Your daughter seems to be coming down with the "bug" that is going around, so you put her to bed half an hour early. After some grumbling, she finally falls asleep, and you tackle the dishes, catch up on a little reading, then head off to bed yourself. But at 3:30 AM, you wake up to a burst of loud coughing. What should you do?

Coughs are one of the most frequent symptoms of childhood illness, and although they can sound awful at times, they usually are not a symptom of anything dangerous. Actually, coughing is a healthy reflex that helps clear the airways in the throat and chest. Occasionally, though, coughs can be cause for a visit to your child's doctor. If you learn to recognize certain types of coughs, you will know how to handle them and when you should seek medical help.

Types of Coughs and What They Mean

• "Barking" Cough
  These coughs are usually caused by croup, an inflammation of the larynx (voice box) and trachea (windpipe) brought on by allergies, change in temperature at night, or most commonly a viral upper respiratory infection. When a young child's airway becomes inflamed, it may swell around the vocal cords, making it harder to breathe. Children younger than 3 years of age have croup most often because their windpipes are narrow - some children have it practically every time they have a respiratory illness.
  
  Croup can occur suddenly in the middle of the night, which can be frightening for both you and your child. Although most cases can be managed at home, if you suspect your child has croup, call your child's doctor to determine whether your child needs to visit him or her.

• "Whooping" Cough
  The "whooping" sound actually occurs after the cough, when the child tries to take in a deep breath after a round of several coughs in a row.
  
  If your child makes a "whooping" noise (which actually sounds like "hoop") after severe bouts of rapid coughing, it is most likely a symptom of pertussis (whooping cough) - particularly if your child has not received her diphtheria/tetanus/pertussis (DTaP) vaccinations.
  
  Infants with pertussis usually do not "whoop" after the prolonged episodes of coughing, but they may not get enough oxygen or they may even stop breathing with this disease. In infants and very young children, pertussis can be deadly, so call your child's doctor right away.

• Cough With Wheezing
  When coughing is accompanied by a wheezing sound as your child exhales (breathes out), it is a sign that something may be partially blocking the lower airway. This might be caused by swelling from a respiratory infection (such as bronchiolitis or pneumonia), asthma, or an object stuck in her airway. Call your child's doctor unless your child has this problem often and you have medicine, such as an inhaler or nebulizer, with instructions on how to use the medicine for home treatment of your child's asthma. If the cough and wheezing do not improve with medication, call your child's doctor.