Key points to remember about coughing in children

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 in children?

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 for my child with a cough?

A daily cough for more 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 daily cough for longer than 4 weeks. You should also see the doctor if your child has 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, or
• a cough that starts suddenly when they have not been unwell - they may have choked on something  

Check out Signs that children are struggling to breathe [1].

If you are worried that something is wrong or if you are in doubt, always see your doctor.

What are the different types of cough in children?

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

What are the common causes of coughing in children?

Colds or upper respiratory tract infections

Young children usually have between 6 and 12 upper respiratory tract infections each year that may cluster 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 smoke-free. Put smoke-free stickers up to let everyone know your home and car are smoke-free. If you want to give up smoking:

• call the free Quitline on 0800 778 778 or text 4006
• check out the Quitline/Me Mutu website [2]
• 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 Whooping cough [3] for more information.

Croup

Croup may cause a harsh or barking cough (see Croup [4]).

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?

Check out Signs that children are struggling to breathe [1].

What about treatments for cough in children?

Most coughs do not require treatment and get better by themselves within 3-4 weeks.

Make sure your child is not exposed to any cigarette smoke.

Cough medicines are not useful

Cough medicines are not useful for treating cough.

Honey may be helpful

Honey may be helpful for a cough due to a viral upper respiratory tract infection. But, wait until your baby is at least 12 months old before giving them honey - it can make young babies sick.

Antibiotics don't help coughing caused by a viral infection

Antibiotics are not helpful for a cough caused by a viral infection. But, if your doctor finds that your child's cough is due to a bacterial infection in the throat or the chest, they may give prescribe antibiotics.

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 [5].