What to Listen for in Coughs in Children

Coughing is a symptom of some of the most common childhood illnesses. In most cases, your child’s cough sounds a lot worse than it is. Coughing is a healthy reflex that helps clear fluid from the throat and chest and protects your airway. Coughing occurs when the nerve endings in your airways get irritated. It is a sign that the body is doing its job.


The most common illnesses associated with a cough are colds, the flu, and asthma. While most coughs aren’t severe, there are some cases when coughing is a symptom of a more severe illness like whooping cough or pneumonia. It can be difficult for parents to determine the cause of a child’s cough and when to see a doctor. Let’s take a closer look at the different types of coughs in babies, toddlers, and children and the signs that indicate it’s time to see a doctor.


8 Most Common Types of Coughs in Children


Understanding the different types of cough most common in children will help you effectively care for your child. It will also help you determine when you should see a doctor to help avoid serious complications. Here are the eight most common types of coughs in children, the illnesses they’re associated with, and when and if you need to take your child to see a doctor.


Barking Cough

If your child’s cough sounds like a barking seal, it is most likely caused by a swelling in the upper airway. The most common cause of barky, raspy, or horse coughs is a condition called croup. Croup is a viral infection that causes swelling of the voice box and windpipe. Inflammation around the vocal cords leads to the barking sound in your child’s cough. Croup is most commonly associated with children from 3-months-old to 6 years, but it can also occur in older children. The condition is most commonly associated with the Fall and Winter months.


A barking cough often gets better during the day and is worse at night. If croup causes a barking cough, your child will most likely experience cold symptoms followed by the sudden onset of this cough. Children may also experience high pitched whistling sounds when inhaling.


Most cases of croup are mild and treatable at home. Exposing your child to cold air can help relax the airways, but be sure to bundle them up to prevent additional illnesses. You can also sit with them in the bathroom with the door closed for 15-20 minutes with a hot shower running to let the steam open up their airways. In some cases, further treatment by your child’s healthcare provider is necessary. Your pediatrician may need to prescribe your child an oral steroid. If you notice rapid breathing, signs of respiratory distress, excessive drooling, or the condition doesn’t seem to improve, contact your healthcare provider immediately.


Dry Cough

A dry cough is one that is persistent but doesn’t produce any mucus or fluid. The common cold or the flu causes most dry coughs. Therefore, a dry cough may be accompanied by symptoms such as:

  • Sore throat
  • Headache
  • Runny nose
  • Mild fever


If your child has a dry cough that lasts for several weeks, you should call their doctor. Since asthma, allergies, or chronic sinus infections also cause dry coughs, your child may need medical treatment to help alleviate their symptoms.


Phlegmy Cough

A phlegmy cough sounds mucousy or wet. It can be accompanied by:

  • Runny nose
  • Sore throat
  • Watery eyes
  • Decreased appetite
  • Production of white, yellow, or green phlegm


The common cold most commonly causes phlegmy coughs. According to the National Institute of Allergy and Infectious Diseases, the average child gets 6-10 colds each year. That’s why phlegmy coughs are a common occurrence in children. They are very contagious in the first few days and can last for several weeks.


In many cases, viruses cause phlegmy coughs. Therefore, antibiotics don’t always help. Nasal sprays and bulb syringes can help clear the mucus in young children who can’t blow their nose on their own. Cool-mist humidifiers and warm baths can also be helpful.


Talk to your pediatrician about using vapor rubs or over-the-counter medications as they can cause more harm than good. If your child’s phlegmy cough is persistent or accompanied by green mucus or a fever, contact a healthcare provider immediately. These symptoms can be signs of a bacterial sinus infection that could lead to severe chest infections when left untreated.


Wheezing Cough

Wheezing coughs have a raspy or whistling sound that’s accompanied by a wheezing sound when your child breathes out. The wheezing occurs because the lower airways in the lungs become swollen. A wheezing cough is frequently seen with asthma or bronchiolitis. Bronchiolitis is an infection of the tiniest airways of the lungs. The infection causes the bronchioles to swell and fill with mucus. More severe conditions also cause a wheezing cough, such as respiratory syncytial virus or RSV. This condition can be life-threatening in infants and young children.


In some cases, a wheezing cough occurs when a foreign object blocks the lower airways in the lungs. If your child has recently inhaled food or a small object, and experiences a wheezing cough, seek medical attention immediately. Whenever a child experiences a wheezing cough, it’s essential to seek medical attention. That’s because most cases make it difficult for your child to breathe. Steroids, breathing treatments, or even hospitalization may be necessary to ease the symptoms and help your child heal.


Nighttime Cough

Does it seem like your child goes all day without coughing then starts right back up at night? Believe it or not, this is a common occurrence with children’s coughs. When children have a cold, mucus from the nose and sinuses can drain down the throat and trigger a cough while sleeping. Asthma can also be a common cause of nighttime coughing because your child’s airways are more sensitive at night.


Asthma is a chronic condition that causes the airways in the lungs to become irritated and narrowed. Sometimes excess mucus can be the only symptom of asthma, but often a chronic nighttime cough can be associated with the condition. The excess mucus caused by asthma creates a tickle in the throat that can cause persistent coughing. Other signs of asthma include a cough with:

  • Exercise
  • Allergies
  • Exposure to cold air
  • Cold or other illness


If you suspect your child has asthma, they must see a doctor. Your child’s doctor will perform a lung function test to diagnose your child. Some cases will require medication on an as-needed basis, but many asthma patients need daily preventative medications to keep the condition at bay. If your child experiences a nighttime cough that’s accompanied by difficulty breathing or speaking, call 9-1-1 immediately.


Whooping Cough

Also known as pertussis, whooping cough is an infection of the airways that is caused by the bacteria Bordetella pertussis. The most common symptom is a back-to-back coughing fit that’s followed by a whooping sound when your child finally takes a breath. The condition often starts as a cold and leads into a more severe cough, so your child may also experience a runny nose, sneezing, and low-grade fever. In some cases, your child may cough more than twenty times in one breath.


Whooping cough is one of the more severe coughs because it’s caused by acute inflammation in the lining of the breathing passages. In some cases, the swelling may block the airway completely. Pertussis is severe in infants under 1 year of age, especially those who have not received the DTaP vaccine. Because of the severity of whooping cough, children receive diphtheria, tetanus, and acellular pertussis vaccines and boosters at two months, four months, six months, 15 months, and between 4-6 years of age.


Whooping cough is very contagious. Babies can stop breathing, and children under six months of age need to be hospitalized and treated with antibiotics. In most cases, children experience a cough that can linger for months, followed by frequent respiratory infections. If your child experiences the symptoms of whooping cough, get them seen by their pediatrician or another healthcare provider immediately to begin treatment.


Cough with Fever

A mild fever can accompany some coughing symptoms. Mild fevers are often a sign that your child has a common cold. When your child experiences coughing with a temperature of 102°F or higher, they may have pneumonia. Pneumonia is a virus or bacterial infection that invades the lungs, causing them to fill with fluid. As the body tries to get rid of that fluid, your child may hack up lots of mucus with a phlegmy cough. Other signs of pneumonia to watch for include:

  • Weakness or lethargy
  • Difficult breathing
  • Rapid breathing
  • A persistent cough that gets worse
  • Wet, phlegmy cough that brings up mucus


In most cases, an X-Ray is necessary to diagnose the condition. When pneumonia is viral, the infection needs to run its course. But in cases of bacterial pneumonia, prescription antibiotics are required to treat the illness. Since some cases of pneumonia can become severe, even requiring a hospital stay, it’s essential to seek medical attention if your child presents with a cough that’s accompanied by a fever of 102°F or higher.


Cough with Vomiting

Some children cough so much that it triggers their gag reflex and causes vomiting. From a common cold to an asthma flare-up, vomiting can happen with any type of cough. When excess mucus builds up in your child’s system, vomiting may also occur. This is because the mucus can drain into the stomach and cause nausea, also known as post-nasal drip.


Vomiting with a cough is not generally a cause for concern unless the vomiting won’t stop or a high fever accompanies it. Parents and guardians should watch for signs of dehydration in a child who is vomiting with their cough. Signs of dehydration include:

  • Decreased urine output
  • Dry mouth
  • Cool skin
  • Irritability
  • An active child who suddenly becomes sluggish
  • Sunken eyes
  • Crying with little to no tears


Contact a medical professional immediately if you think your child may be dehydrated, if they have persistent vomiting with their cough, or if they suddenly begin to cough up blood.


How to Help Your Child at Home When They Have a Cough


No matter the cause of your child’s cough, there are several things you can do at home to keep them comfortable and help them heal.

  1. Increase fluids. It’s essential to keep your child hydrated when they become ill. When an illness is accompanied by symptoms of coughing, drinking plenty of fluids can also help soothe their throat. Cold beverages, in particular, can help ease irritation. Increased hydration also helps make the mucus in the lungs easier to cough up.
  2. Help them rest. When coughing occurs at night, it can be difficult for your child to get the rest they need to recuperate. If your child’s cough is making it difficult to sleep, elevate their head, so they rest in an upright position. Helping your child rest comfortably in an upright position can help prevent persistent coughing during the night.
  3. Add humidity. A warm bath or shower can help with breathing. Let your child sit in a steamy bathroom for 15-20 minutes at a time. You can also use a cool-mist humidifier to make their room more comfortable overnight.
  4. Eliminate irritants. If your child is coughing, irritants in the air can make their symptoms worse. Keep their breathing space free from chemical fumes, cigarette smoke, and dust as much as you can.
  5. Use caution with over-the-counter medications. Be careful giving your child over-the-counter cough medications unless your doctor has advised you. Cough suppressants are bad for young children. Treating them with over-the-counter acetaminophen or ibuprofen may be acceptable to help ease their discomfort, but talk to your healthcare provider first.


When to See a Doctor for Your Child’s Cough or Visit an Emergency Center Nearby


While it may be challenging to determine whether or not your child’s cough warrants a doctor’s visit, it’s always better to be safe than sorry. In most cases, there are tell-tale signs that indicate it’s time to make the call or trip to the doctor.


Call your child’s pediatrician if they experience the following symptoms:

  • Persistent daily cough that lasts more than three weeks
  • Cough that’s accompanied by fast breathing
  • High fever, usually over 102°F
  • Any fever in children three months or younger
  • Inability to speak due to cough
  • A cough that lasts more than a few hours in infants three months or younger
  • Signs of dehydration, such as:
    • Dizziness
    • Excessive drowsiness
    • Sunken eyes
    • Dry mouth
    • Crying with little to no tears
    • Decreased urine output
  • Signs your child is working hard to breathe
  • Whooping, wheezing, or barking sounds with cough
  • Weakness or extreme irritability


In some cases, it may be necessary to visit an emergency center nearby to have your child’s symptoms checked. Signs that you need to visit the nearest ER or call 9-1-1 immediately include:

  • Blue or dusky color to the lips, face, or tongue
  • Coughing up blood
  • Irregular breathing in newborns
  • Your child stops breathing


If your child needs to be seen for more severe symptoms of a cough, iCare ER & Urgent Care is here to help. With convenient locations in Fort Worth, Argyle, and Frisco, we’re here to help when you need medical care quickly. Our urgent care facility treats patients from 7 AM- 8 PM daily, and our emergency center is open 24 hours a day, 7 days a week. Our friendly, professional staff of physicians will listen to your child’s cough, watch them breathe, and listen to their chest and lungs. If X-Rays are necessary, they can be done right in our facility.


Our team is here to deliver quality, dependable medical care that’s both fast and thorough. For all your family’s medical needs, give us a call at (214) 407-8668 or book an appointment and check wait times with our convenient online system.