You’ve been up all night and your toddler won’t stop coughing. Any upper respiratory issue in little ones can be rough to deal with. Coughing in toddlers can be caused by a short-term infection, or it may be a chronic health condition that needs further evaluation. Once the cause is found there are treatments that can help. This article explains some of the most common causes and what you can do about it, and when you should check with your child’s doctor.

What Causes Constant Coughing in Toddlers?

When your toddler won’t stop coughing, it could be a simple virus or bacterial infection, or something more serious. It is always important to have your doctor evaluate a cough, but here are some of the more common causes:

1. Respiratory Infection

Viral and bacterial respiratory infections can cause mild to moderate coughing in toddlers. When your child has a respiratory infection, you will notice symptoms like coughing, fever of 101℉ or higher, stuffy nose, and sometimes vomiting/diarrhea. Your child will seem more tired and sleepy than normal, and may not want to eat much.

2. Allergies

Allergies can cause mucus buildup in the back of the throat that drains. This will cause your child to cough. It is more prominent at night or early morning hours when pollens are highest. Other symptoms of allergies include sneezing, clear drainage, red/itchy/watery eyes, headaches, pressure in the face, and low-grade fevers (99.0 - 100.0℉). Sometimes a dry cough can also be related to allergies.

3. Whooping Cough

Whooping cough is a serious bacterial infection that is preventable by vaccination, but recently has re-emerged. The bacterium, Pertussis, causes very severe coughing in fits that lead to a “whooping” sound as the child takes a breath in. The coughing can be very persistent and last from weeks to months after the infection has cleared. The other symptoms of whooping cough include stuffy nose, fever, severe fatigue, vomiting, and apnea (no breathing).

4. Asthma

Asthma is a chronic lung condition caused by scarred or damaged airways in the lungs. It can also be caused by heart valve issues that leak fluid from the heart back into the lungs. Asthma attacks can come on suddenly with symptoms like shortness of breath, heaviness in the chest, wheezing, and a chronic cough. Many of the coughing attacks with asthma happen during the night or after your child lies down to go to sleep.

5. Airway Obstruction

If your toddler won’t stop coughing and the onset was sudden, one important thing to check is if they may have swallowed something. An airway obstruction that is only partial may allow some air in, but your child will forcefully cough to try and expel the object. Signs of choking include gagging with coughing, pushing the tongue forward, hands grasping the chest or throat, and vomiting.

6. Aspiration

Aspiration is common in small children when they are learning how to drink from a cup and eat solid foods. They make in too much food or liquid and inhale a tiny amount into the lungs. This will cause a period of severe coughing while they try to bring it back up. Once in a while, aspiration is very normal and usually children recover fine. In some cases, a large amount of fluid may be taken in and cause “aspiration pneumonia.” One cause of large amounts of water intake is when toddlers are near water or learning to swim. There are also some neurological causes of frequent aspiration. These things need to be addressed by your child’s doctor.

7. Cystic Fibrosis

Cystic fibrosis is a severe genetic lung disease that causes progressive lung damage. One sign is that children with this disease have a very large appetite, but do not seem to gain any weight. Signs that a chronic cough may be cystic fibrosis include chronic lung infections, diarrhea and stools that float, trouble breathing, need for supplemental oxygen, and lack of weight gain. Children with this condition also have unusually “salty” skin.

8. Acid Reflux

Acid reflux is when the muscle that keeps the esophagus closed off between the stomach and the airway is looser than normal and acid from the stomach can seep back up into the throat. The cough tends to be dry and nagging. You may notice it during feeding times, or long after food has digested and there is only acid in the stomach. Other symptoms include complaining of “tummy ache,” vomiting, refusal to eat, and complaining of “chest hurting.”

9. Attention Seeking

If all serious causes have been ruled out by your doctor, and your child is not sick, they may have just found a new way to get your attention. Keep an eye on this to see if the “coughing spells” happen at certain predictable times. You may look over and notice they stop coughing and smile at you.

What Can You Do to Help?

Warning: It is not recommended that cough medications be given to children under the age of two years old. It is also recommended that you check with your doctor before using anything for your child’s cough.

There are things you can do to bring your child relief. These include:

1. Prevention is number one. Keeping your child healthy by feeding them a healthy diet and practicing hand washing is the most effective way to prevent infections. Make sure your child gets plenty of fresh fruits and vegetables, and nutrient rich foods.
2. Isolation after illness begins. If your child or anyone is running a fever, keep them at home and isolated to their own room. Respiratory illness can spread like wildfire through homes and daycare settings.
3. Encourage fluids. A dry throat can cause excessive coughing. Make sure your child drinks plenty of fluids.
4. Give throat relief. There are some really helpful natural expectorants that can soothe the throat. If your child is over one-year, you can give honey mixed with warm water and lemon, have them suck on ice pops, or have them breathe in some eucalyptus scent.
5. Humidify the air. Dry air can be an issue. Try using a humidifier or placing a pan of boiling water in a safe area of the room. You can also sit with your child in a closed up bathroom with the shower on hot.

When to See a Doctor

If your toddler won’t stop coughing and is turning blue or grey, call 9-1-1 or get to your nearest emergency room. If a cough is a persistent cough for more than 2 to 3 days, you should make an appointment with your pediatrician as soon as possible.