Toddler Cough: Causes, Treatment, and When to Worry

Don't assume your toddler's or kid's cough is nothing more than a cold. Here are the common causes of toddler coughs, the best treatment options, and when you should worry.

boy coughing outside
Photo: Tomsickova Tatyana/Shutterstock

Toddlers cough when the lining of the windpipe becomes irritated. This often happens when the child is sick or fighting off an illness, which produces lots of phlegm. The act of coughing removes the extra mucus and lets air flow more easily through the windpipe into the lungs. Here are common reasons for toddler and kid’s coughs, and the best ways to diagnose and treat the annoying symptom.

Types of Toddler Coughs

The most common reasons for toddler coughs are viruses and asthma, which would likely also have symptoms like choking, wheezing, or cold-like symptoms. Toddler cough and fever may also indicate influenza. If your child is getting over an illness, then the cough will probably be the last symptom to get better. In fact, it's not uncommon for a dry, hacking cough to linger for as long as three weeks after a cold (although you should see some gradual improvement between 10 and 14 days).

There are four distinct types of coughs: dry, wet, croup, and whooping. It is important to know what type of cough your child has, and what it might mean.

Toddler Dry Cough: An infection of the upper respiratory tract, such as a cold or influenza, often causes a dry, hacking cough. Toddler coughing at night may get worse with a cold or flu, and warm rooms may also worsen the symptoms. However, a dry cough may also be an early sign of an infection of the lower respiratory tract, like bronchitis (inflammation of the small airways in the lungs) or pneumonia (inflammation of the lung tissue itself). Other toddler dry cough causes include asthma, which first appears as dry coughing at night, and exposure to cigarette smoke or other similar irritants.

Croup Cough: Croup is a disease that causes a harsh, dry, barking cough that can sound similar to a seal. Croup in toddlers results in a swollen upper trachea or windpipe, and it’s usually caused by a viral infection. A child with croup may make a high-pitched sound, known as stridor, when breathing in.

Toddler Wet Cough: If your toddler has a wet cough, it’s likely caused by fluid secretions and mucus found in the lower respiratory tract (windpipe and lungs). Common causes of wet cough include infections and asthma.

Whooping Cough (Pertussis): Whooping cough has symptoms similar to an ordinary cold, but the cough gradually becomes worse with severe fits of deep, fast coughing. It especially causes toddler cough at night. Frequent coughing fits are generally a series of 5 to 15 staccato coughs in rapid succession. After coughing, the child will breathe deeply, sometimes making a "whooping" sound. Whooping cough can lead to breathing problems and make the child can look blue because of temporary oxygen shortage.

Is Something Stuck in Her Throat?

Most coughs are caused by a respiratory infection. However, your toddler may also have something stuck in her throat or windpipe. Symptoms include rapid coughing followed by wheezing, throat-grabbing motions, turning pale or blue, making no sound, and appearing in obvious distress.

Perform the Heimlich maneuver in children older than 1 year immediately, and call 911 if you’re unable to dislodge the object or if you're dealing with a choking baby. For a partially lodged object (your child can still breathe fine), you can try wiggling it free with pats on the back, then visiting the doctor if that doesn’t work. Often an X-ray will show the cause, but sometimes a child will need a bronchoscopy, in which a tube is passed down the windpipe to look around and clean something out.

Peanuts, popcorn, and bits of hard foods like carrots are especially prone to being aspirated, which is why you should not give them to children under 4 years old. Aspiration can eventually lead to pneumonia, which would cause your child to develop a fever, be short of breath, and start to look and act sick.

Toddler Cough Complications: When to Worry

If your toddler develops any of the following symptoms, give your pediatrician a call, since these can be signs of potential complications related to coughs.

  • The cough is not better after three weeks, gets worse, or starts to sound wet.
  • She starts running a fever.
  • She has trouble breathing, breathes rapidly, or has asthma.
  • She seems lethargic.
  • She vomits or turns red during coughing fits.
  • She has had a fever of 100°F or higher for more than 72 hours.

How to Help Toddler Cough

Is your toddler coughing at night or throughout the day? Try the following treatment options.

Stay hydrated. Give her plenty to drink to prevent the mucus from thickening. Hot liquids or soups will ease soreness and irritation in the chest, and they can loosen mucus as well.

Take advantage of humidity. Let your child inhale humidified air (air that has moisture in it). Water vapor can ease and reduce your child's coughing. This can be done in several ways:

  • Use a cool-mist humidifier in your child's bedroom.
  • Run a warm shower in the bathroom with the door shut. When the room is filled with steam, sit in the bathroom with your child on your lap for approximately 10 minutes. Read or sing to him so that he will be relaxed.
  • Hang a damp towel in your child's bedroom.

Let in cool air. For a toddler dry cough or a croup cough, let him inhale cool air. Breathing this in will reduce the swelling in the respiratory tract, which will then suppress the coughing. You can do this in several ways:

  • Open the window so that your child can inhale cool, humid air. This could especially help toddler cough at night.
  • Take the child outside for a drive with the car windows open.
  • Let the child inhale the vapor from an open refrigerator or freezer.

Avoid physical activity. A toddler with a distinct dry cough should avoid exercise. Older children often notice their cough gets worse during physical activity.

Avoid over-the-counter cough medicines. The American Academy of Pediatrics (AAP) advises against over-the-counter cough medicine and cough syrup for toddlers younger than 4, since they might cause serious side effects. The AAP also says cough medicines aren't very effective for those under age 6. Instead, toddlers will benefit from all-natural approaches, such as honey (if the child is older than 1) or warm liquids.

Get vaccinated. Whooping cough can be prevented by the DTaP vaccine for children and the Tdap vaccine for adults who are often in contact with children.

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