Your toddler's tucked in bed, and you're settling in on the couch for a night of Netflix. Then, from out of nowhere, your child's peaceful sleep suddenly turns into loud, raucous coughs. You drop the remote and go to her side to comfort her, but now your quiet night is disrupted with a worrying thought: Does my child have a mild cold or is something more serious going on?

Wonder no further. Decode the cough with this handy guide, and call the pediatrician for a proper diagnosis or if you have any questions or concerns. Your child may also need a COVID-19 test. In the meantime, here's what to know about the most common conditions that cause coughs. 

Common cold

In some kids, a cough may be the first sign of the cold, and in other kids, the runny nose or sneezing may come on first, followed by a cough and sometimes a mild fever.[1] Beyond the usual cuddles, soothing words and all-around TLC, try these tactics to make her feel better:

  • Give your child lots of liquids. Water is best, but warm decaffeinated tea may also help ease the tickle that sets off the cough. Toddlers ages 1 to 3 can also have up to 4 ounces of juice a day, but don't give juice to babies under 1. If your child refuses to drink, cool Popsicles may tempt her — and they can also soothe a sore throat.
  • Run a cool-mist humidifier in her room at night. (A warm humidifier may pose a danger in your child's room if she gets too close to it.) This will fill the air with moisture, which will soothe an inflamed, scratchy throat, and it will loosen up the mucus and ease congestion.
  • Try using nasal drops and a bulb syringe. They'll help clear out mucus in the nose.
  • Offer a spoonful of honey before bed. The sweet stuff can coat the throat and alleviate soreness in kids older than 1. (Don't give honey to babies younger than 1 because there's a risk of botulism, a life-threatening illness.)
  • Don't give your toddler cough or cold medicines. The Food and Drug Administration (FDA) and the American Academy of Pediatrics (AAP) don't recommend cough and cold meds for young kids. They aren't effective, and what's worse, they can put your toddler at risk for dangerous side effects.

COVID-19

COVID-19, the disease caused by the coronavirus, can cause similar symptoms in adults and children. Besides a cough, your child may also have a fever, chills, shortness of breath, muscle aches, headache, fatigue, sore throat and a loss of taste or smell. To keep your child and your family safe:

Continue Reading Below

More on Coughs and Colds

Colds in Toddlers: Causes, Symptoms, Tips and Remedies
Stuffy Nose in Babies and Toddlers
Sore Throats in Children
Colds in Toddlers: Causes, Symptoms, Tips and Remedies
Stuffy Nose in Babies and Toddlers
Sore Throats in Children

  • Call the doctor. Ask about getting your child and potentially other family members tested for COVID-19. Your pediatrician may also want to rule out other causes. 
  • Isolate. If a child has COVID, keep her home for at least five days and separate from other people in your household. She should then wear a mask for another five days if she returns to school or day care. (Talk to the facility about its specific policy, and learn more about quarantine and isolation guidelines for children in general.) 
  • Reduce the risk of transmission. Lower the likelihood of another family member contracting the virus by having everyone wash their hands frequently, wearing well-fitting masks (for people over the age of 2), ventilating your home as much as possible and cleaning high-touch surfaces frequently. 
  • Watch for worsening symptoms. Call the pediatrician if your child has trouble breathing; persistent chest pain or pressure; new confusion; trouble waking or staying awake; or pale, gray or blue-colored skin, lips or nail beds.
  • Get vaccinated — and boosted, if eligible. Everyone 6 months and up can get immunized against COVID-19. It's safe and recommended because it greatly reduces the risk of serious illness.

Croup

Croup occurs when the voice box and windpipe become inflamed, causing the airways to swell and become narrow.[2] It's typically caused by a viral infection, including COVID-19 and the flu. 

Croup can sound like a barking cough accompanied by a high-pitched squeak when inhaling. Other symptoms include fever, hoarseness, and difficulty swallowing or breathing. To relieve this toddler cough:

  • Take your child into the bathroom, get a hot shower running and close the door. Then stay in the steamy bathroom for 15 to 20 minutes. The warm moist air should ease the inflammation in the airways. Or try cool, moist air by taking her outside into the cool night, or by opening the freezer and having her breathe in for several minutes.
  • Run a cool-mist air humidifier in her room for the next few nights. Croup generally lasts three to seven days.
  • Know when to call the doctor. If at any point your child has a high fever, struggles to breathe, has noisy breathing at rest (called stridor) or develops a bluish hue around her mouth, get medical help right away.

Bronchiolitis

Bronchiolitis is an infection that results in swelling and inflammation in the tiny airways (bronchioles) of the lungs. The most common cause of bronchiolitis is respiratory syncytial virus (RSV), but other viruses, such as the common cold and the flu, can also cause bronchiolitis.

It may sound like a wheezy, phlegmy cough accompanied by high-pitched whistling or wheezing sounds when your toddler breathes. Your child may also have a fever, runny nose, vomiting and fatigue. 

These symptoms can turn into more severe problems, such as difficulty breathing and a rapid heartbeat. Though RSV and bronchiolitis tend to be more dangerous in infants, it can be serious in toddlers too. In some cases (though not most), it can require hospitalization. 

To nip this cough in the bud before it gets out of hand:

  • Call the pediatrician (or on-call doctor) right away for a phone or in-person appointment.
  • Offer your child lots of liquids, such as water, juice or electrolyte solution to soothe her throat and prevent dehydration.
  • Run a cool-mist humidifier in her room at night to fill the air with moisture. This will help relieve the swelling in the bronchioles, and it will loosen mucus in the airway to ease the cough and congestion.
  • Try using nasal drops and a bulb syringe to clear out mucus in the nose.
  • Watch for other symptoms. If your child also has a high fever, labored breathing, blue lips or fingernails, or shows signs of dehydration (cracked lips, sunken eyes, tearless crying and a decrease in urination), get her to a doctor or the ER quickly.

Asthma

Asthma is a chronic lung condition in which airways swell, spasm and become clogged with mucus. Your child may have a continuous cough (along with wheezing) that won't quit, night after night  — but no cold symptoms.

What to do:

  • Bring your toddler to the doctor for an asthma evaluation. It's important to get a proper diagnosis and treatment; she may need inhalant or oral medications. The doctor can also help you figure out potential asthma triggers and how to avoid them. 
  • Ease symptoms. In addition to the medications the doctor may prescribe, offer your child liquids and run a cool-mist humidifier in her room at night.

Pneumonia

Pneumonia is an infection that causes lung tissue to become inflamed and filled with pus. Common symptoms include a phlegmy cough and labored breathing along with a high fever, aches, chest pain, vomiting, chills, and/or sometimes a blue color around the lips. 

It usually comes on the heels of a viral or bacterial infection. To treat it:

  • Call your pediatrician — your toddler needs medical attention right away.
  • Help your child feel better by offering her liquids (to avoid dehydration) and running a cold-mist humidifier in her room.

Whooping cough

Whooping cough is a bacterial infection also known as pertussis.[3] These dry coughing attacks — multiple coughs in a row — feature a high-pitched whoop sound when your child inhales. Though outbreaks of whooping cough have been declining, your toddler is most at risk if she didn't get the DTaP vaccine (the P stands for pertussis).

To treat the cough:

  • See your pediatrician — your child needs antibiotics.
  • Help your toddler feel better by encouraging her to drink as much as she can (to avoid dehydration) and running a cool-mist humidifier in her room to soothe her breathing passages.

When to call the doctor

Yes, coughs are common, but if your child is coughing and doesn't seem quite right, err on the side of caution and call your doctor. It's especially important to check in if you notice any of the following symptoms:

  • Trouble breathing or shortness of breath
  • Faster rate of breathing than usual
  • Bluish color to the face
  • A fever of 100.4 degrees Fahrenheit or higher
  • Coughing in infants for more than a few hours at a time
  • Coughing with a whooping sound on inhalation
  • Coughing up blood
  • Wheezing when breathing out
  • Harsh, noisy sound when breathing in (stridor)
  • Dehydration

Toddler cough remedies

Toddlers should never be given over-the-counter cough or cold medicines for their coughs.

Instead, offer toddler cough remedies like: 

  • A cool mist humidifier running in your little one's room
  • Steam from a hot shower
  • Liquids like water, juice, oral rehydration solution (e.g., Pedialyte) or warm, caffeine-free tea
  • Saline drops in the nose and a bulb syringe to take the mucus out
  • A teaspoon of honey if your child is older than 1