Cough

Cough

Coughing is common in children, especially when they are preschool age. A cough that lasts longer than 4 weeks is not normal and may be a sign of chest disease.

Key points to remember

Many children will continue coughing for 3 weeks or more following a simple cold.

  • coughing is common in children, especially when they are preschool age
  • causes of cough include colds, asthma and chest infections - secondhand cigarette smoke commonly causes children to cough even when they are well
  • many children will continue coughing for 3 weeks or more following a simple cold
  • a cough that lasts longer than 4 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 4 weeks

How common is coughing?

Coughing is common in children, especially when they are preschool age, and is usually short lived.

10 to 20 percent of preschoolers will cough for 3 weeks or more following a cold. Even children without a cold may cough on average 10 times a day but not consistently every day and usually not at night.

When should I seek help?

A daily cough for greater than 4 weeks is not normal and may be a sign of chest disease.

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

  • a persistent daily cough for longer than 4 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

If in doubt, always see your doctor.

Different types of cough

A cough is usually wet or dry.

A wet cough sounds 'chesty' and phlegmy.

A dry cough:

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

Common causes of different types of cough

Colds or upper respiratory tract infections

Young children usually have between 6 and 12 upper respiratory tract infections each year that may be clustered around the winter months.

Asthma

An asthma related cough is usually dry and happens 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

Secondhand cigarette smoke commonly causes children to cough even when they are well. Make sure your child's environment is smokefree. 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 
  • check out the Quitline website
  • ask your health professional

Chest infections

A wet, chesty cough is likely to be an infection. If it lasts more than 4 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 the whooping cough page for more information.

Croup

Croup may cause a harsh or barking cough (see the croup page).

Some questions your doctor may ask 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 5 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 may be helpful for a cough due to a viral upper respiratory tract infection. (Wait until your baby is at least 12 months old before giving them honey – it can make young babies sick)
  • 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

If your child has a bad cough, it's important to recognise it early

A long lasting (persistent) wet cough can lead to the development of lung diseases such as bronchiectasis. See a video narrated by former Warriors rugby league player Wairangi Koopu. It focuses on recognising the signs of infection that can lead to bronchiectasis, and acting on them.

Transcript available at the Ministry of Health website.

Starship Foundation and the Paediatric Society of New Zealand acknowledge the cooperation of the Starship Respiratory Service and the Asthma Foundation in making this content available to patients and families.

This page last reviewed 06 October 2015.
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