Decode Your Child’s Cough

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It's always distressing to hear your child cough, especially in the middle of the night. Still, as common as this symptom is, it's helpful to know that a cough often sounds worse than it actually is.

"Coughing is the body's way of clearing and protecting the airways from irritating mucous and other secretions," says Dr. Charles Shubin, MD, director of the Children's Health Center at Mercy Family Care in Baltimore, Maryland. Coughs also provide valuable clues about your child's illness. Follow our guide to figure out what's worrisome and what's not—and help your child feel better fast.

Asthma

Cough Clues: A persistent cough that's often whistling or wheezy, lasts longer than 10 days, and worsens at night or after your child exercises or is exposed to pollen, cold air, animal dander, dust mites, or smoke.

Other Symptoms: Your child is wheezing or has labored, rapid breathing.

Likely Culprit: Asthma, a chronic condition in which small airways in the lungs swell, narrow, become clogged with mucous, and spasm, making breathing difficult. Common asthma triggers include environmental irritants, viral infections, and exercise.

"Children with asthma, in essence, have sensitive lungs," says pediatrician Dr. Mark Widome, MD, author of Ask Dr. Mark.

What to Do: In mild asthma cases, a chronic cough may be the only symptom, Dr. Widome says. Have a doctor examine your child for an accurate diagnosis. Mention any family history of allergies, asthma, or eczema, which can increase your child's likelihood of the disease.

Bronchiolitis

Cough Clues: A phlegmy or wheezy cough that's often accompanied by fast, shallow, or difficult breathing.

Other Symptoms: Your child starts out with cold symptoms, such as sneezing or a stuffy nose, that last about a week. He may develop a fever up to 103 degrees. He's lethargic and makes a wheezing sound when he exhales.

Likely Culprit: Bronchiolitis, an infection of the tiny lower airways in the lungs called bronchioles. It's usually caused by respiratory syncytial virus (RSV) and most often occurs from late fall to early spring. Not to be confused with bronchitis (a frequent upper-respiratory infection in older kids and adults), bronchiolitis is common among babies and toddlers.

"Almost all kids will get a bout of it by age three," says Dr. Susanna McColley, MD, division head of pulmonary medicine at Children's Memorial Hospital, in Chicago, Illinois.

What to Do: Call your pediatrician right away if your little one seems to be struggling to breathe or is too irritable to eat or drink. Infants with bronchiolitis sometimes need to be hospitalized to receive oxygen treatment. If your child's symptoms are mild (a wheezy cough without breathing trouble), put a cool-mist humidifier in his room to help loosen mucous in his lungs, and make sure he drinks plenty of fluids.