Children — especially those under five — often get multiple colds, accompanied by a cough, each year. But sometimes, a cough can be a sign of an underlying medical condition (like asthma or allergies) or of a serious illness that urgently needs treatment.
Here are nine common causes of coughs in children — and what you should do about them. Seek medical help immediately if your child has problems breathing or is turning bluish. You should also seek medical help if you have an infant (three months or younger) who has a fever of 100.4°F or more — or a child of any age with a fever of 104 oF or more.
Croup
Croup is often caused by an infection that swells the voice box and windpipe, making breathing difficult and noisy. Common symptoms include a bark-like cough, hoarse voice, and stridor—a squeaking or whistling sound when breathing in.
Croup is most common in children between the ages of three months and five years. As children age, their windpipes grow, so the swelling doesn’t affect their breathing as much. Croup can happen at any time of year, but it’s more common in fall and winter.
How to treat: Try to keep your child calm. Crying can worsen symptoms. Sometimes, a child may develop a fever due to croup. Treat the fever with ibuprofen or acetaminophen if they are six months or older. Encourage fluids to prevent dehydration. A warm bath in a steamy bathroom may help.
Get medical help right away if:
Your child makes a whistling sound that gets louder with eachcbreath.
Your child has stridor when resting.
Your child can’t speak or make verbal sounds because they can’t breathe well.
Your child struggles to breathe or catch their breath.
Your child has bluish lips or fingertips.
Your child drools or has trouble swallowing saliva.
These can mean your child has dangerous swelling of their airway.
Pertussis
Also called whooping cough, pertussis is a highly contagious and serious respiratory illness. It affects the mucous membrane and causes coughing fits marked by a distinct whooping sound at the end. The cough episodes are often violent and may also cause vomiting.
Pertussis most often occurs in infants and younger children and can be fatal in young children, especially babies who have not received all their vaccinations.
How to protect young children: Pertussis is a bacterial infection that spreads through coughs and sneezes. Two vaccines — DTaP and Tdap — can prevent pertussis. DTaP, which stands for diphtheria, tetanus, and acellular pertussis, is part of important childhood immunizations to keep children healthy.
How to treat: Antibiotics are the treatment for whopping cough. Do not take over-the-counter cough medicines unless your doctor recommends them. Use a cool humidifier mist to help loosen mucus and soothe the cough.
When to call your doctor: If you suspect whooping cough, see your child’s doctor. Antibiotics work best when they are started early in the infection.
RSV
Respiratory syncytial virus (RSV) is similar to the common cold but can be quite severe — or even fatal — for infants. That’s because it can lead to pneumonia or bronchiolitis (see below). This can make breathing extremely hard for a young baby since their airways are already small.
How to protect young children: Between September and January, women between 32 and 36 weeks pregnant should get the RSV vaccine. Antibodies that the mother’s body makes from the vaccine will be transmitted to the baby, giving them some protection about six months after birth and providing coverage during RSV season.
Infants whose mothers did not receive the RSV vaccine during pregnancy can receive the antibody nirsevimab between October and March. Protection lasts around five months.
Get medical help right away if:
Your child is struggling to breathe in any way.
You notice any bluish tint to their lips or fingers.
You see their chest sinking below or in between the ribs with each exhale.
You suspect your child may have RSV.
COVID-19
Cough and fever are common symptoms of COVID-19 in children. Other symptoms of COVID-19 in children include congestion, runny nose, headache, and fatigue. This makes it hard to tell if your child has COVID-19 or another respiratory infection. You can administer an at-home test if you suspect your child may have COVID-19.
How to protect kids from COVID-19: The best way to prevent complications is to have your child get the COVID-19 vaccine. Children as young as six months old can receive a vaccine against the virus that causes COVID-19.
When to call a doctor: Most cases of COVID-19 in children can be treated at home with rest, hydration, and a humidifier to ease congestion (if present). If your child has a fever, ask your healthcare provider about giving fever-reducing medications. If your child is at high risk of complications from COVID-19, ask your doctor if they recommend an antiviral medication. (Conditions that put a child at higher risk of complications include chronic lung diseases, heart disease, neurological disorders, and being born prematurely). If your child develops any difficulty breathing, call a doctor immediately.
Bronchiolitis
Bronchiolitis is a common lung infection in young children, especially in children under age two. It’s caused by a virus, most often RSV. With bronchiolitis, mucus builds up in the bronchioles — tiny airways in the lower respiratory tract that lead to the lungs.
Bronchiolitis makes it hard to breathe and causes wheezing. It can also lead to dehydration. Children who stay well-hydrated usually get better within 14 to 21 days.
How to treat: Children with mild to moderate symptoms can get care at home. Use age-appropriate fever-reducing medication. Make sure they drink enough to stay hydrated. A cool mist humidifier may also help with breathing.
When to call a doctor:
If your child’s cough makes a bubbling, crackling, or rattling sound when they inhale.
If your child has trouble breathing.
If your infant stops feeding or is dehydrated.
Pneumonia
Pneumonia, a common illness in children younger than five years old, is a lung infection that causes inflammation of the alveoli or air sacs. Sometimes, the air sacs fill up with fluid or pus. You can develop pneumonia from a virus or bacteria. In children, viruses are often the cause. However, they can develop a secondary bacterial infection as the virus irritates the airways and weakens their immune system.
Symptoms can include worsening cough with phlegm, high fever, shortness of breath, fatigue, and loss of appetite. Children may have milder symptoms of pneumonia than adults.
How to treat: Most of the time, pneumonia clears up with rest and medication to control any fever. If a bacterial infection causes pneumonia, your child needs to take antibiotics to clear it up.
How to protect young children: The pneumococcal conjugate vaccine (PCV) protects children against the bacterial cause of pneumonia. It’s part of childhood immunizations your child needs by age six.
When to call a doctor:
Your child has a fever that goes away but returns after a few days.
Your child has a fever lasting more than a few days, even after antibiotic use.
Your child has trouble breathing.
Your child has increased fatigue and sleepiness.
There are signs of infections elsewhere in the body, such as red, swollen joints, neck stiffness, bone pain, vomiting, or other new symptoms or signs.
Cold
Colds often cause a wet, productive cough that sounds like it’s coming from the chest. Your child may have phlegm or mucus with the cough.
How to treat: Cough and cold medicines aren’t typically recommended for children. Instead, focus on making sure your child gets ample fluids and rest. A warm bath in a steamy bathroom may help loosen congestion. Running a dehumidifier in their room (if the air is dry) may also help.
When to call a doctor:
Your child’s cough lasts longer than four weeks. Your child may have an infection or a medical condition that’s causing the cough (rather than just a cold).
Your child’s cough starts sounding more like a bark.
Allergies
Your child may have seasonal allergies in response to triggers such as pollen or ragweed. Or they may be allergic to other allergens, such as dust mites or pet dander. Allergies can also cause coughs, runny noses, watery or itchy eyes, sneezing, and congestion, making it hard to tell if your child has a cold or allergies.
How to tell if it’s allergies or a cold: Kids under the age of two don’t usually have seasonal allergies. Allergies also do not typically cause fatigue, body aches, or a fever. Colds and cases of flu eventually get better, while seasonal allergies can go on as long as the allergen is present.
When to call a doctor:
Your child has allergy symptoms that last more than two weeks.
Your child’s allergies trigger an asthma attack. If your child has a severe asthma attack, get medical help right away.
Asthma
Asthma is the most common chronic (long-term) childhood disease. It’s an inflammatory disease that affects the lungs. Symptoms include wheezing, coughing, tightness in the chest, and trouble breathing. Exercise, allergies, and cold weather can trigger asthma symptoms.
How to treat asthma: If your child has asthma, they should take their asthma medicines as prescribed and follow their asthma action plan.
Get medical help right away if:
Your child has lots of breathing problems or is struggling to breathe.
Your child is short of breath at rest, can’t speak, or can only speak in single words.
Your child’s wheezing is loud.
Your child is drowsy or confused.
Good Neighbor Pharmacy, March 2025
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