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Here’s what your baby’s cough could mean


Every child will experience coughing at some point in his or her life.  As a parent, watching your child cough can make you feel helpless knowing the cough be from many different ailments, ranging from innocent to dangerous, including upper respiratory infections, asthma, pneumonia, gastroesophageal reflux, choking and many others. If a cough is present in your child, it may be hard to know whether you should call your child’s pediatrician for advice, schedule an appointment or head straight to an emergency center for immediate care. It’s important to remember that coughs are a natural part of life, signaling the body’s way of protecting itself. Coughing keeps the airways clear and rids our body of mucous. In children, a cough should rarely be suppressed.

I recently chatted with regarding this topic, prompting me to share some additional information with parents and caregivers below.

What does a wet cough indicate?

If your child has a wet cough, it might be from a respiratory illness causing the airways to produce phlegm or mucous. This respiratory illness can be caused by a virus or bacteria, which can usually be identified by your pediatrician.  

What does a phlegmy cough indicate?

If your child has a cough with lots of phlegm, it could signal many things, too. Children with asthma often produce a phlegmy cough when their asthma is flaring up. A phlegmy cough can sometimes be due to post-nasal drip or drainage when children have runny noses. In younger infants, a phlegmy cough could be due to bronchiolitis, a lower tract respiratory infection brought on by viruses like respiratory syncytial virus (RSV).  In severe cases, a phlegmy cough with a high fever might signal a more serious infection, like pneumonia. However, the most common cause of a phlegmy cough is the common cold, which can last up to two weeks. Children get an average of 10 colds per year, which means they can be coughing 5 months out of each year!

What does a dry/hoarse cough indicate?

In young children and babies, a dry or hoarse cough could signal croup. In simple terms, croup is when a portion of a child’s upper airway becomes swollen. Croup is typically triggered by a virus as well. This cough often sounds “bark-like” and may be associated with noisy breathing. Croup can most times be managed from home with warm humidified air, a steamy shower and other supportive measures. Sometimes croup requires medical care and rarely, a severe case might require hospitalization.

What can a cough indicate when paired with chest retractions?

If your baby has suffered from a cold for a few days and now has a cough with a raspy, whistling sound, wheezing or “chest congestion,” this could be bronchiolitis, which is typically also caused by viruses. This inflammatory reaction affects young children and infants in the winter months and can be diagnosed by your pediatrician through a physical exam. Most babies can be treated at home without medication, but severe cases might also require hospitalization. Antibiotics are not effective in treating bronchiolitis.

When should I start (or stop) worrying about my baby’s cough?

Coughing is a natural part of life and our body’s way of reacting to illness. Most coughs are innocent. When coughs are associated with other symptoms, such as high fevers or difficulty breathing, consider seeking medical care. Due to safety concerns, cough medications and suppressants are no longer recommended for young children. This also allows the child’s body to naturally clear itself of mucous, avoiding suppression of natural urges. Simple solutions for coughing include proper hydration, nasal aspirators with saline mist and cool mist humidifiers. For children over 1 year old, honey is a wonderful cough treatment alternative.

If you have any questions about your child’s symptoms, we recommend downloading the free Texas Children’s Pediatrics app, which has an easy-to-use symptoms checker and advice-giving capabilities, right on your smart phone.