Coughing in Children

Cough In Children

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 more serious disease.

Key points to remember about coughing in children

• coughing is common in children, especially in preschoolers
• 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 about 3 weeks after a simple cold
• a cough that lasts longer than 4 weeks is not normal and may be a sign of more serious 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

Many children will continue coughing for about 3 weeks after a simple cold.

How common is coughing in children?

Coughing is common in children, especially in preschoolers.

10 to 20 in 100 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 maybe not every day, and usually not at night.

When should I seek help for my child with a cough?

Go to the doctor if your child has a cough and:

• is working hard with their breathing
• is breathing fast
• has a temperature higher than 38.5 degrees Celsius
• isn't speaking normally or can't finish a whole sentence because of their coughing or breathing
• has wheezing or whistling in their chest
• the cough started very suddenly - they may have choked on something
• the cough started very suddenly and they have a skin rash - this could be an allergic reaction
• you are worried

Check the signs that show your child is struggling to breathe

If your child has had a daily cough for longer than 4 weeks, take them to the doctor.

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

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 (upper respiratory tract infections)

Young children usually have between 6 and 12 colds each year that are more common in the winter months. Children can keep coughing for a few weeks after a cold.  

Asthma

An asthma-related cough is usually dry and happens at night, with sport or in the early morning. Children who have an asthma cough also usually have other symptoms such as wheeze. They may also have eczema or hayfever, or a history of asthma and allergy in the family. If your child has a cough but no other symptoms, they are unlikely to have asthma.

Cigarette smoke

Secondhand cigarette smoke can cause 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
• ask your health professional

Chest infections

If your child has a wet, chesty cough and a fever, it is likely to be an infection - take your child to the doctor. A wet, chesty cough and a fever can sometimes be a sign of pneumonia. 

Read about pneumonia

Whooping cough

Whooping cough can cause very serious illness in babies and young children. Older children usually get a less severe disease but the cough and vomiting can be very distressing.

Check information on whooping cough

Croup

Croup may cause a harsh or barking cough.

Check information on croup

What if my child has a wet cough lasting more than 4 weeks?

If your child has a wet cough lasting more than 4 weeks, they may have a more serious disease such as bronchiectasis. It's very important to recognise this early. Take your child to the doctor.

Check some information about bronchiectasis

Watch this video featuring former Warriors rugby league player Wairangi Koopu. It focuses on recognising the signs of infection that can lead to bronchiectasis, and acting on them. 

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 usually spit or cough up phlegm. They usually 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?

Are there any other breathing symptoms?

• wheeze?
• whistling in the chest?
• fast breathing?
• shortness of breath?
• sucking in of the chest?

Check the signs that show your child is struggling to breathe

What about treatments for cough in children?

Most children with a cough don't need treatment. The cough usually gets better within 3 to 4 weeks.

Make sure your child is not around 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 caused by a cold. 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. If the cause of your child's cough is a bacterial infection in the throat or chest, your doctor may suggest antibiotics.

ACKNOWLEDGEMENTS

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.