7 Types of Coughs Parents Should Watch for in Children

By Opeyemi Daramola, M.D. January 10, 2018

Coughs are generic symptoms of many different acute and chronic illnesses—most commonly the cold everyone seems to get one time or another during the winter months. But did you know there are seven different coughs you should be aware of (and be able to identify that are symptoms of specific childhood illnesses? A doctor describes those seven coughs, what commonly co-occurring symptoms to watch out for, and the basic treatment plan for each.

Now that we are fully into the winter months, we often expect to encounter someone at home or at work with some variety of cough. A cough is a generic symptom associated with multiple acute and chronic illnesses. Children of all ages may exhibit coughs, mostly from viral infections, hypersensitivity to environmental factors, or as a response to frequent transitions from the cold outdoors to heated indoor air and vice versa. Typically, ill children with a runny nose, cough, and sore throat tend to have the common cold, which they are happy to share with you; a majority of these cases are self-limited and resolve without intervention. However, here are some cough varieties that may raise your eyebrows and prompt medical attention.

The Barking Seal Cough

Sometimes children with colds may develop a sudden barking cough in the middle of the night after sleeping without issues for a few hours. The barking cough then returns for more nights and may be associated with a hoarse voice, a whistling sound while breathing (stridor), or skin between the ribs pulling in during breathing (retraction). This may be a sign of croup—an infection of the airway caused by viruses similar to those that cause the common cold. This can affect children up to age 5. Usually, most children get better with conservative therapy, including a cool mist humidifier, rest, and supportive care. However, any sign of croup warrants a phone call and/or visit to the doctor.

The Night Cough That Won’t Go Away

If your child has a dry cough in the winter that rears its head at night or when he runs around, it could be a sign of asthma. This cough may occur with shortness of breath. Many parents have the impression that wheezing must be noted as an absolute sign of asthma, but not all wheezes are asthma and not all asthmatics wheeze. This type of cough should prompt a visit to the pediatrician.

A Cough with Phlegm, Mucous, and Runny Nose

Do you find that your child has a yellow runny nose for weeks with a productive cough? Do they also have a foul mouth odor that you inhale as you kiss them goodnight? This is usually concerning for upper respiratory infections including sinusitis. Viral colds may worsen into a sinus infection requiring antibiotic treatment and nasal sprays. Of note, children with bacterial upper respiratory infections may also develop some temporary snoring from swelling in the nasal passages and at back of their throat.

A Cough Accompanied by a Sneeze

Dry, unproductive coughs lasting for weeks with a seasonal pattern is concerning for allergic hyper-responsiveness in many children. These patients may also have recurrent nosebleeds, chronic red eyes, “shiners” from rubbing the eyes, and bouts of sneezing. A simple nasal spray or temporary course of oral medication can help. Not all children need allergy testing: sometimes the parental history, a simple exam, and trial of medication are all that is needed for peace in the house.

The Coughing Cheerleader

Children with acid reflux, voice overuse, or vocal abuse may have scar tissue on the voice or a polyp. These types of coughs can occur at any time of the year in the absence of all other symptoms and can be confirmed with direct visualization of the voice box.

A Wet Cough

A whistling, rapidly breathing, irritable child with a wet productive cough over a few days may be suffering from bronchiolitis, which is an infection of the tiny spaces in the lungs. Children with pneumonia may share similar symptoms and do require medical attention.

The Whoop Cough

When a child (including adolescents!) has a chronic cough for several days that transitions into violent coughing fits, gasps for air, and vomiting, your child may have whooping cough. No longer considered a relic from the Great Depression, whooping cough is encountered now primarily because of lack of herd immunity based on vaccination choices. Occasionally, the immunity in adolescents and adults may also wear off and they may get infected. If you suspect whooping cough, discuss this with doctor immediately.

Overall, parents should be reassured that most coughs are self-limited and go away, but some of the ones listed above require more than just a hug and a warm blanket. Your pediatrician will help with most of these concerns but may need to involve pulmonary doctors and/or ear nose and throat specialists when a cough is more than just a cold.