Coughs in Babies and Toddlers: Causes, Symptoms, and Treatment

If your little one has a cough, you’re probably wondering what’s causing it. Although a cough can sound awful, it's usually not a sign of a serious condition. In fact, coughing is a healthy and useful reflex that helps clear the airways in the throat and chest. Most of the time, your baby or toddler’s cough can be managed with simple home remedies. In some cases, however, your child’s cough may be a sign of something more serious and might require treatment from their healthcare provider. Read on to learn about the different types of coughs, what can cause a cough, and what treatment may be needed.

What Can Cause a Cough?

Coughing is almost always due to an irritation of the air passages. When the nerve endings in the throat, windpipe, or lungs sense the irritation, air is reflexively and forcefully ejected through the passageways. Basically, coughing helps keep the airways clear. The most common irritant is mucus, a fluid that cleans and moisturizes the nasal passages. When a lot of mucus is secreted—such as during a cold, for example—this fluid accumulates in the back of the throat, irritating the airways and triggering a cough. Coughs are usually associated with respiratory illnesses, such as colds, bronchiolitis, croup, flu, and pneumonia. However, a cough can also be caused by allergies, ingestion of a foreign object (such as a small toy or a nut), or breathing in a temporary irritant, such as paint fumes or tobacco smoke.

Why Don’t All Coughs Sound the Same?

Not all coughs are created equal, which is why some coughs sound dry and barky, while others are wet and seem to come from deep within. Most often, it’s the location of the irritation that affects the sound of the cough. For example, an irritation of the trachea (windpipe) or bronchi (the tubes that branch from the trachea into the lungs) sounds deeper and raspier. An irritation in the larynx (also called the voice box) causes the cough to sound like a bark. The way a cough sounds doesn't always indicate what's triggering the cough, though it may be an important clue. Your healthcare provider will also consider other factors and symptoms when determining the cause of your baby’s cough.

Types of Coughs

In the table below you can see different types of coughs and some potential causes. Keep in mind that characteristics of a cough may vary, and that only your child's healthcare provider can make an accurate diagnosis.

Treating a Cough

The treatment your baby’s cough needs, if any, depends on what is causing the cough in the first place. For example, the treatment your child’s healthcare provider would recommend for a cough caused by asthma will likely differ from that of a cough caused by a viral infection. That said, many coughs are caused by viruses. Most of the time, the virus is allowed to run its course, and the cough will eventually go away when the infection clears. Do not give your baby or young child any over-the-counter cough or cold medicines. These may produce serious side effects and have not been shown to be effective.

Home Remedies for Your Baby’s Cough

Most coughs will go away on their own, but in the meantime, you may wish to try the following to help your child feel more comfortable:

• Offer more fluids to keep the airways moist and your child well hydrated

• Turn on a cool mist humidifier, especially if the air in your home is very dry

• For an older child who coughs at night, try elevating the head of the bed.

Some parents may choose to sit with their child in steamy bathroom, running a hot shower with the door closed. However, though this practice has been recommended in the past, there is no actual evidence that this helps improve breathing. It’s always wise to consult your healthcare provider about any home remedies for cough.

Specific Coughs and Their Symptoms

To treat your child’s cough, your provider first needs to diagnose the root cause. A cough can be a symptom of several different illnesses and conditions, each of which may produce additional symptoms. Click on the links below to learn about some of these illnesses and conditions, and to view a list of other symptoms that may be present in addition to cough.

• Allergies

• Asthma

• Bronchiolitis

• Choking

• A cold

• Croup

• Flu

• Pneumonia

• Sinus Infection

• Whooping Cough

Allergies

Allergies can produce a chronic cough, one that doesn’t go away for a long period of time. When the respiratory system is irritated by an allergen, mucus will drip down to the back of the throat, which can cause a cough that is dry and difficult to stop. Some coughs associated with allergies also bring up a clear mucus. Taking steps to remove potential allergens from your home can help prevent allergy attacks. While most allergies are more of an annoyance than a health risk, there is some overlap with asthma in terms of symptoms. The best plan is to get your little one checked out by their healthcare provider for a professional diagnosis and treatment recommendations.

Asthma

Asthma is one of the most common chronic diseases affecting children. Though symptoms vary widely from child to child, a prominent symptom is wheezing, a whistling noise in the chest during breathing. Treatments for asthma in older children might include controller medications that are taken using nebulizers, spacers, or inhalers. Your child’s healthcare provider can make a diagnosis and explain whether lifestyle changes or medication is needed. If your child has asthma, taking steps to reduce allergens that can trigger asthma around the home may help, such as using dust mite-proof covers on the child’s mattress and pillows.

Bronchiolitis

Bronchiolitis is an infection that affects the bronchioles, the small breathing tubes inside the lungs, and can cause a dry and persistent cough. It is a common disease in early childhood, mostly affecting children under 2 years of age. Bronchiolitis is usually caused by the respiratory syncytial virus (RSV), resulting in inflammation and swelling in the bronchioles. This inflammation can hinder air flow. Bronchiolitis is not the same as bronchitis, which is an infection of larger airways called the bronchi. Your child’s healthcare provider may recommend treating minor symptoms of bronchiolitis with saline nose drops or acetaminophen. If you notice any signs of dehydration like a dry mouth or urinating too little, or if your little one has difficulty breathing, call the healthcare provider right away.

Choking

If something is swallowed the wrong way—like food, liquid, or another object—then your child may start to cough suddenly. This is the lungs' way of trying to dislodge the item and clear the airways. If your child or baby coughs for more than a few minutes or if they’re having trouble breathing, get medical attention immediately so that the foreign object can be removed safely. Do not put your fingers down their throat to try to remove the object, as this may push whatever is stuck there further down.

To help prevent choking incidents, do not give your baby or toddler pieces of hard food, such as nuts; do not leave your child unattended at mealtimes; and do not keep anything that may be a choking hazard within reach. A cough that doesn’t get better could be caused by your little one having swallowed something small like a toy, bead, or coin, so be sure to consult your healthcare provider if you suspect this is what has happened.

A Cold

Among the most common cough-producing illnesses is the common cold, which is an upper respiratory infection. Colds are caused by viruses, which can spread from one person to another via a sneeze, cough, or contaminated surface or hand. The symptoms tend to go away on their own in about 7 to 10 days, but it’s possible for cold-like symptoms to persist and for an illness such as pneumonia to develop. If the symptoms get worse, or your child is under 3 months old and develops a cough or cold, it’s safest to speak to your little one’s healthcare provider immediately. In a newborn, a cold can quickly turn into something more serious, so it’s worth getting medical attention at the first sign of symptoms.

Croup

Croup is an inflammation of the larynx (voice box) and trachea (windpipe) and can cause a barking cough in children. It is caused by a virus, usually the parainfluenza virus, and tends to occur most often in children between the ages of 3 months and 3 years, especially in the fall and winter. Some parents try to manage croup symptoms by having their little one inhale warm, humidified air (such as from a steamy bathroom) and even taking them outside, weather permitting, for some cool night air. Though these strategies have been recommended in the past, there is no evidence to suggest they are actually effective. Consult your child’s healthcare provider for advice on what's best for your child. It's possible that the provider may prescribe medication to help decrease the swelling in the throat and upper airways.

Flu

Flu, short for influenza, is caused by a virus, and comes with some of the same symptoms as the common cold, including a dry hacking cough. However, with the flu, your child will likely feel much sicker. Flu symptoms usually go away on their own in about a week or two, and you can help keep your little one comfortable with plenty of fluids and rest. Your child’s healthcare provider may also recommend some form of treatment to help ease the symptoms. The best way to protect your little one from the flu is with the flu vaccine. Experts recommend that everyone over the age of 6 months get this vaccine each year before flu season starts, ideally by the end of October.

Pneumonia

Pneumonia usually occurs when a viral respiratory tract infection spreads to the chest and lungs, but it can also be caused by a bacterial infection. The name literally means “infection of the lung,” and can cause a persistent cough, among other symptoms. If you suspect your child or baby has pneumonia, contact your healthcare provider. Your little one might be prescribed an antibiotic or another medication if diagnosed with pneumonia. You can help prevent your baby from getting the infection that can lead to pneumonia by ensuring their immunizations are up to date, which will include getting the vaccine against pneumococcal disease.

Sinus Infection

Sinus infections are sometimes caused by bacteria resulting in inflammation in one or more of the sinuses, but they can also be a complication of a cold or an allergy inflammation (especially for children over the age of 2). The mucus from the sinus may drip back into the throat and trigger an irritated cough. Many sinus infections can be treated with antibiotics, so talk to your child’s healthcare provider if you notice any of the above symptoms in your little one.

Whooping Cough

Whooping cough is caused by the pertussis bacteria, which attacks the lining of the bronchi and bronchioles—the breathing passages in the lungs—making them inflamed and narrowing the airways. Babies under 1 year are at the biggest risk of getting whooping cough, which can be a life-threatening condition and may require hospital treatment. The good news is that whooping cough in babies can be prevented by vaccination. If your little one does get whooping cough, the infection can be treated with an antibiotic, but it’s important to catch it early. If you have any concerns that your baby may have whooping cough, see your healthcare provider immediately. With this disease, the cough itself can last for months and even return after a period of being symptom-free. Home remedies for your baby’s cough, such as the use of a cool-mist vaporizer, can help soothe the irritated lungs.

When to Contact Your Child’s Healthcare Provider

Call your child’s healthcare provider if your baby has a cough or a cold and is under 3 months old. For babies and children of any age, call your healthcare provider right away if your child

• is struggling to breathe

• has a cough that appears suddenly and comes with a fever of 101 degrees Fahrenheit or higher

• is having trouble eating or sleeping due to the cough

• experiences a painful and persistent cough, especially if it comes with a “whooping” sound

• has a cough that causes vomiting or your child to turn blue

• starts coughing after choking on food or another object—sometimes this type of cough may begin hours or days after the foreign object has been inhaled.

How to Prevent a Cough

Most coughs are viral, so the best thing you can do to help prevent your little one getting a cough is to try to prevent them from coming in contact with a virus. Here are some ways to ward off a viral infection:

• Wash your and your little one’s hands regularly, and make sure that all family members and care providers do this also

• Cover your mouth and nose when coughing or sneezing; and when your little one is old enough, teach them to do the same

• Throw used tissues in the trash immediately

• Wash dishes and utensils in the dishwasher or in hot, soapy water

• Don’t share toothbrushes, utensils, cups, or washcloths

• As your little one grows older, teach them not to touch their eyes, nose, or mouth unless they've washed their hands first

• Keep doorknobs, countertops, and toys sanitized.

If your little one’s cough is caused by something other than a viral infection, ask your healthcare provider for advice on how to manage the cough associated with the condition.

The Bottom Line

Like a sore throat or the sniffles, coughs are one of those symptoms that your little one might get from time to time. Although it’s usually nothing to worry about, if you're concerned about your child’s cough or have any questions about a particular illness, reach out to their healthcare provider.

In the meantime, comfort them with hugs and kisses. With the right care, your baby’s coughs will resolve, and they'll be back to their normal happy and healthy self.

_{How We Wrote This Article The information in this article is based on the expert advice found in trusted medical and government sources, such as the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists. You can find a full list of sources used for this article below. The content on this page should not replace professional medical advice. Always consult medical professionals for full diagnosis and treatment.}