• November 29, 2022
  • Dr. Ayodeji Otegbeye

There is nothing more concerning for a parent than when our children start getting sick, and that usually starts with some coughing.  But is it just a minor issue, or a sign of something worse to come?

Coughing is extremely common and can be a sign of various conditions. While it’s true that your children’s cough can be a worrying development, most of the time a cough alone is not a cause for concern, and usually isn’t anything too serious.

The trick is being able to distinguish your child’s various coughs from the harmless variations to ones that may indicate something more serious is happening.

In this blog, we will be exploring the different types of coughs, what they may mean, and when it might be time to call your doctor to address a more serious condition.

Common Coughs

The following are common coughs that are helpful to identify, and to understand what they indicate.  We explore each one and detail what conditions they may be associated with.

Dry Cough

It is a cough that does not produce any phlegm.

Many things can cause an acute dry cough, but it is most commonly due to viral respiratory tract infection which may include Influenza and COVID-19 in children and adolescents. Influenza and coronavirus testing are performed at Night-Lite Pediatrics Urgent Care and we can assist in the diagnosis of Influenza and coronavirus.

A dry cough does not contain much mucus, and your child may also suffer from a sore throat and/or runny nose.

Although most coughs of this type will clear relatively soon on their own, if symptoms do worsen or persist, or your child is at high risk due to pre-existing lung or heart conditions, then you should make an appointment with a medical professional or pediatric urgent care center, as it could be a sign of a more serious infection or a feature of an underlying undiagnosed condition such as asthma, allergies or acid reflux.

Wet (Congested) Cough

Unlike a dry cough, a wet cough is often accompanied by phlegm or mucus, that may be either white, green, or yellow in color. Wet cough is sometimes described as congested cough in children because of their inability to expectorate the phlegm. These wet coughs stem from the chest and can sound deeper than other coughs.

In the appropriate season, which is usually winter, wet cough is commonly the result of a viral infection. A wet cough with high fever more than 102°F may point to a more serious viral or bacterial infection and should be promptly evaluated with a medical professional. Night Lite Pediatrics Urgent Care providers will evaluate your child and perform a chest x-ray where necessary.

Wet or congested cough may also be difficult to clear (or) expectorate in infants and toddlers.

If a bacterial infection is left untreated, it could develop into a more serious chest infection. If you are noticing a wet cough in your toddler that isn’t going away, and if it is associated with other symptoms such as difficulty with feeding, vomiting, increased rate of breathing or wheezing, you should seek pediatric urgent care before it becomes more severe. Our pediatricians will be able to diagnose the issue in more detail and provide the recommended medications and treatment plan for a full recovery.

Recognizable Cough Sounds:

Croup Cough

Croup results in a dry, barking, harsh, croaky or seal-like cough. This cough is most often due to a viral upper respiratory infection and it is common in children under the age of three years because of inflammation just below the vocal cords which is the narrowest portion of a child’s upper airway. This makes it difficult to get air into the lungs when the child inspires (breathes in).

Usually, a croupy cough is accompanied with cold symptoms, such as a runny or stuffy nose. You may also notice that your child has trouble breathing, is taking rapid breaths, and could be making a distinct high pitch sound (stridor) when inhaling. If you spot these symptoms with the croup cough, call a pediatrician, or seek medical attention immediately. A same day primary or urgent care visit will usually suffice, and the treatment is usually with a steroid which reduces the swelling.

wet cough in toddler that won't go away - Night Lite Pediatrics

Our pediatricians can help determine the cause of your child’s respiratory distress.

Whooping Cough

It is a paroxysmal cough (with or without inspiratory whoop).

A whooping cough is typically a type of cough that many parents will have already heard about. Known medically as Pertussis, it gets its nickname from the whooping sound that is created when a child inhales following a coughing fit.

The signs that your child may have a whooping cough are:

  • Persistent coughing
  • Night-time coughs
  • Difficulty breathing
  • Whooping noise when your child inhales
  • Repeated episodes vomiting after paroxysms of cough.
  • Holding or cessation of breathing after a coughing spell.

The whooping cough is a serious bacterial infection and early antibiotic treatment may decrease the severity of the infection and in some cases may require a hospital stay. If you spot any of these signs especially in under-immunized children, contact a pediatrician right away or seek evaluation in a pediatric urgent care center (Night-Lite Pediatrics Urgent Care).

Wheezing Cough

People use the word wheezing for many different types of airway sounds but a wheezing cough is another type of cough that includes a distinct whistling sound which is heard when the child exhales (breathes out). This whistling is usually indicative that there is an issue in the lower airway of the lungs, either due to an inflammation or mucus build-up.

Commonly, a child’s cough of this type is due to either a viral infection called bronchiolitis in younger children or asthma. This type of cough should be diagnosed as soon as possible to prevent a more serious illness from developing; If it is due to an exacerbation of underlying persistent or seasonal asthma, institute your child’s asthma treatment plan if you have one, otherwise contact urgent pediatric care as soon as possible. At Night Lite Pediatrics Urgent Care, we have the ability to give repeated breathing treatments and additional medications that may relieve asthma and we also give advice on how to care for a child with bronchiolitis.

Staccato cough

It is characterized by an abrupt onset of cough with different levels of pitch or tone. It may be seen in newborns under the age of two months and it is typical for lung infection with chlamydia.

wet cough no other symptoms - Night Lite Pediatrics

Prescribed medicines can help alleviate sore throats and a runny nose.

How to help your children’s cough

Depending on the type of cough that your child has, there are several things that you can do to help alleviate your child’s suffering. Many mild coughs will go away on their own within 5-10 days.

Simple things at home can also help if your child has a cough, such as keeping them hydrated, having them breathe in hot steam, or consuming hot tea mixed with honey.

Also, ensure that they aren’t exposed to environments that might make their coughs worse; such as cold air (like a cool mist humidifier), too much activity, or exposure to tobacco smoke

A crossover trial comparing menthol and eucalyptus oil in school children revealed that menthol increased the perception of nasal patency but did not affect spirometry (pulmonary function test).

Another study that compared a vapor rub combination (camphor, menthol, and eucalyptus oils) with petrolatum and no treatment revealed reduced cough severity; improved child and caregiver sleep, and reduced a combined symptom score.

The use of cough medicine or cough drops is discouraged in children less than 6 years of age because of increased risk of side-effects but can be helpful to soothe their symptoms. Consultation with a pharmacist or medical professional is strongly recommended to ensure that you are administering them safely.

How to prepare for a doctor visit

What should I take note of before I call my doctor or request a virtual (telemedicine) visit about my child’s cough?

Important features to take note of are indicated below and it is advisable to have the answers handy rather than the parent of patient’s individual bias. By doing this, your physician will have the best shot at making a correct diagnosis.

A pediatrician or pediatric urgent care physician would need to know the following:

  • Any recent or underlying medical problem whether it’s chronic or seasonal.
  • When the cough started and how it has progressed?
  • The nature of the cough which could be dry, wet (congested, chesty), croupy (barking, seal-like), whooping.
  • Severity of the cough and whether it fluctuates or gets worse in a particular time of the day.
  • Any associated symptoms such as runny nose, sore throat, fever, vomiting, difficulty with feeding, weight loss, wheezing, change in child’s color during or without coughing spells, foul smell from the nose or breath, wheezing, shortness of breath, choking episode, chest pain, blood in the expectorated, secretions or cessation of breathing.
  • What makes the cough worse such as exercise, eating, lying down or anxiety.
  • The types of treatment that has been offered or implemented and other medications that the child-adolescent is on.
  • Presence or absence of similar symptoms in household members or schoolmates.
  • Presence of pets in the household or places where the patient has spent time.
  • Any travel in the last three months.

Your pediatrician, pediatric urgent care specialist physician would want to classify the cough into the different categories based on how long the cough has been present. It is helpful to be cognizant of this is the duration impacts the possible causes of the same quality of cough.

Coughs are usually classified as:

  • Acute: when the cough has lasted for less than two weeks.
  • Persistent: when the cough lasts for 2 to 4 weeks.
  • Chronic: when the cough lasts greater than four weeks.
  • Chronic coughs may get worse and are classified as acute on chronic

Disclaimer: This article is not intended to be used for diagnosis or treatment. It is aimed at presenting a perspective only and is not a substitute for a prescription. Anyone experiencing a medical condition should consult their doctor.

Dr. Ayodeji Otegbeye

About The Author

Dr. Ayodeji Otegbeye

Dr. Ayodeji Otegbeye, better known as “Dr. O” is the President and Founder of Central Florida Pediatrics Intensive Care Specialists and Night Lite Pediatrics Urgent Care. Dr. O was the Medical Director of Children’s Medical Services in the Central Florida Region (Orange, Seminole, Osceola and Brevard Counties) from 2004 – 2019; and the Medical Director of Leesburg Regional Hospital Pediatric Hospitalist Program.

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