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 the 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]
Think of these tips as a friendly helping hand, but whenever you’re in doubt — or just need that peace of mind — never hesitate to give your pediatrician a quick call or visit
What does a dry cough mean?
- 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.
- 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 like the flu.
- 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. 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]
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What does a wet cough with congestion mean?
A phlegmy or wet cough in babies is likely caused by a viral illness like the common cold or the flu if your child’s symptoms also include:
- Sore throat
- Congestion (runny or stuffy nose)
- Sneezing
- Headaches or muscle aches
- Mild fever (between 99.5 and 100.3 degrees Fahrenheit)
- Loss of appetite
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.
What does a cough with wheezing mean?
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. It may sound like high-pitched noises when your child exhales.
Babies with bronchiolitis often also have:
- Fast or shallow breathing
- A rapid heartbeat
- Vomiting after coughing (sometimes)
- Runny nose
- Congestion
- Fever
- Nostril flaring
- Irritability
- Poor appetite
- Retractions (when the areas below and between the ribs and in the neck sink in when a baby inhales)
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 from 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.[3] Other signs of an allergy include:
- Red, itchy, or watery eyes
- Congestion
- Sneezing
- Difficulty breathing (sometimes)
- Hives or rash (occasionally)
- Stomach upset, diarrhea or vomiting (not always)
What does a barky cough mean?
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 signs often include:
- Labored or noisy breathing (you may hear a high-pitched breathing sound when your child inhales)
- Fever
- Stuffy nose
- Difficulty swallowing
- Irritability
- A hoarse voice
It's a good idea to check in with your pediatrician just to get a confirmed diagnosis, though.
What does a coughing attack with a whoop on inhalation mean?
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.
What does a cough with labored or rapid breathing mean?
A cough in babies can rarely be caused by pneumonia, an infection in the lungs that usually develops after another viral or bacterial illness.
Signs of pneumonia vary depending on a child’s age and the cause of the illness, 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
- Abdominal pain caused by excessive coughing
- In very severe cases, a bluish color around the lips and fingernails
If you think your child might have pneumonia, call your doctor or head to an emergency room immediately.
When should you call the 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.
Always call the doctor if your baby develops a cough and is younger than 4 months old. Also check in with the pediatrician if your older baby or toddler's cough is accompanied by any of the following:
- Coughing that disturbs her sleep
- 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, or a fever that persists for more than a couple of days
- Coughing that lasts more than two weeks
- Making a “whooping” sound on inhalation
- Coughing up blood
- Wheezing when breathing out
- A harsh, noisy “musical” sound when breathing in (the medical term is 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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