe or catch their breath, has bluish lips or fingernails, and/or experiencing excessive drooling or seems to have trouble swallowing saliva.

Pertussis

Pertussis, also called whooping cough, is a highly contagious and serious illness of the respiratory mucous membrane. Caused by bacteria, pertussis is easily spread through infected coughs and sneezes, but can be prevented by a series of vaccines (DTaP and Tdap).

Call your pediatrician if: Your child's cough is marked by a series of short, violent coughs sometimes followed by a high-pitched intake of breath that sounds like whoop.

Could my child's cough be COVID‑19?

COVID‑19 is a contagious respiratory virus that can cause a wide range of symptoms, including a cough and fever. Anyone can have mild to severe illness due to COVID‑19, including children. It is not possible to tell the difference between COVID‑19 and a cold or upper respiratory infection without testing. Because of that, it is best to get tested for COVID‑19 to rule it out. If your child tests positive for COVID‑19, they should isolate themselves from those who are not infected. The best way to prevent COVID‑19 is for everyone who is eligible to get the COVID‑19 vaccine.

Call your pediatrician if: Your child has a fever or chills, a cough, shortness of breath or difficulty breathing, fatigue, muscle or body aches, a headache, loss of taste or smell, a sore throat, congestion or runny nose, nausea/vomiting or diarrhea. Your child should be tested for COVID‑19 if they are experiencing a combination of any of these symptoms, especially if they have been exposed to someone who has COVID‑19.

How to help a child's cough

No matter the cause of your child's cough, here are a few cough treatments you can try at home:

1. Increase fluids. Increasing fluid intake can help soothe a sore throat and make the mucus in your child's lungs easier to cough up.

2. Rest in an upright position. Plenty of rest will help your child regain their health, but congestion may make it difficult to sleep. Try elevating the head of the bed by placing a few pillows under the mattress to help your child rest more easily.

3. Consider adding some humidity. A warm bath or shower may help ease your child's breathing, and a cool-mist humidifier in their room overnight may also help.

4. Eliminate irritants. These can include chemical fumes, cigarette smoke and dust or allergens.

Most importantly, give over-the-counter medications with care. Cough suppressants can often do more harm than good and are not recommended for children. However, children may need a dose of over-the-counter medication like acetaminophen for pain or fever greater than 100.4F. Follow directions carefully. Always contact your child's doctor before giving any over-the-counter medication to a child younger than 6. Learn more about home remedies for cough in kids.

If you're concerned about your child's cough, call your pediatrician right away, especially if your child is working hard to breathe.

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