Updated 06 June 2016

What your child's cough means

Download some of the most common coughs in this article.


Coughs are one of the most frequent symptoms of childhood illness, and although they can sound awful at times, they usually are not a symptom of anything dangerous.

Occasionally, though, coughs can be cause for a visit to your child's doctor. If you learn to recognise certain types of coughs, you will know how to handle them and when you should seek medical help.

The following audio clips have been reproduced with kind permission by Prof Eugene Weinberg, paediatric specialist at Red Cross Hospital, Cape Town.

Nighttime Cough
Lots of coughs get worse at night because the congestion in a child's nose and sinuses drains down the throat and causes irritation while the child lies in bed. This is only a problem if your child is unable to sleep.

Asthma can also trigger nighttime coughs because the airways tend to be more sensitive and become more irritable at night.

Listen to the nighttime cough of an asthmatic child.


Cough With Wheezing
When coughing is accompanied by a wheezing sound as your child exhales (breathes out), it is a sign that something may be partially blocking the lower airway. This might be caused by swelling from a respiratory infection (such as bronchiolitis or pneumonia), asthma, or an object stuck in her airway.

Listen to the wheeze of asthma in a child.


Although wheezing usually during exhalation, stridor (pronunced: stry-door) is noisy, harsh breathing (some doctors describe it as a coarse, musical sound) that's heard when a child inhales (breathes in).

Most often, it's caused by swelling of the upper airway, usually from viral croup. However, it's sometimes caused by a more serious infection called epiglottitis or a foreign object stuck in the child's airway. If your child has stridor, call your child's doctor immediately.

Listen to stridor in a child with croup (notice the typical barking cough of croup as well).


"Barking" Cough
These coughs are usually caused by croup, an inflammation of the larynx (voice box) and trachea (windpipe) brought on by allergies, change in temperature at night, or most commonly a viral upper respiratory infection. When a young child's airway becomes inflamed, it swells up, making it harder to breathe. Children under 3 years of age have croup most often because their windpipes are narrow - some children have it practically every time they have a respiratory illness.

Croup can occur suddenly in the middle of the night, which can be frightening for both you and your child. Although most cases can be managed at home, if you suspect your child has croup, call your child's doctor to determine whether your child needs to visit him or her.


"Whooping" Cough
The "whooping" sound actually occurs after the cough, when the child tries to take in a deep breath.

If your child makes a "whooping" noise (which actually sounds like "hoop") after severe bouts of rapid coughing, it is most likely a symptom of pertussis (whooping cough) - particularly if your child has not received her diphtheria/tetanus/pertussis (DTP) vaccinations. The whooping cough spell is often followed by vomiting.

Infants with pertussis usually do not "whoop" after the prolonged episodes of coughing, but they may not get enough oxygen or they may even stop breathing with this disease. In infants and very young children, pertussis can be deadly, so call your child's doctor right away.

Listen to the typical whooping cough sound.


Sudden Cough
When a child suddenly starts coughing, it may mean she has swallowed some food or liquid "the wrong way" (into the airway) or something (a bit of food, vomit, or perhaps even a small toy or coin) is caught in her throat or airway. Coughing helps clear the airway and may even continue for a minute or so simply because the throat or airway is irritated. But if the coughing does not seem to improve or your child has trouble breathing, call your child's doctor. Do not try to clear the throat with your finger because you might push the obstruction even farther down the windpipe.


Daytime Cough
Allergies, asthma, colds, and other respiratory infections are the usual culprits. Cold air or activity can make these coughs worse, and they often subside at night or when the child is resting. You should make sure that nothing in your house, like air freshener, pets, or smoke, is making your child cough.


Cough With a Cold
Because most colds are accompanied by a cough, it's perfectly normal for your child to develop either a wet or dry cough when she has a cold. The cough usually lasts about a week, often after all other symptoms of the cold have disappeared.


Cough With a Fever
If your child has a cough, mild fever, and runny nose, chances are she has a simple cold. But coughs with a fever of 102 degrees Fahrenheit (39 degrees Celsius) or higher can mean pneumonia, particularly if your child is listless and breathing fast. In this case, call your child's doctor immediately.


Cough With Vomiting
Children often cough so much that it triggers their gag reflex, making them throw up. Usually, this is not cause for alarm unless the vomiting persists. Also, if your child has a cough with a cold or an asthma flare-up, she may throw up if lots of mucus drains into her stomach and causes nausea.


Persistent Cough
Coughs caused by colds can last weeks, even up to 3 weeks, especially if your child has one cold right after another. Asthma, allergies, or a chronic infection in the sinuses or breathing passages might also be responsible for long-term coughs. If your child's cough lasts for more than a month, you should visit your child's doctor.


Coughs in Young Infants
Coughing can wear out babies younger than 6 months, so keep a close eye on any cough your infant develops. These infants are also the population that is most at risk for complications from respiratory syncytial virus (RSV), which is most common in the winter. RSV causes colds and ear infections in older children and adults, but in young babies, it can cause bronchiolitis and pneumonia and lead to severe respiratory problems.

The disease starts out like a normal cold but becomes worse until the child has wheezing, a cough, and difficulty breathing. Some children may have to be admitted to the hospital to receive oxygen and fluids.

(Picture: Boy coughing from Shutterstock)


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Cough Expert

Professor Keertan Dheda has received several prestigious awards including the 2014 Oppenheimer Award, and has published over 160 peer-reviewed papers and holds 3 patents related to new TB diagnostic or infection control technologies. He serves on the editorial board of the journals PLoS One, the International Journal of Tuberculosis and Lung Disease, American Journal of Respiratory and Critical Medicine, Lancet Respiratory Diseases and Nature Scientific Reports, amongst others. Read his full biography at the University of Cape Town Lung Institute.

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