What does my child’s cough mean?

Causes and treatments for common coughs in kids and teens

During cold and flu season, many families may have members coughing for days or weeks. With a wide range of sounds, severity and causes for coughs, it can be hard for parents to know how to help relieve their child’s cough or when to call the doctor.  

Here, Dr. Rei Tosu, a pediatrician in CHOC’s primary care network, outlines the different sounds and signs of common coughs, what may cause them and how to help.   

Daytime cough

Signs, sounds and symptoms

Coughing worsens throughout the day.

What causes it

If your child has a respiratory illness or allergies, cold air or activity may worsen your child’s cough during the daytime.

How to help

• Make sure there’s nothing in your house that may be irritating your child’s throat like air freshener, pets or tobacco smoke.
• Sometimes, brief exposure to the outdoors can relieve the cough. Try going outside for 10 to 15 minutes with your child.
• Make sure to speak to your healthcare provider before administering any over-the-counter cough or cold medicines, especially if they are under 2 years of age.
• Cough drops may be used to help provide some relief to older kids, but avoid giving cough drops to your child under 3 years to prevent choking.

Nighttime cough

Signs, sounds and symptoms

Coughing is frequent at night when your child is sleeping.

What causes it

• If your child already has a cold, laying down in bed may cause mucus from the nose and sinuses to drain into their throat, causing them to cough while sleeping.
• Asthma may trigger nighttime coughs because airways may be more irritable at night.

How to help

Nighttime coughs are only a problem if they keep your child awake. A cool-mist humidifier in your child’s bedroom may help them sleep. Speak to your pediatrician before giving your child any over-the-counter nighttime cold and flu medications.

Cough with a fever

Signs, sounds, symptoms

• Cough.
• Mild fever.
• Runny nose.
• Congestion.

What causes it

The common cold or other respiratory viruses.

How to help

• If your child is under 28 days old and has a fever of 100.4 or more, visit your nearest emergency department.
• Use CHOC’s guide to fevers in English and Spanish for temperature-taking tips, home remedies and more information on when to seek help.
• Cool beverages like juice may offer some throat relief to your child. Avoid soda, milk or orange juice, which can irritate a throat that’s sore from coughing.

Cough with vomiting

Signs, sounds and symptoms

Your child coughs so much that it makes them throw up.

What causes it

• Frequent coughing may trigger your child’s gag reflex, causing them to gag or throw up.
• A child with a cold or asthma flare-up might vomit due to mucus draining into the stomach and causing nausea.

How to help

Usually, the vomiting with a cough will end quickly. If the vomiting doesn’t stop, call your doctor.

Cough with wheezing

Signs, sounds and symptoms

If your child makes a wheezing (whistling) sound when breathing out (exhaling), this could mean that the lower airways in the lungs are swollen.

What causes it

A cough with wheezing may be caused by a few different things:

• Congestion. If your child has a cold or respiratory illness and is congested, breathing in and out may cause a wheezing or whistling sound.
• Asthma.
• Bronchiolitis, a common lung infection in young children and infants that causes inflammation and congestion in the small airways of the lung.
• If the lower airway is blocked by a foreign object.

How to help

• Call your healthcare provider if your child starts to cough after inhaling something such as food or a small toy.
• Call your pediatrician if your child’s wheezing persists. 
• If your child has severe difficulty breathing, visit your nearest emergency department.
• Make sure you have an asthma action plan from your doctor if your child has asthma.

“Barky” cough

A “barky” cough is usually caused by swelling in the upper part of the airway in the neck. Most of the time, barky coughs are caused by croup, a common infection in children.

Signs, sounds and symptom

• Cough that sounds like seal’s bark.
• High-pitched “creaking” or whistling sound when breathing in (also called stridor).
• Huskier-than-normal voice or hoarse cry.
• Runny or stuffy nose.
• Cough may be present with or without fever.
• Worsened symptoms at night that may wake your child up.
• Symptoms may seem to get better in the morning but may worsen as the day goes on.

What causes it

A virus is the most common cause of croup. But the illness may also be caused by bacteria, allergies or reflux from the stomach.

Croup is spread through person-to-person contact. The infection starts in the nose and throat and moves into the lungs.

How to help

• Most children with croup feel better within three to seven days with rest, fluids and over-the-counter anti-inflammatories and painkillers such as ibuprofen or acetaminophen.
• A cool-mist humidifier may provide some relief for your child.
• Turn on the hot water in your shower and close the door so the bathroom steams up. Sit in there for about 20 minutes, and the steam may help your child breathe more easily.
• Sometimes, the symptoms of croup can be mistaken for other health problems. Make sure your child sees their healthcare provider for a diagnosis.

Whooping cough

Whooping cough (pertussis) is a contagious illness. It causes intense fits (paroxysms) of coughing. It mainly affects babies and young children.

Signs, sounds and symptoms

• Back-to-back coughing spells without breathing in between.
• When the child has a break in their coughing, you may hear a “whooping” sound as they breathe in.
• The illness often starts like the common cold, with a runny nose and sneezing.

What causes it

Whooping cough is caused by Bordetella pertussis bacteria.

This infection is very contagious and can be passed from child to child through coughing and sneezing. Whooping cough can be severe in children under the age of 1 who did not receive the pertussis vaccine. 

How to help

• Call your doctor if you hear a whooping sound or if your child is wheezing. If your child has severe difficulty breathing or their lips, face or tongue look dusky, gray or blue, visit your nearest emergency department immediately.
• Have your child receive the DTaP vaccine, which protects against three diseases: diphtheria, tetanus, and pertussis. For maximum protection, kids should receive the DTaP vaccine when they are ages 2 months, 4 months, and 6 months, 15 months and 4 to 6 years old.

Persistent cough

Signs, sounds and symptoms

Your child’s cough persists for weeks.

What causes it

• Coughs cause by colds may last weeks, especially if your child has been infected with one cold after another.
• Asthma, allergies or chronic infections might cause lasting coughs.

How to help

If your child’s cough lasts more than three weeks, call your doctor.

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