Whether it’s a dry cough or a phlegmy one, a wheezy cough or a barking one, no cough sounds good to a parent’s ear.
Luckily, the reasons behind most of your child’s coughs will probably be minor and relatively easy to treat (lots of liquids, rest and TLC), but sometimes coughs in children can signal something a little more serious than a run-of-the-mill cold or an allergy.
If you’re wondering just what culprit is behind that cough your baby or toddler is dealing with, take a look at the coughing symptoms below, and what each kind means.[1]
Be sure to call — or see — your doctor to confirm the diagnosis. Use this information only as a general guide (and remember that your child may not have all the symptoms listed for each illness), and get tips on how to treat some common childhood illnesses.
A dry cough
- With a sore throat: If your toddler has a dry cough and her only other symptom is a slight sore throat, it's most likely caused by irritants like overly dry air or tobacco smoke. It could also be caused by COVID-19, so your pediatrician may suggest your child gets tested to see whether that could be the culprit.
- With flu-like symptoms including chills, fever, fatigue and aches: If your child's dry cough is accompanied by fever, sore throat, muscle aches, headache, exhaustion, chills, loss of appetite, dizziness, a runny or stuffy nose or even vomiting and/or diarrhea, you can most likely attribute it to a virus and if it's the right season, the flu. It could also be COVID-19. You may want to get your child tested for the flu and/or COVID-19 to see what's causing the symptoms.
- With shortness of breath, fever, fatigue and loss of taste and/or smell: These are usually hallmark signs of COVID-19, though more often in adults than young children, and they can also be signs of the flu or another upper respiratory virus or condition. Check with your pediatrician about getting your child a COVID test and a proper diagnosis.
- With gagging: Acid reflux — a common problem in newborns and infants due to an immature digestive system — may be to blame for a dry cough with gagging in babies. It could also be a more serious, related digestive problem in babies known as infant GERD.[2]
A wet cough with congestion
A phlegmy or wet cough in babies is likely caused by a viral illness like the common cold or even the flu if your child’s symptoms also include sore throat, congestion (runny or stuffy nose), sneezing, headaches, muscle aches, mild fever and loss of appetite.
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These kinds of coughs can be persistent, sometimes lasting for up to two to four weeks.
Not sure whether your child has a wet cough or a dry cough? A cough is your body’s way of getting rid of irritants in your respiratory tract and preventing infection. A wet cough — sometimes called a productive cough — involves coughing up mucus (otherwise known as phlegm). A dry cough does not.
A cough with wheezing
A baby’s cough may be bronchiolitis, an inflammation of the tiny airways known as bronchioles that’s usually caused by a virus (most commonly RSV), if it’s accompanied by wheezing, or high-pitched noises when your child exhales.
Babies with bronchiolitis often also have fast/shallow breathing, a rapid heartbeat, vomiting after coughing (sometimes), runny nose, congestion, fever, flaring of the nostrils, irritability, poor appetite and retractions (when the areas below and between the ribs and in the neck sink in when a baby inhales).
COVID-19 or asthma may be to blame if the cough and wheezing also come with shortness of breath, so you'll want to get a proper diagnosis at the doctor. In young children with asthma, the cough may sound like a "bark" and could even lead to vomiting.
Allergies can also trigger coughing in children, along with red/itchy/watery eyes, congestion, sneezing, difficulty breathing (sometimes), hives or rash (occasionally), and stomach upset, diarrhea or vomiting (not always).[3]
A barky cough
If your toddler’s cough is loud and harsh and sounds like a barking seal, it’s likely a sign of croup — a scary-sounding but usually benign inflammation of the vocal cords typically caused by a viral infection.
It tends to flare up at night, and a baby’s symptoms often include labored or noisy breathing (you may hear a high-pitched breathing sound when your child inhales), fever, stuffy nose, difficulty swallowing, irritability and a hoarse voice. It's a good idea to check in with your pediatrician just to get a confirmed diagnosis, though.
A coughing attack with a whoop on inhalation
Severe coughing attacks of multiple coughs in a row followed by a high-pitched whoop sound when your child inhales are a classic sign of the bacterial infection known as whooping cough, or pertussis, in babies and toddlers.
These coughing fits sometimes lead to trouble breathing and a red or purple face or vomiting. Toddlers and babies may also have cold-like symptoms, including a runny nose, sneezing and low-grade fever.
Whooping cough is very contagious and can be dangerous for infants. You can protect your child by being sure she gets the DTaP vaccine series starting at 2 months of age and making sure you get the Tdap vaccine (the equivalent for adults) while you're pregnant.
If you think your baby has whooping cough, be sure to see your doctor right away.
A cough with labored or rapid breathing
A cough in babies can rarely be caused by pneumonia, an infection in the lungs that usually develops after another viral or bacterial illness.
Symptoms vary depending on a child’s age and the cause behind the pneumonia, but they may include very fast or labored breathing, flaring of the nostrils when breathing, breathing with grunting or wheezing, fever, vomiting, chills, loss of appetite, chest pain, stuffy nose and abdominal pain caused by excessive coughing.
In very severe cases, a baby may have a bluish color around the lips and fingernails.
If you think your baby or toddler might have pneumonia, check in with your doctor or head to an emergency room immediately.
When to call your doctor
Yes, coughs are common, but if any of your child's symptoms don't seem quite right, err on the side of caution and call your doctor.
You should also check in with the pediatrician if your baby or toddler's cough is normal but disturbs her sleep at night, or is accompanied by 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
- Making a “whooping” sound on inhalation
- Coughing up blood
- Wheezing when breathing out
- A harsh, noisy “musical” sound when breathing in (stridor)
- Dehydration
Though caring for a coughing baby or toddler can be nerve-wracking, just know that your little one will get better in time. Try to take comfort in the fact that you'll get through this and your child will be back to her old self soon.
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