Croup occurs when the airway just below the vocal cords becomes inflamed, causing a dry, barky and brassy cough. What really gives this cough away is the stridor that often follows, a distinctive, high-pitched whistling when a child breathes in. The whistle is the result of air struggling to get where it needs to go. Croup is usually caused by respiratory viruses, such as the flu, common cold or respiratory syncytial virus (RSV).

When to see a doctor for a stridor cough

When you hear that stridor, it’s time to make an appointment. A same-day primary or urgent care visit should be fine — unless your child seems to be struggling to get air. If that’s the case, head straight to the emergency department. The treatment is usually a steroid, which reduces swelling. The sooner they get it, the less they’ll need and the better they’ll feel. 

Wheezing coupled with a dry cough is the telltale sign of asthma. “People use the word wheezing for a lot of different sounds,” Dr. Brown says, “but in asthma, it’s a whistling coming from inside the chest, more often when breathing out than breathing in, but sometimes both.”

Unlike a typical viral cough, which gets worse at bedtime but clears up after a while, the asthma cough can really get going in the middle of the night and doesn’t go away. “It’s not just a few coughs here and there,” Dr. Brown says. “It’s 20 to 30 minutes of sustained coughing.” 

When to see a doctor for a wheezing cough 

The wheeze is your call to action. If your child has an asthma diagnosis, you might already have an asthma action plan. (If you don’t, ask your doctor.) If not, get them checked out by their primary care provider. And as always, if your child seems to be struggling to breathe, seek emergency care right away. 

When you think of choking, you might think of a child with a blocked windpipe, who's unable to breathe. But sometimes it’s more subtle. If a child has a choking episode and then a dry cough that hangs around afterward, they might have part of the swallowed object (or another object altogether) still lodged in their lungs. A cough that hangs around with no runny nose or other cold symptoms can be a telltale sign.

When to see a doctor for a cough after choking 

If a child has something in their lungs, it needs to come out. A medical provider can listen with a stethoscope for changes in the sound of the breath in different parts of the lungs, which can point to a foreign object. Specialists can confirm it by looking for areas of air trapping with an X-ray. If there is something in there, a pediatric surgical team can generally remove it under anesthesia with a bronchoscope.  

During winter, a wet cough is usually the result of a virus, although ongoing exposure to cigarette smoke or other irritants also can cause a wet cough. Wet coughs can sound bad — so forceful at times they can trigger the gag reflex and cause vomiting. Surprisingly, according to Dr. Brown, that’s not necessarily a big deal in and of itself. “Unless it doesn’t stop,” he says. “Then you may be looking at gastrointestinal illness as well.”

When to see a doctor for a wet cough 

A wet cough with a high fever (higher than 102 degrees Fahrenheit) points to a more serious infection that needs medical attention. Look for increased breathing rate, too, as that can be a sign of airway trouble. It’ll be more apparent when the child is asleep, as that’s normally not a time they’d be breathing fast. If they don’t seem to be struggling, it’s OK to wait until the next morning to take them in. 

When a highly contagious virus is going around, such as COVID-19, many parents’ ears perk up with the slightest sound of a hack, and for good reason: The most common cause of a new cough in a child is a viral infection.  

While there are many different viruses that can cause your child to cough, SARS-CoV-2, the virus that causes COVID-19, is one of them. Remember, getting your child the COVID-19 vaccine is an important step in protecting them from the virus and potential complications.

When viruses are circulating in your community, it’s a good idea to check in with your pediatrician at the first sign of a cough or other symptoms of COVID-19 in kids. The doctor can ask about your child’s symptoms and direct you to the appropriate test (or tests), so you know what you're dealing with and what actions to take next.

Learn about the differences between COVID-19, the flu, RSV and other respiratory viruses from a pediatric infectious disease specialist. 

Over the counter (OTC) cough and cold medicines can cause serious side effects in young children. Therefore, in October 2008, the U.S. Food and Drug Administration recommended that OTC cough and cold medicines never be used in children under 4 years of age.

“There’s not much evidence they help in anyone,” Dr. Brown says, “and they can cause adverse reactions in young children.”  

From ages 4 to 6, OTC medicines should be used only if recommended by your child's doctor. After age 6, the medicines are safe to use, but follow the dosage instructions on the package. If you have questions, ask your child’s doctor. 

Fortunately, you can treat coughs and colds in young children with home remedies that are safe, inexpensive and beneficial. Try one of these simple but effective home remedies to treat your child’s symptoms:  

• For children 3 months to 1 year of age, hydration is the best home remedy for a cough. Continue to offer your baby breast milk or formula. If your baby is having trouble feeding due to a cough or congestion, try offering smaller amounts more frequently or using a syringe or spoon. Contact your child’s provider if you’re concerned that your baby is dehydrated. They might recommend offering small amounts of water or an oral rehydration solution, such as Pedialyte. Avoid honey for babies under one year, as it can cause infantile botulism. If a baby is younger than 3 months, see your child's doctor.  
• Children 1 year and older can take 1/2 to 1 teaspoon of honey as needed. Offer it on its own or stir it into warm water to soothe a sore throat, thin mucus and calm a cough. Research has shown honey is better than drugstore cough syrups at reducing the frequency and severity of nighttime coughing.  
• Kids 6 years and older can use cough drops to coat an irritated throat and reduce a cough. They can also use hard candy if cough drops aren't available. 

Using a humidifier at night is another way to alleviate irritation in the airways. However, make sure you know what kind of humidifier you have and how to use it safely. Without proper cleaning, mold and bacteria can build up in the humidifier and worsen respiratory symptoms.  

If you do use a humidifier, Dr. Brown recommends cleaning it once a week by filling the tank with enough distilled white vinegar to cover any parts in contact with water. Let that sit for 20 minutes. Then use a toothbrush to scrub the cracks and corners, rinse it well and let it air dry.