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Cough in children and colds: home relief and signs of breathing trouble

Is this an emergency?

This is not an emergency service. Call 911 or go to the nearest emergency room if you have:

  • The chest pulls in with each breath, flaring nostrils or grunting
  • A high-pitched noise when breathing at rest (stridor)
  • Bluish lips or face
  • Drooling and unable to swallow
  • More than 60 breaths a minute
  • Asthma with shortness of breath that the inhaler does not relieve
  • Very listless or hard to wake

Help lines:

Warning signs: when to go to the ER

A cough in children usually comes from a viral cold and gets better on its own with fluids, rest, saline nose drops and, from age 1, a little honey. Over-the-counter cough and cold medicines are not recommended under age 4. Call 911 if your child is working hard to breathe, the chest pulls in with each breath, they are grunting or their lips look blue.

  • Common cold — runny nose, sneezing and cough; improves within a week
  • Flu (influenza) — high fever, body aches and tiredness
  • COVID-19 — fever, cough and sore throat
  • Bronchiolitis (RSV) — babies with cough, wheezing and fast breathing
  • Croup — hoarse, barking cough
  • Allergies — recurring cough with sneezing and itching

Common causes of cough in children

Young children catch many colds a year. Most coughs come from viral infections:

  • Common cold: runny nose, sneezing, cough, sore throat and sometimes a low fever. Symptoms usually peak in 2 to 3 days and improve within a week, although the cough can linger.
  • Flu and COVID-19: higher fever, body aches and tiredness. See flu and COVID-19.
  • Bronchiolitis: inflammation of the small airways, mostly in babies. RSV is the most common cause in children under 1.
  • Croup: a hoarse, barking cough, sometimes with a high-pitched noise when breathing in.
  • Allergies or asthma: a cough that keeps coming back, with sneezing or wheezing. See allergies.

Signs of breathing trouble: call 911

These signs mean your child needs help right away, at any age:

  • The skin pulls in between the ribs or below the neck with each breath (retractions).
  • The nostrils flare with each breath.
  • Grunting at the end of each breath.
  • A high-pitched noise when breathing at rest (stridor).
  • Bluish lips or face.
  • Drooling and unable to swallow.

Cough in children: warning signs by age

With your child calm or asleep, count how many times the chest rises in one full minute. More than 60 breaths a minute at any age is an emergency.

We do not see babies under 6 months by video. A baby under 3 months with a temperature of 100.4 °F (38 °C) or higher is an emergency: call 911 or go to the ER.

  • 6 to 12 months: get seen in person soon if your baby breathes more than 50 times a minute, is feeding much less than usual or has fewer wet diapers. A weak, high-pitched or nonstop cry means go to the ER.
  • 1 to 5 years: get seen in person soon if your child breathes more than 40 times a minute. A high-pitched noise when breathing at rest, drooling or being unable to swallow is an emergency.
  • 6 to 17 years: if your child has asthma and shortness of breath does not improve with the inhaler, it is an emergency. Chest pain or fainting during exercise also needs care right away.

Cough medicine for children: what not to give

Many adult medicines are not safe for children:

  • Under 4: over-the-counter cough and cold medicines are not recommended. From 4 to 6, only if a doctor recommends them. Under 2, never give products with a decongestant or antihistamine.
  • Honey: never under 12 months, because it can cause infant botulism. From age 1, a little honey can help ease a cough.
  • Aspirin: never give it to a child unless their doctor says so.
  • Cough drops: not under age 3, because of the choking risk.
  • Dose by weight: acetaminophen and ibuprofen for fever are dosed by your child's weight, using the device that comes with the medicine.
  • Do not combine products with the same ingredient. We do not prescribe codeine cough syrups or any other controlled substance.

Home relief for cough and cold

These steps are safe for most children:

  • Saline (salt water) nose drops and, for babies, a bulb syringe to clear mucus before feeds and sleep.
  • A cool-mist humidifier in the bedroom.
  • Plenty of fluids to help thin mucus.
  • Rest, and keep your child away from cigarette smoke.
  • Frequent handwashing so the rest of the family does not catch it.

Does my child's cough need an antibiotic?

Almost never. Colds, flu and most chest colds are viral, and antibiotics do not work on viruses, even when mucus is thick, yellow or green. Unneeded antibiotics can cause side effects and resistance. Read antibiotics by telehealth.

When can a video visit help with your child's cough?

An online doctor visit can help if your child is 6 months or older, is breathing comfortably, and you want to know whether the cough is normal, how to ease it or what dose to give for their weight. It can also help if the cough has lasted more than 10 to 14 days. The doctor will watch your child breathe on camera and assess whether an in-person visit is needed. If appropriate, the doctor can prescribe medication. We do not prescribe controlled substances.

The doctor is a general practice physician and is not a pediatrician. A parent with patria potestad or a legal guardian must be on camera for the whole visit. See the child doctor visit and how to prepare your child. If there is also a fever, read fever in children.

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Frequently asked questions

What can I give my child for a cough?
Fluids, saline nose drops, a cool-mist humidifier and, from age 1, a little honey. Over-the-counter cough medicines are not recommended under age 4, and never give honey to a baby under 12 months.
When is a child's cough dangerous?
When your child is working to breathe: the chest pulls in, the nostrils flare, they grunt, make a high-pitched noise when breathing or have bluish lips. Call 911 or go to the ER.
How long does a cold cough last in children?
A cold usually improves within a week, but the cough can hang on longer. If it lasts more than 10 to 14 days, or gets worse instead of better, get your child checked.

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