When to Address Your Child's Cough - Blog of the children's educational center

Seven questions about coughing with a pediatric pulmonologist.

January 23, 2025

Chronic cough is defined by health professionals as lasting for a period of 4 weeks or longer. It’s that time of the year when coughs, colds, and respiratory illnesses are prevalent. Having a persistent cough for you or your child is a common issue. Dr. Drew Barber, a pulmonologist, discusses the reasons behind chronic cough and when it’s necessary to seek medical attention.

Common causes of chronic cough in children include asthma, allergies, respiratory infections, GERD (gastroesophageal reflux disease), and environmental irritants. It’s important to monitor the frequency and severity of the cough, as well as any other symptoms such as wheezing, shortness of breath, or chest pain.

If your child’s cough persists for more than four weeks, doesn’t improve with over-the-counter remedies, or is accompanied by other concerning symptoms, it’s recommended to consult with a pediatric pulmonologist like Dr. Barber. A thorough evaluation may include a physical exam, lung function tests, imaging studies, and possibly allergy testing to determine the underlying cause and develop an appropriate treatment plan.

What is a chronic cough?

A cough that lasts for 4 weeks or more is typically classified as chronic cough.

Chronic cough is often a symptom of an underlying medical condition such as asthma, allergies, gastroesophageal reflux disease (GERD), or chronic obstructive pulmonary disease (COPD). It can also be caused by smoking, environmental irritants, or medications.

People with chronic cough may experience other symptoms such as wheezing, shortness of breath, chest tightness, or coughing up blood. It is important to see a doctor for proper diagnosis and treatment, as chronic cough can significantly impact quality of life.

What causes chronic cough in kids?

Common viral infections in children often lead to chronic cough. Other causes can include asthma, protracted bacterial bronchitis, aspiration, reflux, primary ciliary dyskinesia, and cystic fibrosis.

It is important for parents to monitor their children’s cough and seek medical advice if it persists for more than a few weeks. Chronic cough can be a sign of an underlying condition that may require treatment. Asthma and allergies are common triggers for chronic cough in children, so it is important to have these conditions properly managed by a healthcare provider.

In some cases, chronic cough may be a symptom of a more serious condition such as cystic fibrosis or primary ciliary dyskinesia. These conditions require specialized care and treatment to manage symptoms and improve quality of life.

Why doesn’t cough medicine help a chronic cough?

Viral infections are the primary cause of coughs in children, but over-the-counter remedies are not effective. Treatment should target the underlying issue, such as asthma.

Chronic coughs can be caused by a variety of factors, including smoking, allergies, postnasal drip, or acid reflux. In these cases, simply taking cough medicine may not address the root cause of the problem.

It’s important to consult with a healthcare provider to determine the underlying cause of a chronic cough and develop a treatment plan that targets the specific issue. This may involve lifestyle changes, medication, or other interventions to effectively manage the cough.

When do you recommend families seek medical attention for their child’s cough?

If your child’s cough persists for more than 4 weeks or is accompanied by wheezing, breathing difficulties, or intolerance to exercise, it’s important to seek medical advice.

In addition to the above symptoms, it is also recommended to see a doctor if your child’s cough is causing them to vomit, have a high fever, chest pain, or if they are showing signs of dehydration.

Coughs sometimes raise questions of pneumonia. When is this a concern?

If a child with a cough also experiences fever, rapid breathing, chest pain, or other distressing symptoms, pneumonia should be considered, and medical attention sought.

Pneumonia is an infection that inflames the air sacs in one or both lungs, and can be caused by bacteria, viruses, or fungi. Common symptoms of pneumonia include cough, fever, chills, and difficulty breathing. It is important to seek medical attention if you suspect pneumonia, as it can be a serious condition, especially in young children or older adults.

To prevent pneumonia, make sure to wash your hands frequently, avoid smoking, and get vaccinated against the flu and pneumonia if recommended by your healthcare provider. Stay healthy to reduce your risk of developing pneumonia.

When families come to you, how do you get to the bottom of what’s causing their child’s cough?

Diagnosing the cause of a cough requires a thorough history and physical examination. Clues related to asthma may involve a dry cough, wheezing, a family history of asthma, or improvement with steroid treatment.

Is there anything you recommend families doing or NOT doing to help a child’s cough until it gets better or they see a doctor?

For children with a cough, it is recommended to provide supportive care measures such as hydration and rest. Honey should be avoided for children under one year of age, and cough suppressants are not beneficial.

If your child has a persistent cough, consulting a healthcare provider can help differentiate between conditions such as RSV, flu, pertussis, or other issues. Understanding when to take your child to the pediatrician is crucial.

Additional Tips for Managing Your Child’s Cough:

Keep your child hydrated with water, warm broth, or herbal tea. Avoid giving them sugary drinks.
Use a cool-mist humidifier in your child’s room to help alleviate coughing and congestion.
Elevate your child’s head while they sleep to help reduce nighttime coughing.
Encourage your child to practice good hand hygiene to prevent the spread of germs that can cause coughing illnesses.

Remember, if your child’s cough is severe, accompanied by difficulty breathing, wheezing, or chest pain, seek medical attention immediately.

Vaccines Can Prevent Whooping Cough

Pertussis, also known as whooping cough, is highly contagious and usually peaks during the fall and winter months. Vaccination is essential for prevention.

Symptoms of Pertussis Can Last for Several Weeks

Pertussis can be severe in young children, leading to significant symptoms and hospitalization. Early intervention is key for better outcomes.

Early Treatment if Whooping Cough Is Most Effective

If your child has a cough that persists for over a week, especially if exposed to whooping cough, seeking medical advice is recommended. Antibiotics can be effective if the condition is caught early.

Coughs in children are usually not serious, but if concerned, consulting a medical professional is advisable. Understanding the common causes of coughs and knowing when to seek medical guidance is important.

Common causes of coughs in children:

Common cold
Flu
Asthma
Allergies

When to seek medical guidance for a child’s cough:

If the cough lasts for more than a week
If the child is having difficulty breathing
If the child’s cough is accompanied by a high fever

It’s always better to be cautious when it comes to your child’s health. If in doubt, contact a healthcare provider for guidance.

What is a Cough?

A cough is a natural way for the body to clear mucus and irritants from the airways, often triggered by colds or the flu.

In addition to colds and the flu, coughs can also be caused by allergies, asthma, bronchitis, smoking, or other respiratory conditions.

There are different types of coughs, including dry coughs, chesty coughs, and whooping cough. It’s important to pay attention to the type of cough you have in order to determine the underlying cause and receive appropriate treatment.

If a cough persists for more than a few weeks, it’s important to consult a healthcare provider to rule out any underlying health issues and receive proper treatment.

Common Causes of Coughs

Causes of cough include the common cold, flu, allergens, pneumonia, bronchitis, asthma, and environmental pollution.

Types of Coughs in Babies and Children

There are different types of coughs in infants and children, including dry coughs and chesty coughs, each caused by various factors like allergies, cold air, pollution, or infections.

Dry coughs

Dry coughs do not produce phlegm and may be caused by allergies, cold air, pollution, pneumonia, or other factors.

Chesty cough

Chesty coughs indicate the production of phlegm to clear the airways. This type of cough may be a sign of infection following a cold, especially if accompanied by green or yellow mucus, as well as symptoms like wheezing, fever, or difficulty breathing. If these symptoms are present, medical attention is necessary.

In cases of bacterial infections, antibiotics may be prescribed by a healthcare provider, but viral infections such as colds, bronchiolitis, and the flu do not require antibiotic treatment.

Outliers

Less common causes of cough in children include croup, characterized by a barking cough with a rasping sound during breathing. Seeking medical assistance is advised if a child shows symptoms of croup.

Asthma can lead to persistent coughing, triggered by factors like cold air, allergies, pollution, stress, or infections.

How to ease coughing in babies and children

How can you help your child if they are coughing?

Ensure your child stays hydrated with fluids to soothe the throat.
If there is no wheezing and the child is breathing normally, warm water with lemon and honey can be given if they are over 1 year old.
Always consult a healthcare provider before administering any cough medication to your child.

When to see a GP and what signs are a medical emergency

For persistent coughs, concerns regarding asthma, or if the child is unwell, it is recommended to see a general practitioner. Immediate medical attention should be sought if breathing becomes difficult or if the child has a high fever.

If the child experiences a fever or discomfort along with a cough, ibuprofen or paracetamol can be given for relief.

If the child is experiencing severe symptoms such as chest pain, wheezing, or bluish lips, seek emergency medical help immediately.

Always trust your instincts as a parent, if you feel that something is seriously wrong with your child, do not hesitate to seek medical attention.

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Dry vs. wet coughs in kids

Dry coughs indicate irritation in the upper airways, while wet coughs suggest irritation in the lower airways. Children, especially younger ones, may experience breathing difficulties.

Croup manifests as a distinctive bark-like cough and wheezing sound. Immediate medical attention is necessary if these signs are present.

Wheezing along with a dry cough could be indicative of asthma. A persistent nighttime cough may require evaluation by a healthcare provider.

If a child coughs after choking, there might be an object lodged in the lungs. Seeking medical help is essential in such cases.

If an object is suspected in the lungs, a medical professional can use a stethoscope to detect changes in breath sounds, indicating a foreign object. Confirming with an X-ray, specialists can usually remove it under anesthesia if detected.

In winter, a wet cough often results from viral infections but can also be caused by ongoing exposure to irritants like cigarette smoke, leading to forceful coughing. Significant wet coughs that persist may indicate gastrointestinal illness, according to Dr. Brown.

When to seek medical attention for a wet cough

A wet cough accompanied by a high fever above 102 degrees Fahrenheit suggests a severe infection. An increased breathing rate may indicate airway issues, especially during sleep. Waiting until the next morning is acceptable if the child does not seem to be in distress.

Coughs and respiratory illnesses

During cold and flu season, coughs are common due to viral infections such as the flu, RSV, and COVID-19. While most cases resolve within a week, young or immunocompromised children may experience more severe symptoms.

When viruses are circulating in the community, consulting a healthcare provider when your child has a cough can help determine the cause and appropriate actions.

My child’s cough won’t go away

Viral infections typically last 7-10 days but can vary depending on the specific virus in circulation. Annual flu vaccinations target prevalent strains, and children’s coughs may persist for weeks due to recurring viruses.

Managing a child’s cough at home involves staying hydrated, getting adequate rest, and maintaining a nutritious diet. Avoid giving OTC cough and cold medications to children under 4 years old.

Treating a child’s cough at home

Home remedies like hydration for infants, honey for older children, and cough drops can help alleviate symptoms. Humidifiers may also help soothe airway irritation when used safely and cleaned regularly.

Only treat cough and congestion symptoms that significantly impact your child’s comfort or sleep.