Springdale Mason Pediatrics

Cough - Viral (Age 0-5)


  • Viral infection of the lower airway (the bronchi) that go to the lungs
  • This is the most common cause of a cough in children
  • Medical names are viral bronchitis, lower respiratory infection, LRI

Call or Return If

  • Trouble breathing occurs
  • Wheezing occurs
  • Cough lasts more than 3 weeks
  • You think your child needs to be seen
  • Your child becomes worse

About This Topic


  • A cough is the sound made when the cough reflex clears the lungs
  • A coughing fit or spell is over 5 minutes of nonstop coughing
  • Coughs can be dry (no mucus) or wet (with mucus). A runny nose and sore throat are other common symptoms. Fever may be present.

Phlegm or Sputum

  • The mucus or phlegm can be white, yellow or green.
  • Yellow or green phlegm is a normal part of the healing of viral bronchitis.
  • This means the lining of the trachea (windpipe) was damaged by the virus. It's part of the phlegm your child coughs up.
  • Antibiotics are not helpful for the yellow or green phlegm seen with colds.
  • The main treatment of a cough with phlegm is to drink lots of fluids. Also, if the air is dry, using a humidifier will help. Sipping warm clear fluids will also help coughing fits.


  • Most coughs are part of a cold (acute bronchitis). Bronchitis in children is always caused by a virus.
  • Many viruses can cause a cough. This includes cold viruses, influenza and croup viruses.
  • Bacteria do not cause bronchitis in healthy children.
  • Chronic bronchitis in adults is caused by smoking.

Trouble Breathing: How to Tell

  • Trouble breathing is a reason to see a doctor right away. Respiratory distress is the medical name for trouble breathing.
  • Here are symptoms to worry about:
  • Struggling for each breath or shortness of breath
  • Tight breathing so that your child can barely speak or cry
  • Ribs are pulling in with each breath (called retractions)
  • Breathing has become noisy (such as wheezes)

Prevention of Spread to Others

  • Cover the nose and mouth with a tissue when coughing or sneezing.
  • Wash hands often. After coughing or sneezing are important times.

After Care Advice

  • Coughs are a normal part of a cold.
  • Coughing up mucus is very important. It helps protect the lungs from pneumonia.
  • A cough can be a good thing. We don't want to fully turn off your child's ability to cough.
  • Here is some care advice that should help.
Homemade Cough Medicines:
  • Goal: Decrease the irritation or tickle in the throat that causes a dry cough.
  • AGE 3 months to 1 year: Give warm clear fluids to treat the cough. Examples are warm apple juice and lemonade. Amount: Use a dose of 1-3 teaspoons (5-15 ml). Give 4 times per day when coughing. Caution: Do not use honey until 1 year old.
  • AGE 1 year and older: Use HONEY ½ teaspoon (2 ml) as needed. It's the best homemade cough medicine. It can thin the secretions and loosen the cough. If you don't have any honey, you can use corn syrup.
Drug Store Cough Medicine (DM):
  • Don't give any non-prescription cough medicines to young children. They are not approved by the FDA under 6 years. Reasons: not safe and can cause serious side effects. Also, they are not helpful.
  • Honey has been shown to work better for coughs. (Caution: Do not use honey until 1 year old).
  • OTC cough syrups containing honey are also available. They are not more effective than plain honey and cost much more.
Coughing Fits or Spells:
  • Breathe warm mist (such as with shower running in a closed bathroom).
  • Give warm clear fluids to drink. Examples are apple juice and lemonade.
  • Reason: Both relax the airway and loosen up any phlegm.
  • For vomiting that occurs with hard coughing, give smaller amounts per feeding.
  • Reason: Vomiting from coughing is more common with a full stomach.
  • Try to get your child to drink lots of fluids.
  • Goal: Keep your child well hydrated.
  • It loosens up any phlegm in the lungs. Then it's easier to cough up.
  • If the air in your home is dry, use a humidifier. Reason: Dry air makes coughs worse.
  • For fevers above 102° F (39° C), give acetaminophen (such as Tylenol) or ibuprofen. See a Dose Table. Note: Lower fevers are important for fighting infections.
  • For ALL fevers: Keep your child well hydrated. Give lots of cold fluids.
Antibiotics Not Needed:
  • Antibiotics are not helpful for viral infections.
  • They can only kill bacteria.
Avoid Tobacco Smoke:
  • Tobacco smoke makes coughs much worse.
What to Expect:
  • Viral coughs usually last for 2 to 3 weeks.
  • Sometimes, your child will cough up lots of phlegm (mucus). The mucus can normally be gray, yellow or green.
Return to School:
  • Your child can go back to school after the fever is gone.
  • Your child should also feel well enough to join in normal activities.
  • For practical purposes, the spread of coughs and colds cannot be prevented.

Author: Barton Schmitt MD, FAAP
Copyright 2000-2021 Schmitt Pediatric Guidelines LLC
Disclaimer: This health information is for educational purposes only. You the reader assume full responsibility for how you choose to use it.
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