When to See a Doctor for a Cough

When a Cough Is More Than a Cold

When you're wondering if it's time to call your child's doctor about a cough, his age and the sound of the cough matter.

For most kids, coughs caused by colds, sinus infections and other common illnesses are a normal part of childhood. For some, though, coughs can signal an underlying condition such as asthma or allergies—or both. Your child’s physician is always the best resource for medical care and advice, but some coughs have telltale symptoms that indicate that it’s probably time to call your doctor.

Follow Your Instincts

Always trust your gut when it tells you to reach out to your pediatrician or another health care professional regarding your child’s cough. You know your child better than anyone, and it’s best to listen to your parenting gene when it’s sounding an alarm. Even if he simply has a cold, the worst that can happen is that your doctor tells you how to soothe the symptoms so both you and your child can sleep easier.

Age Matters

It’s very unusual for infants to cough, so call your doctor right away if your baby is younger than 4 months old and develops a cough. Even common cold viruses cause mucus buildup that can quickly block tiny nasal passages and airways, making it difficult for your baby to breathe.

The respiratory syncytial virus (RSV), for example, is a highly contagious virus that causes moderate cold-like symptoms in older children and adults, but in infants and children less than a year old, it’s a dangerous viral infection.

Once your child is older than age 1, coughs are less alarming and most often caused by a cold. No matter their age, though, call your doctor if your child has difficulty breathing, seems to worsen rather than improve after a few days, or coughs persistently throughout the day and night.

Identifying Coughs by Sound

A cough’s characteristics often help determine the underlying cause and whether it’s time to call the doctor. For instance, a barky cough that develops suddenly that’s accompanied by harsh breathing (stridor) as your child inhales may be croup, which causes swelling of the voice box and windpipe. Croup is most common in children under age 5 and may cause difficulty breathing.

If your child wheezes or you hear a whistling sound when she breathes out or exhales, it could mean the lower airways in her lungs are swollen. This can occur with asthma or viral bronchiolitis that’s often caused by RSV. A wet or a phlegmy cough may indicate pneumonia. Any of these conditions can cause respiratory distress that can quickly become life-threatening.

You should always feel comfortable contacting your child’s doctor about a cough, but consider it urgent if your child has a cough and:

  • Difficulty breathing or is breathing faster or more shallowly than normal
  • A high fever
  • Is younger than 4 months
  • Has stridor, wheezing or noisy breathing
  • Significant irritability
  • Signs of dehydration, such as a dry or sticky mouth, dizziness, drowsiness or lethargy, sunken eyes
  • Prolonged cough followed by a “whooping” sound
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