Types of Toddler Coughs and How To Treat Them

If your toddler is coughing at night, it's understandable to be concerned. One of the most common reasons toddlers cough is irritation of the lining of their windpipe, which often comes with upper respiratory illnesses like the common cold.

It's especially common for toddlers to cough at night when they're sick because when they lie down, mucus from their nose drains into their throat and causes irritation. Coughing can sometimes be helpful as it can remove extra mucus and allow air to flow more easily through the windpipe into the lungs. But it can also be disruptive to sleep, painful, and downright miserable for everyone.

Here are the most common types of toddler coughs to know. Learn what causes a cough in toddlers and the best ways to treat a cough to get your little one feeling better.

Types of Toddler Coughs

There are four distinct types of coughs: dry, wet, croup, and whooping. It's important to know what type of cough your toddler has and what it might mean. The most common reasons for toddler coughs are respiratory infections, allergies, and asthma.

Coughing associated with a viral or bacterial infection often comes with other tell-tale symptoms like a sore throat, runny nose, and fever. Asthma-related coughs commonly come with some wheezing and are often worse at night. Coughing associated with environmental or seasonal allergies, on the other hand, will develop when your child is exposed to the substance they're allergic to such as pet dander or pollen.

If your child is getting over an illness, their cough will probably be the last symptom to improve. It's not uncommon for a dry, hacking cough to linger for as long as three weeks after a cold (although you should see some gradual improvement between 10 and 14 days) in toddlers and young children.

Dry cough

A dry cough sounds like a rough, hacking cough, and does not contain mucus. An infection of the upper respiratory tract such as a cold or influenza can cause a dry cough, which may be worse at night. Warm, dry rooms may also exacerbate the symptom. A dry cough is also one of the most common symptoms of COVID-19 (though a wet cough or even a croup-like cough is also possible with COVID-19).

A dry cough can also be an early sign of an infection of the lower respiratory tract like bronchitis, which is inflammation of the small airways in the lungs. Other causes of dry coughs in toddlers include asthma, which first appears as dry coughing at night and often worsens with exposure to cigarette smoke or other similar irritants.

A dry cough isn't always due to an illness. Sometimes, it's a response to things in their environment like dust, tobacco smoke, pollen, or pollutants. Exposure to environmental irritants can produce wheezing, coughing, and shortness of breath.

Wet cough

A wet cough includes phlegm or mucus that may be clear, yellow, or green. These coughs sound wet. This type of toddler cough is often worse at night and can disrupt sleep due to mucus drainage and the resulting throat irritation.

Some of the most common causes of wet cough are respiratory infections like:

• Colds and influenza: It's common for colds and the flu to initially cause a wet cough, but as the viruses run their course, a wet cough can turn into a lingering, persistent dry cough that can last several days or weeks.
• Sinus infection: A sinus infection, also called acute sinusitis, can also lead to a wet cough. When mucus builds up in the sinus cavity, it pushes mucus and phlegm into the throat and nasal passages, leading to a wet cough. This type of cough can last up to eight weeks.
• Pneumonia: Pneumonia is a lung infection that is characterized by a wet, mucusy cough. Additionally, pneumonia also causes crackling, bubbly, or rumbling sounds while breathing.
• Respiratory syncytial virus: Respiratory syncytial virus (RSV) is a common virus that can present as a mild cold in toddlers. But for kids under the of age 1, RSV can be serious and is the most common cause of pneumonia and bronchiolitis, which is when the small airways in the lungs become inflamed. An RSV cough sounds wheezy, wet, and forceful. It can also make breathing difficult.

In addition to respiratory infections, wet coughs can also be caused by asthma or allergies. Grass and tree pollen, mold and fungi spores, dust, and animal dander are all common allergens that can irritate the lining of the nose and trigger post-nasal drip that causes a chronic, wet cough.

Croup cough

Croup causes a harsh, dry cough that can sound similar to a seal's bark thanks to irritation and swelling in the upper trachea (windpipe) and larynx (voice box). It is common for a croup cough to be worse at night. Croup is usually caused by a viral infection. A child with croup may also make a high-pitched sound known as stridor when breathing in, which warrants a call to a health care provider.

Whooping cough (pertussis)

Whooping cough or pertussis has symptoms similar to the common cold, but the cough gradually becomes worse with severe fits of deep, fast coughing. This infection is known to cause toddlers to cough at night.

The frequent coughing fits associated with pertussis are generally a series of five to 15 coughs. They are commonly described as "staccato" coughs because of the nature of the coughing, which is rapid and repetitive with a breath between each cough.

After coughing, the child will breathe deeply, sometimes making a "whooping" sound. Whooping cough can lead to breathing problems and a change in the appearance of the child's skin (often resulting in a bluish, grayish, or purplish appearance, depending on skin tone, especially around the lips, gums, and nail beds) because of a temporary oxygen shortage.

Is Something Stuck in My Child's Throat That's Making Them Cough?

While most coughing in toddlers is caused by respiratory infections and other health conditions, the sudden onset of intense coughing may be caused by something irritating or getting stuck in their throat or windpipe.

If this type of cough occurs at night, it can sometimes indicate sleep apnea, asthma, or less commonly, choking on excess saliva. More commonly, however, a choking-type cough occurs during the day, when toddlers eat multiple food items at once or drink too quickly.

While some short-lived reflexive coughing and gagging can be normal and is not a medical emergency, it's important to be able to distinguish it from true choking, which is when the airway is blocked and the child is having trouble breathing.

If you suspect your toddler is choking, you should immediately administer choking first aid (in children older than 1 year, that means performing the Heimlich maneuver) and call 911. Keep in mind that blind sweeps in the mouth can be dangerous and aren't recommended.

For a partially lodged object (your child can still breathe fine), you can try wiggling it free with pats on the back. Consult with your child's doctor if that doesn't work. Often an X-ray will show the cause, but sometimes a child will need a bronchoscopy, in which a tube travels down the windpipe to look around and clear the airway.

When To Call a Health Care Provider About a Toddler Cough

While most nighttime and daytime toddler coughs resolve on their own, there are times when coughing signals a more serious problem or complications that require treatment.

If your toddler develops any of the following symptoms along with their cough, it's time to call a health care provider:

• Their cough is accompanied by wheezing, whistling, or stridor.
• Their cough is chronic and lasts more than three weeks.
• They vomit or turn red during coughing fits.
• They start running a fever that lasts more than three days.

If, on the other hand, your toddler is showing any of these symptoms, you should seek more immediate care:

• They have trouble breathing or are breathing rapidly.
• They show changes in skin color (bluish, grayish, or purplish), especially around the lips, gums, and nail beds.
• They seem lethargic or "out of it."
• They experience severe chest pain.
• They have a fever over 104 degrees Fahrenheit.

As always, trust your gut. If your child looks or acts very sick or you think your child needs to be seen, seek medical care right away.

How To Help Your Toddler's Cough Day or Night

Is your toddler coughing at night or throughout the day? Try the following treatment options.

Keep them hydrated

Give your toddler plenty of clear, ideally unsweetened, liquids to drink. You may also want to keep a cup of water by their bed in case they wake up coughing.

If they have a wet cough, staying hydrated can help prevent the mucus from thickening, which can make coughing worse. Warm liquids or broth-based soups can also ease soreness and irritation in the throat and chest, relax the airways, and loosen mucus. If you are still nursing, offer plenty of breastfeeding sessions to keep them hydrated and comforted.

Take advantage of humidity

Let your child inhale humidified air (air that has moisture in it). A humidifier in the bedroom can work wonders to help toddler coughing at night because dry air can make coughing worse. This can be done in several ways:

• Use a cool-mist humidifier in your child's bedroom.
• Run a warm shower in the bathroom with the door shut. When the room is filled with steam, sit in the bathroom with your child for about 10 minutes. Read or sing to them so that they will be relaxed.
• Hang a damp towel in your child's bedroom.

Let in cool air

For a dry cough or a croup cough, you can also try encouraging your toddler to inhale cool air. Cool air can reduce the swelling in the respiratory tract, which can help suppress the coughing. You can do this in several ways:

• If the weather is cool or cold, go outside or open the window so that your child can inhale the cool air.
• Take your child outside for a drive with the car windows open.
• Let your child inhale the cool air from an open refrigerator or freezer.

Limit physical activity

A toddler with a distinct dry cough should avoid heavy physical activity and exercise. Older children often notice their cough gets worse during physical activity. Encourage your toddler to rest and enjoy some downtime. Many toddlers can go about their day as normal with a cough but encourage periodic rest and restful activities like reading together, watching a movie, or coloring.

Avoid over-the-counter cough medicines

The American Academy of Pediatrics (AAP) advises against over-the-counter cough medicine and cough syrup for children younger than 4 years old since they can cause serious side effects. The AAP also says cough medicines aren't very effective for those under age 6 (and aren't approved for this group). Instead, toddlers will benefit from home remedies for relieving a cough, such as honey (if the child is older than 1) or warm liquids.

Get vaccinated

Vaccines are a safe and effective way to prevent many different infections and diseases. Getting vaccinated against illnesses known to cause severe coughing is one of the best ways to prevent cough. In addition to getting your toddler vaccinated if and when they are able, it's also important that parents, older siblings, and other family members be vaccinated to reduce the risk of passing an illness to your toddler.

Here are a few vaccines to discuss with a health care provider:

• Whooping cough: This highly contagious respiratory disease can be prevented by the DTaP vaccine for children and the Tdap or DTaP vaccine for adults who are often in contact with children.
• Influenza: The influenza vaccine, more commonly called the flu shot, is an annual vaccine that can prevent the spread of the flu.
• COVID-19: COVID-19 vaccines are widely available for adults, children, and infants over the age of 6 months. This vaccine may not prevent COVID-19 infection, but it will reduce the risk of developing severe illness that can lead to hospitalization or death.
• Pneumococcal: The pneumococcal vaccine can help prevent pneumonia, as well as meningitis and sepsis in kids under the age of 2 and older adults.