Clarifying Coughs: From Dry to Whooping, Your Guide to Coughs

When Shannon Duffy heard her three-year-old’s cough, worry gripped her. She knew the dry wheeze of her 14-year-old’s asthma and the rattle of her six-year-old’s allergies. And now, she knew her youngest child’s hacking could be a sign of whooping cough, a bacterial infection that was spreading in her community and that can be fatal to toddlers.

“I stayed up all night with little Amelia, then rushed to get her treatment,” says Shannon, 44, of Sleepy Eye, Minnesota. “The doctor assured me it was just a mild virus, but I’m glad I was proactive and kept my child out of harm’s way.”

How can you tell when a rattle or wheeze means disease? “Without a doctor’s input, there’s no easy answer,” says David Rosen, MD, of Discovery Pediatrics in Valencia, California. “No two kids’ coughs are the same, and even ones that sound harmless could signal something serious.”

Coughing is the body’s way of expelling an irritant from the airways. And unless you’re certain your child’s cough is just mild and just caused by a passing cold or virus, you need to watch for these signs and symptoms, which merit a call to the doctor:

Cough with Sudden Onset; Sharp Pain; Blood; Non-Stop Vomiting; Sustained, Rapid, Labored Breathing; or Blue Lips/Face

These could signal anything from a choking episode to a collapsed lung to a grave bout of asthma or pneumonia. “Call 911 and head to the emergency room immediately,” urges Rosen.

Barky Cough or Croup
Usually triggered by inflammation of the upper airways and often linked to a virus or allergies, a barky cough (called croup) can also signal windpipe blockages. “With a chicken bone or other obstruction, a high-pitched ‘strider at rest’ gasp often comes with the inhalation,” says Horowitz.

Cough with Fever
Babies under three months with any fever—and older children with ones above 100.4° Fahrenheit—may have bacterial or viral infections that are triggering coughs.

Dry Wheezing

This could indicate a cold or flu in the upper airways—or an obstruction, pneumonia, or bronchiolitis (inflammation of small respiratory vessels) in the upper airways. It’s also a common sign of asthma or allergies.

Wet Cough

Often caused by bronchitis, wet coughs can be problematic in younger children, who tend to swallow mucus instead of spitting it out and thus may have vomiting or upset stomachs.

Whooping cough

Triggered by a bacterial infection against which children are routinely immunized,these back-to-back coughs are followed by a deep breath that makes a whooping sound.

Effective home remedies for childhood coughs include warm chamomile or peppermint tea; cool-mist humidifiers; and sitting in a steamed-up bathroom for 10 to 20 minutes. Follow medication directions carefully, and only give cough drops to kids over age three and cough medicine to those over age four.