Key points to remember

• coughing is common in children, especially when they are pre-school age
• causes of cough include colds, asthma and chest infections. Second-hand cigarette smoke commonly causes children to cough even when they are well
• many children will continue coughing for three weeks or more following a simple cold
• a cough that lasts longer than four weeks is not normal and may be a sign of chest disease
• you need to see a doctor if your child has had a cough and a fever, is working hard at breathing, or the cough has lasted more than four weeks

How common is coughing?

When should I seek help?

It is important to take your child to the doctor if they have:

• a persistent daily cough for longer than four weeks, or
• a cough and another problem, such as:
  – working hard with their breathing, or
  – breathing fast, or
  – having a temperature higher than 38.5 degrees Celsius, or
  – not speaking normally or being unable to finish a whole sentence because of their coughing or breathing, or
  – wheezing or whistling in their chest, or
• a cough and you are worried that something is wrong

Different types of cough

• is less likely to produce phlegm (mucus) 
• can sound irritated, harsh, barking, or whooping

Common causes of different types of cough

Common causes of cough are:

• colds or upper respiratory tract infections. Young children usually have between 6 -12 upper respiratory tract infections per year
• asthma – an asthma-related cough is usually dry and occurs at night, with sport or in the early morning. An asthma cough is usually associated with other symptoms such as wheeze, allergy (eczema or hayfever), or a history of asthma and allergy in the family. If coughing is the only problem the child has, it is very unlikely to be due to asthma
• smoke exposure – second-hand cigarette smoke commonly causes children to cough even when they are well. Make sure your child's environment is smoke-free. Put smokefree stickers up to let everyone know your home and car are smokefree  
   
  If you want to give up smoking:
  – call the Quitline on 0800 778 778 for free
  – check out the website Quit / Me Mutu 
  – ask your health professional
• chest infections – a wet, chesty cough is likely to be an infection. If it lasts more than four weeks, there may be underlying chest problems and your child should see a doctor. Don’t just assume that a wet cough is a “post-nasal drip” or mucus running down the back of the throat from a sinus infection
• whooping cough (see whooping cough on this website)
• croup – may cause a harsh or barking cough (see croup on this website)

Some questions your doctor may ask you

Here are some questions that your doctor may ask you about your child's cough:

• what is the cough like?
  – is it a dry cough?
  – is it a wet cough?
  – is it a barking cough?
• does your child produce spit or phlegm?
  - children under five years do not spit up phlegm and may swallow it; small children and babies sometimes vomit it up
• when does your child cough?
  – at night?
  – early in the morning?
  – with feeding?
• does your child cough with exercise or sport?
• are there any other breathing symptoms?
  – wheeze?
  – whistling in the chest?
  – fast breathing?
  – shortness of breath?
  – sucking in of the chest?

What about treatments for cough?

• most coughs do not require treatment and get better by themselves within 3 - 4 weeks
• stop all exposure to cigarette smoke
• cough medicines are not useful for treating cough. However honey (unless there is a reason your child shouldn't have it) may be helpful for a cough due to a viral upper respiratory tract infection 
• antibiotics are not helpful for a cough caused by a viral infection. However, if your doctor finds that the cough is due to a bacterial infection in the throat or the chest, antibiotics may be prescribed

Where to go for information about cough

Acknowledgements

Starship Foundation and the Paediatric Society of New Zealand acknowledge the co-operation of the Starship Respiratory Service and the Asthma Foundation in making this fact sheet available to patients and families.