Cough in Children

Key points:

Coughs have many causes, including colds, flu, bacterial infections, irritations, allergies, asthma and psychological reasons.
See your doctor if: you’re worried about your child’s cough; if your child has a persistent cough plus persistent fever and reduced appetite; if your child’s fluid intake or wet nappies are half or less than half of usual; or if you notice your child’s chest is sucking in while breathing at rest (not while coughing or crying)
Most children with coughs don’t need special treatment.
If a cough lasts longer than 4 weeks, children might need treatment or further investigation.

About cough

Coughing is a natural reflex of the body. Coughing helps clear any dust, mucus, or irritants from your child’s airways.

While it can be uncomfortable, coughing is usually a sign that the body is working to protect your child’s lungs and airways.

Causes of coughs in children and teenagers

There are many causes of coughs in children.

By far the most common cause of coughing is a viral respiratory tract infection, like a cold or the flu. Young children can get 6-12 colds a year.

Other, much less common, causes of a cough include:

bacterial respiratory tract infections
pneumococcal disease
allergies and asthma
gastro-oesophageal reflux
irritants like cold air, second-hand smoke and pollution
inhaled foreign objects or choking
swallowing problems or structural issues with the windpipe
psychological reasons – for example, a habit cough or a tic.

Cough symptoms

Your child’s cough and any other symptoms will vary according to the cause of the cough.

A cough that follows a cold will typically be wet. It’s often worse at night. This is because mucus drips from the back of your child’s nose and mouth into their windpipe when they lie down. This kind of cough usually goes away within 3 weeks, but it might last for up to 6 weeks after the other symptoms of the cold have gone.

An asthma cough is often worse at night and after exercise. Your child might also have a wheeze and breathing difficulties like shortness of breath.

A barking, hoarse cough could mean that your child has croup.

If your child starts coughing suddenly and wheezing, they might have inhaled a foreign object.

If your child has had a very heavy cold and then gets bouts of coughing for many weeks afterwards, it might be whooping cough. This kind of cough sounds like barking when your child breathes out and ‘whooping’ when they breathe in.

If your child is less than 12 months old and has breathing difficulties as well as a cough, it might be bronchiolitis.

If your child has a wet, chesty cough that produces mucus and that lasts more than 4 weeks, it might be bacterial bronchitis.

In an older child or teenage child, a cough might become a habit. Usually these coughs are ‘honking’ coughs and don’t happen when the child is asleep.

Medical help: when to get it for children with a cough

If your child is well except for the cough, your child probably doesn’t need to see a GP.

But take your child to see the GP if:

The cough goes on for longer than 2 weeks with or without a cold.
The cough is interfering a lot with your child’s sleep or daily life.
Your child has persistent fever and reduced appetite or loss of weight as well as a cough.

Take your child to a hospital emergency department if:

The cough starts suddenly or there’s a risk your child has inhaled a foreign object.
Your child has difficulty breathing.

Call 000 for an ambulance if:

Your child is choking.
Your child has significant breathing difficulties.
Your child is drowsy or hard to wake up.
Your child’s skin is turning blue or very pale.

Tests for cough

Most children with coughs don’t need any tests.

A GP can usually work out the cause of your child’s cough by checking the history of the cough and any other symptoms and by examining your child.

The doctor might order a chest X-ray if your child has pneumonia, or the doctor wants to make sure your child hasn’t inhaled something.

If the doctor wants to check for serious infection, they might send your child for a blood test.

The doctor might take a swab of the back of your child’s nose if they think your child has whooping cough.

If your child is 5 years or older, your GP might send your child to have some lung function tests if the GP suspects asthma. These tests measure how much and how fast your child can breathe out.

If your child’s cough has lasted longer than 4 weeks or your child is having problems with weight gain or growth, your GP might send your child to see a paediatrician or respiratory specialist for further investigation.

Treatment for cough

General Care:

Keep your child hydrated. Offer extra fluids like breastmilk, water, soups, warm drinks, juices or oral rehydration solutions
Encourage plenty of rest to help your child recover

Treatment for a cough depends on the underlying cause.

The most common cough is the one that follows a cold. This kind of cough is probably caused by irritation in your child’s respiratory tract, rather than by infection. Your child doesn’t need any special treatment, and the cough will improve with time.

If your child is bothered by a cough from a cold or flu, one teaspoon of honey at night might reduce how bad the cough is and how long it lasts. But don’t give honey to children younger than 12 months because of the risk of infant botulism, a rare but serious form of food poisoning.

If your child’s cough is caused by asthma, it can be treated with anti-asthma medicine like a Ventolin puffer with a spacer, but this treatment depends on your child’s symptoms and the age of your child. Sometimes young children who have wheezes caused by viruses will be given asthma treatments.

Tobacco smoke can make your child’s cough worse, so keep your home free of second-hand smoke.

Ask your pharmacist or GP if you have questions about medicines or treatments that might work for your child’s cough.

Cough prevention

Your child and family can take simple precautions to prevent the spread of infections that cause coughs:

Wash your hands regularly with warm, soapy water.
Keep your hands away from your face as much as possible.
Cough or sneeze into a tissue or your elbow.

It’s also a good idea to consider flu immunisation to reduce the chances of your child developing a cough caused by flu. It’s recommended that all children over 6 months be immunised against flu every year. If you want your child immunised against flu, talk to your GP.

Getting your child immunised against pneumococcal disease through the National Immunisation Program can reduce the chances of your child developing a chronic cough caused by pneumococcal disease.

If your child’s cough is caused by asthma, you can usually prevent it by making sure your child follows their asthma action plan. It’s also important for your child to see their doctor regularly to review the plan.

You can minimise the risk of inhaling foreign objects by not letting babies and toddlers eat anything smaller than a 20-cent coin, like whole nuts or trail mix. They also shouldn’t play with small objects that they could inhale.

Cultural remedies and comfort measures for cough

In many cultures and communities, traditional remedies are used alongside medical treatments to relieve coughs. These remedies can provide temporarily relief and may support recovery when used appropriately.

These practises can provide comfort and warmth for the entire family and can make children feel loved and attended to. Many of us remember our familial home remedies with fondness from childhood.

Natural remedies for cough that are common in the Arabic-speaking community include:

Honey: Honey can soothe the throat and reduce coughing in children over 12 months. It can be given on a spoon or mixed with warm water, lemon, or milk. Please note that honey is dangerous in children under 12 months and may cause a neurologic disease called Botulism
Fenugreek: Fenugreek seeds are soaked in water overnight then given to the child to sip during the day to help reduce coughing and support the immune system
Olive oil and water: a splash of olive oil in warm water is often used to coat and soothe the throat
Saltwater gargle: Older children gargle a solution of saltwater for 20 – 30 seconds which may be effective to reduce irritation
Eucalyptus Vicks VapoRub or similar balms: Rubbing a small amount of this menthol and Eucalyptus balm on the chest and back (avoiding the nose and mouth) is believed by many families to provide relief from the cough and congestion, especially at nighttime
Thyme tea or steam: Some families prepare thyme tea or thyme steam baths. Thyme tea is prepared by brewing fresh or dried thyme leaves in water to make a soothing warm drink for your child to sip on throughout the day. It is believed to have relaxing, anti-inflammatory, antioxidant, properties
Steam Baths / Steam Inhalation: some families help their child breathe in steam from a hot bowl for a few minutes to clear their airway, reduce mucus, and temporarily reduce coughing. Please note that many children (including babies) present to the Emergency Department with extensive burns from steam baths for respiratory illnesses, so appropriate care and safety are critical if you choose to use this method. If you are using this method in a child under 5, please note that they may not understand the danger and may tip the boiling water onto themselves, causing life-threatening injuries. All children should be closely supervised if you choose to risk using this method.

Always consult a GP before introducing remedies, especially if your child has any allergies or medical conditions.