Kids Coughing 101 – What You Need to Know

In the pediatric ER, cough is one of the most common complaints we get from parents. It brings millions of parents to emergency rooms across the country looking for relief. Many times, parents do their own investigating to determine what coughing means for their kids.

Does a wet cough mean pneumonia?
Does a barking cough automatically mean croup?

Today we are breaking down what your child’s cough means and how you can treat the symptoms.

There are many reasons why your child may cough. It can be as simple as an irritation of the throat, a common cold, or it can be an indication of something more chronic, like seasonal allergies or asthma. In order to successfully treat a cough, it’s important to determine and diagnose the cause of the cough.

Let’s look at a few different types of coughing and break them down into what you need to look out for as a parent.

Illness Causing Coughing in Kids

One of the most common causes for cough is a viral illness. This type of cough will typically present with other symptoms, including fever, runny nose, sore throat, body aches, and possibly even vomiting or diarrhea.

Many times, a cough due to an illness can linger for up to 3 weeks and can be dry or wet depending on the type of virus.

Barking Cough

A barking cough is the common sound associated with croup. Croup is a common illness for children ages 3 months to 5 years. It is a virus that causes swelling of the upper airway (voice box and windpipe). It often starts out just like a cold, but as the swelling increases, your child’s cough will start to sound like the bark of a dog. Your child’s voice may become hoarse, and their breathing will be heavy and loud.

A great tip and home remedy for croup is to use steam to help soothe the airway. Have your child sit in a bathroom full of steam created by hot water from the tub or shower.

As croup progresses and your child’s airway becomes more swollen, you may hear a whistling noise, called stridor. If your child displays any of these symptoms or is having difficulty breathing, please see your pediatrician.

Wet Cough vs. Dry Cough

Many parents will refer to their child’s cough as wet or dry. But what is the difference?

A dry cough can be associated with an irritation in the upper airway, located more through the sinuses, throat, and vocal cords. A wet cough is associated with the lower airway, which produces mucus as a response to irritation. Many things can cause either a wet or dry cough.

Having a particular type of cough does not automatically mean your child has a particular illness. For instance, a wet cough does not necessarily mean your child has pneumonia. Always consult your pediatrician if you are concerned about your child’s persistent cough or associated symptoms.

Allergies or Asthma Causing Coughing in Kids

A cough that is caused by allergies or asthma can typically be associated with a feeling of tightness in the chest and shortness of breath. This type of cough can lead to wheezing, which can best be heard during a physical exam from a doctor.

Wheezing is a distinctive, high pitched whistling sound that usually happens as your child is breathing out. It sounds as if it is coming from the chest, rather than the nose.

Although an illness or obstruction can cause wheezing, the most common cause is asthma and allergies.

Typically, a cough caused by allergies and asthma will last for a long time, whereas a cough caused by a virus will most likely resolve in 2-3 weeks. Unlike a viral cough that can worsen over a few days, coughing from asthma or allergies is mostly sudden in nature and possibly triggered by your surroundings (outdoor pollen, pet dander, etc.).

Reflux Causing Coughing in Kids

Although not as common, children can cough due to acid reflux. Typically, that’s when stomach acids flow back up into the esophagus. This acid can irritate the esophagus and lead to coughing. Associated symptoms might include upper stomach and chest pain, a burning sensation in the throat, and a bad taste in the mouth.

So when should parents worry about a child’s cough and go to the emergency room?

Although persistent coughing can be incredibly stressful for a family, it doesn’t necessarily mean that there is something dangerous happening. Many illnesses are associated with a lingering cough.

However, you should look out for certain signs and symptoms that require immediate medical attention. If your child is vomiting, having difficulty breathing, or experiencing chest tightness, shortness of breath, and high fever, you should seek medical attention for further imaging and management.

Common Treatments for a Child’s Cough

After being evaluated by your pediatrician, your child may be prescribed a prescription medicine to treat their cough. There are also over-the-counter (OTC) medications and natural remedies available that can further help relieve your child’s symptoms.

  • Cough and cold medications
    There are many over-the-counter (OTC) cold medications and cough syrups for kids which are helpful. When using these OTC medications, look closely at the active ingredients and age requirements. Cold and cough medications are NOT recommended for children under the age of 4. When introducing any medication, whether OTC or prescription, it’s important to have a discussion with your pediatrician first and review the options for safe use.
  • Honey
    Honey is a time-honored treatment for cough relief. If your child is over the age of 1 year old, you can give them a lukewarm cup of water with buckwheat honey. Many parents of older children find honey to be helpful, especially with relief of nighttime coughing!
!

Safe use tips for honey

Do not give honey if your child is under 1 year old due to the risk of infant botulism.

  • Steam
    Go into your bathroom, shut the door, and put the shower on as hot as it will go. Let your child play in the bathroom for 15 minutes to allow the steam to help break up any mucus
!

Safe use tips for steam

Keep your child away from the hot water source to prevent burns.

  • Saline drops and suction
    Saline drops with suction are a great way to break up nasal congestion! However, use this method sparingly, especially if your child is an infant. Frequent suctioning can lead to inflammation in the nasal passages, which may actually cause more congestion. I recommend suctioning before bedtime and with feeds, when necessary.
  • Humidifier
    Putting moisture into the air is one of the best ways to treat congestion or nighttime cough. However, make sure the water is fresh and sterile to prevent expelling bacteria and germs into the air. Use a cool mist humidifier rather than the warm mist variety to avoid potential burns.
  • Elevation
    Raise your child’s head slightly using a pillow during their naps and bedtime. If your child is too young for a pillow, put something under the mattress to slightly raise the side of the mattress where your child’s head rests. This slight elevation helps to keep your child’s nasal passages open while they sleep.

Final Thoughts on Relieving Cough Symptoms

The source or cause of coughing can be complex and difficult to diagnose. If your child is suffering with a cough, speak with your pediatrician to determine the best treatment plan to get your child feeling better soon.

~Dr. Katie

Meet Our Experts

Dr. Katie Friedman

Dr. Katie Friedman is a board certified pediatrician and specialist in pediatric emergency medicine. She is also a wife, and mother of two. Along with her sisters (Alison, a veterinarian and Carrie, a fashion stylist), she is a co-founder of Forever Freckled, a website dedicated to helping people with pets, children, and everyday lifestyle.