When to See a Doctor for a Child's Cough

There are a few sounds that tend to command a parent's attention, and a child's cough is certainly one of them. Are they sick? Is it in their lungs? Could they have asthma? Do they need to see a healthcare provider?

Fortunately, most coughs in children are minor and don’t require treatment. However, there are some that may warrant a trip to the pediatrician or even the emergency room.

This article explains the most common types of childhood coughs—just as a pediatrician might describe them to you—and how to respond to them.

When to See a Pediatrician for a Child’s Cough
Verywell / JR Bee

Frequent and Persistent Cough

If your child is coughing frequently—more than every five minutes for more than two hours—call your pediatrician. The cough could be caused by irritation from mucus in the throat, or it could be a sign of breathing troubles.

A frequent, persistent cough could also be a sign of asthma. The child might benefit from breathing treatments with an inhaler or nebulizer.

Short and Fast (Whooping) Cough

Pertussis, commonly known as whooping cough, is a serious infection. It can affect people of any age, but it is most serious for children younger than 1 year old. It can be fatal in infants.

Pertussis is characterized by a fast cough accompanied by a "whoop" sound that occurs when taking a breath. But infants with pertussis don't always have a cough. They may instead experience brief stops in breathing (apnea) and their skin turning blue (cyanosis).

The best way to prevent whooping cough is with the pertussis vaccine. It is usually given as a combination vaccination called the DTaP, which includes protection against two other serious bacterial diseases: diphtheria and tetanus.

The combination vaccine can be given starting at 2 months old. Adults should get a booster (called Tdap), especially if they are pregnant or have young children at home.

Productive (Wet) Cough

A productive, or wet, cough is one that brings up mucus that has drained from the head or phlegm that has been produced by respiratory tract. You can actually hear the fluid moving in the airways as the child coughs.

Your child may have a productive cough due to the common cold or flu. Though it's not pleasant, a productive cough is the body's way of keeping the lungs clear and protecting it from further infection.

Doctors typically only recommend taking steps to suppress the cough if a child cannot get adequate rest. However, a loud, wet cough could be a sign of a concern that requires treatment.

Persistent green or yellow mucus with coughing, sneezing, and/or blowing of the nose indicate that your child may have developed a sinus infection. Antibiotics or allergy medication may be necessary.

And the following are all signs of pneumonia, an infection caused by a virus or bacteria that invades the lungs and causes them to fill with fluid: 

  • A cold lasts for more than a week
  • The cough is wet, loud, and phlegmy
  • Breathing seems faster than normal

Bacterial pneumonia is treated with antibiotics, while viral pneumonia needs to run its course. Severe cases may require a hospital stay.

If any of these apply to your child, see a pediatrician—even if you've already paid them a visit earlier on in the course of the illness.

Dry Nighttime Cough

If your child has had an annoying, on-and-off cough that gets worse at night and with activity, call the pediatrician.

It is possible your child may have asthma, a chronic condition where the airways of the lungs become inflamed and narrow. There may also be excess mucus, which could explain your child’s coughing.

Call 911 if your child is having trouble breathing or becomes unable to speak, eat, or drink.

Barking Cough

A child's cough that sounds like a seal or small dog barking is a sign of croup, an upper airway infection.

This illness is most common in children under age 8 and usually starts or worsens at night. Children may wake during the night with a barking cough and a loud whistling sound when they breathe in, called stridor.

These sounds can be scary for kids and parents, but they don't always warrant a trip to the emergency room. If your child wakes up with a barking cough, take them to the bathroom and turn on the hot water in the shower. Sit in the steamy room for 15 minutes.

This step often relieves coughing and stridor. If it does, you can go back to sleep and contact the pediatrician in the morning. If it does not help, take your child to the nearest emergency room.

Wheezing Cough

People often confuse the term wheezing with the sound kids make when they breathe and are congested.

If it sounds like you can hear mucus when your child is breathing, there probably isn't anything to be concerned about. True wheezing is a high-pitched whistling sound when breathing out (exhaling).

If your child is coughing and wheezing without any history of asthma, contact your pediatrician or seek medical attention right away. If your child does have asthma, follow your family's asthma action plan.

When to See a Doctor

With time and experience, most parents learn when it's time to see a doctor for a child's cough. If you're still uncomfortable making that call, or you're just not sure your gut is right, review this list.

Any of these is an indication that you should seek medication attention for your child:

  • A fever of 100.4 degrees F or higher in an infant 2 months old or younger
  • A fever of 102 degrees F or higher in a child of any age
  • Blue lips
  • Excessive crankiness or sleepiness
  • Labored breathing, including nostrils widening with each breath, wheezing, fast breathing, or shortness of breath
  • Loss of appetite or thirst, with signs of dehydration (such as decreased urination)
  • Persistent ear pain
  • Severe headache
  • Worsening health in general

Comfort Care

In addition to the tips provided above, you can try to ease your child's cough by:

  • Using a humidifier at night: This puts extra moisture in the air and soothes a child's irritated airways.
  • Giving children 12 and up cough drops. Younger children should not use them, as they may present a choking hazard.
  • Giving your child cool drinks or popsicles to help soothe an irritated throat.

Avoid Cough Medicines

Children under age 2 should not be given over-the-counter cold medicines that contain a decongestant or antihistamine. They can cause a rapid heart rate and/or convulsions.

For older children, check with their pediatrician. And remember that children should never be given medicines that are designed to be taken by adults.

Summary

It's easy to think a cough is a cough. But there are different types, and their characteristics can help you and your child's healthcare provider determine what may be the cause.

Your child's practitioner will probably ask you to describe what the cough sounds like when you call. Frequent and persistent, whooping, productive/wet, dry overnight, barking, and wheezing are all possibilities that can help guide their recommendations for next steps.

But remember: Even if your child has a cough that can be managed at home, always call your pediatrician if it gets worse, persists, or is accompanied by other symptoms.

Frequently Asked Questions

  • Why do young children cough more at night?

    Lying flat in bed can make a cough worse because nasal drips down the throat and causes irritation. Levels of the hormone cortisol also drop at night, which cause airway obstruction. This can aggravate asthma or other respiratory conditions. 

  • Can Vicks VapoRub help a child stop coughing at night?

    Yes. If a child is at least 2 years old, Vicks rubbed on the chest can ease the child’s cough and cold symptoms and help them sleep better. The product contains menthol, camphor, and eucalyptus oil, which are cough suppressants.

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8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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