Barking cough in children

A bark usually comes from vibration or swelling around the upper airway. Colds are a frequent trigger, while bronchiolitis affects smaller airways in young children and asthma can cause cough with wheeze or chest tightness. Allergy, reflux, and inhaled irritants may also contribute. The sound can be louder at night or when the child is upset, so observe the child when calm as well as during a coughing spell.

Keep the child calm and upright, because crying can make noisy breathing more obvious. Offer small, frequent drinks and check that urination remains usual. Avoid smoke, fragrances, and steam that could burn the skin or airway. Do not give honey to a child under one year, and check every medicine with a pharmacist or clinician before use. A video of the cough can help if it stops before assessment.

Call emergency services for severe breathing difficulty, blue or grey lips, pauses in breathing, inability to swallow, drooling, collapse, or unusual sleepiness. Seek urgent clinical advice for noisy breathing at rest, ribs pulling in, poor drinking, repeated vomiting, or symptoms after choking. A child who is steadily worsening should be assessed even without fever.

Ask whether the noise is stridor or wheeze, whether the child needs an inhaler or another treatment, and which changes require emergency help. Mention the child's age, vaccination history, onset, exposures, and fluid intake.