Cough in children

Cough in children is very common. A cough can be worrying for parents especially if it lasts a long time and interferes with a child’s sleep, but most do not need investigation or treatment.

An acute cough is a cough that is present for less than 4 weeks, whereas a chronic cough is 4 weeks or more.

Common causes of cough

There are many causes of cough in children, with the most common being a cold, flu or other viral infections. When a child has a common cold, a cough is one of the last things to resolve, and it is common for children to have an ongoing dry cough for several weeks.

Cough can also be caused by breathing in something like food. It is important to note if your child choked on anything in the days or weeks before the cough started.

Whooping cough (pertussis)

Whopping cough (pertussis) can cause a very distinctive severe dry cough with a ‘whooping’ sound. A child may have coughing fits and struggle to catch their breath in between. Some children may also vomit after coughing. There is no treatment for the cough itself which can last for up to 100 days.  A short course of antibiotics will usually be prescribed to prevent your child from spreading the infection to other people. If your child is not yet immunised or has been around an adult that has prolonged coughing, it is worthwhile talking to your doctor about the potential of pertussis.  Some viral infections can also mimic whooping cough, such as respiratory syncytial virus (RSV).

Psychogenic or habitual cough

A cough that is harsh, loud and honking in nature, is usually present during the day, but doesn’t occur when a child is asleep may be a habitual cough. A habitual cough is a chronic cough that has no underlying physical cause or medical diagnosis, and does not respond to conventional medical treatment. The cough is usually a habit that has developed after an infection or another issue has caused a cough. If your child has a persistent cough that you think may be a habit cough, see your GP.

Reactive airways disease (RAD)

In some children cough can be a sign of reactive airways disease, sometimes called ‘childhood asthma’. A family history of asthma, hay fever, eczema or allergies makes RAD more likely. During acute viral infections, a child will have trouble breathing and have wheeze. This requires a Salbutamol inhaler. If the cough is mainly present when sleeping, in cold air, or with exercise, particularly if associated with wheeze, it may be worthwhile keeping a cough diary and discussing with your GP.

Persistent bacterial bronchitis (PBB)

A wet or productive cough every day for 4 weeks or more, may be a persistent bacterial bronchitis. It is not normal for a child to have a wet cough for weeks at a time and you should always see your doctor to discuss this. PBB often follows a cold and is a chronic infection in the chest. The treatment for this is a course of antibiotics, for a minimum of 2 weeks and until the cough is dry.

Treatment

There is no treatment which works to stop a cough.  As long as your child is eating and drinking well, and is able to keep up with other kids, the cough will get better in time.

There is no cough medicine that works in children. A natural cough therapy that can sometimes help is honey in warm water – but it is important to only give it to your child if they are 12 months or more.

It is also important to avoid any exposure to smoke especially tobacco– both in the air or on clothing.

Usually if there is only a dry cough and no other infectious symptoms, they should be able to return to school or daycare. Book an appointment to see your family doctor or general practitioner in 2 weeks’ time for a review.

When to seek help

See your GP if your child has any of the following:

• Prolonged productive or wet cough
• Shortness of breath, work of breathing or wheezing
• History of choking prior to the cough starting
• Blue colour change
• Looks unwell

If the treatment you have been given is not working as expected, see your GP.

In an emergency, call Triple Zero (000) and ask for an ambulance.

If you're not sure whether to go to an emergency department, call 13 HEALTH (13 43 25 84) and speak to a registered nurse.

Developed by the Emergency Department, Queensland Children’s Hospital. We acknowledge the input of consumers and carers.

Resource ID: FS392. Reviewed: November 2023.

Disclaimer: This information has been produced by healthcare professionals as a guideline only and is intended to support, not replace, discussion with your child’s doctor or healthcare professionals. Information is updated regularly, so please check you are referring to the most recent version. Seek medical advice, as appropriate, for concerns regarding your child’s health.