Cough in Children: When to Worry & How to Help

Understanding when a cough needs care

Knowing when to treat a cough at home versus seeking medical attention helps you care for your child confidently. Our pediatric team provides clear guidance to help you recognize symptoms and respond appropriately, ensuring your child gets the right level of care at the right time.

Home Care
These symptoms usually improve with rest and simple care:

Cough following a typical cold (days 3–5 are often the worst)
Mild daytime cough that gets better
Cough that gets better with nasal clearing or humidifier use
"Tick" or "habit" cough that disappears at night or when distracted
Cough after waking due to post-nasal drip from allergies or virus

Call the Clinic
We want to check your child within the next 24–48 hours if:

Your baby is under 2 months of age
The cough doesn't improve or worsens after a week
The cough comes with other symptoms like chest pain, returning fever, or shortness of breath
Hard coughing causes them to throw up
Barky cough (could be croup)
They have low energy (lethargic, less playful, poor feeding/eating)
Nighttime cough keeping them awake for more than a night or two (can hint at asthma or another underlying issue)
A cough that starts dry but becomes wet with fever and low energy (possible pneumonia)
Fits of rapid coughing followed by gasping or vomiting after coughing (possible whooping cough)
Persistent cough after meals (could signal reflux)
Cough with wheezing or breathing that sounds "tight" (Common in RSV or asthma flare-ups)
Seasonal-pattern cough or strong family history of asthma/allergies
Late-appearing fever after days of cough

Seek Emergency Care
Call 911 or go to the ER for:

Trouble breathing
Signs of trouble breathing in infants: ribs pulling in, nostrils flaring, grunting, or see-saw breathing (belly going out while the chest goes in)
Babies struggling to feed because of cough
Severe chest pain that isn't just soreness from coughing
Shortness of breath at rest or with minimal activity

Important considerations:

Age

Infants under 2 months with any cough should be evaluated by their clinician. Children under 2 years are more susceptible to RSV and bronchiolitis. Keep a close watch for any trouble breathing (an emergency). Contact your clinician if you notice they have to work harder to breathe or are having difficulty feeding. As always, trust your parental instinct: If you're concerned, call us.

Asthma

Children with asthma often cough before they wheeze — a cough can be their early warning sign. Your Zarminali pediatrician can help develop an asthma action plan tailored to your child's needs. Their personalized asthma action plan may adjust what "mild" vs. "urgent" looks like when it comes to cough.

Vaccination Status

Before they're vaccinated, young infants are at the highest risk of whooping cough (pertussis) complications such as pneumonia and apnea (stopped breathing). Vaccination can protect them from severe sickness, symptoms, and complications. Vaccinating the whole household can further protect your baby. If your child is vaccinated against whooping cough, their symptoms may be milder, but they should still be seen.

Season

Walking pneumonia often circulates among older kids and teens in community outbreaks. Persistent, unusual cough in an adolescent deserves a visit, even if they don't have a fever or appear very sick.

At-home care that helps most children

Parents often ask, "How do I make the cough better?" These at-home remedies should help your little one feel better — whether they're coming home from a clinic visit or simply dealing with a routine cold.

Effective home remedies:

Honey (for kids over age 1)
Research shows honey works better than over-the-counter cough syrups. A spoonful coats the throat and calms the cough reflex. But don't give honey to babies under one year old.
Hydration, hydration, hydration
Fluids (water, warm soup, electrolyte drinks) loosen mucus and make coughs more productive, clearing the airways.
Humidifier
Just like warm fluids, moist air helps loosen secretions. It can also ease dry or harsh coughs.
Nasal care
Clearing congestion can reduce post-nasal drip coughs in the morning. If you're loosening mucus with hydration and a humidifier, pair this with nose-blowing or gentle suctioning (for infants), and saline.
Sleeping elevated (if age-appropriate)
Propping up older kids on an extra pillow can decrease nighttime coughing.
Pain and fever relief when appropriate
Tylenol or ibuprofen (depending on age) can make kids more comfortable and sometimes improve cough symptoms indirectly. Use the correct formulation and dosage for your child's age and weight.
Avoid over-the-counter cough medicines in young children
Studies show they don't work well in kids under 12 and may cause side effects.

Pediatricians listen like detectives to the tone of your child's cough. How it sounds tells them what the cause could be, helping us provide the most accurate diagnosis and treatment for your little one.

What the cough sounds like matters:

Barky cough: If your child sounds like a barking seal or puppy, it might be croup. Croup may also come with stridor — a high-pitched whistling sound when your child inhales.
Wet cough: The wetness is usually mucus-related, which can happen with any congestion cough.
Deep cough: Pneumonia can cause coughs to sound like they're coming from deep in the chest.
Dry, tight cough: Common in RSV or asthma flare-ups.
Cough with wheeze: Usually more airway inflammation or asthma.
Cough with a gasp or "whoop": Whooping cough has a unique sound, and the coughing sometimes leads to vomiting.