Cough in children

Coughing is a common symptom in children, especially when they are under 5 years of age. It is an important reflex that helps clear mucus from your airways. A cough can sound awful, but it is rarely a sign of serious illness.

COVID-19 pandemic

A cough, with or without other respiratory symptoms, such as fever or runny nose, could also be a COVID infection. Test for COVID-19 and stay home until well or sure this isn’t COVID.

How to look after your child with a cough

There are no medicines to treat most coughs. Antibiotics don’t help a cough caused by a viral infection. They are only needed if your doctor finds that your child's cough is due to a bacterial infection in their throat or chest.

Image credit: Canva

Self-care can help to relieve symptoms and make your child more comfortable 

  • Encourage rest and give lots of water to drink.
  • For children older than 12 months, honey can help soothe their cough.
  • Vapour rubs can be applied to their chest and back. However, there is little scientific evidence as to how well they work and they are not recommended for babies under 3 months. Avoid putting the rub near the nostril area.
  • Simple pain relievers such as paracetamol (commonly known as Pamol or Panadol) can be used to reduce pain or fever and make your child more comfortable. If you aren't sure how much to give, use our paracetamol dose calculator.
  • Cough and cold medicines are designed to help reduce the symptoms of the common cold such as runny nose and cough. They do not cure the infection. The ingredients in these medicines can cause serious side effects in young children. To avoid harm:
    • over-the-counter cough and cold medicines are not recommended for children under 6 years of age
    • only those labelled as safe for children should be given to children 6 years of age and older.
    • find out more by talking to your pharmacist or see cough and cold medicines – advice for parents.
  • Keeping your home smoke free, warm, clean and dry is best for your children’s health. Read more about keeping your home warm and dry. 

Cough-free – the way to be

(Ministry of Health - Manatū Hauora, NZ, 2016)

When to get help

When to contact a healthcare provider or call Healthline 0800 611 116 for advice

  • If your child is working hard to breathe or is breathing fast.
  • If your child has a temperature higher than 38.5 degrees Celsius.
  • If your child has difficulty speaking normally or is unable to finish a whole sentence because of their coughing or breathing
  • If you can hear wheezing or whistling in their chest.
  • If your child has a cough that has lasted more than 4 weeks.

Call 111 and ask for an ambulance or go to the nearest hospital if your child:

  • Is choking. Food or an object going down the wrong way can cause a cough that starts suddenly when eating or playing. 

What are the different types of cough?

A cough is often described as being wet or dry.

A wet cough:

  • sounds chesty and phlegmy
  • is also known as a productive cough (brings up mucus from your chest).

A dry cough:

  • is less likely to produce phlegm (mucus)
  • can sound irritated, harsh, barking, or whooping
  • is also known as a non-productive cough.

There are many causes of cough, the most common being viral infections such as a cold or the flu. Other common causes include smoking, allergies (such as hay fever), asthma and bronchitis. Cough may also be a sign of gastro-oesophageal reflux disease (GORD). In this video, Dr Shah, a GP, describes the common causes of cough and when you should see your doctor.


(NHS, UK, 2015)

What are the causes of cough in children?

Colds or chest infections

Young children usually have between 6 and 12 upper respiratory tract infections each year. These may cluster around the winter months. If they are at daycare, this can be more. A wet, chesty cough may be due to a chest infection. If it lasts more than 2 weeks you need to see a doctor. Read more about colds or chest infections.

Bronchiolitis

Bronchiolitis is a common viral chest infection in children under 12 months of age. Read more about bronchiolitis.

Post-viral cough

Some children can have a persistent dry cough for 3 weeks after a viral infection. As children may have many infections in a year this can seem like one long infection. A persistent wet cough for more than 4 weeks is unusual and you should see your doctor.

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 hay fever), or a history of asthma and allergy in the family.

If coughing is the only symptom your child has, it is very unlikely to be due to asthma. Read more about asthma in children.

Smoke exposure

Second-hand cigarette smoke commonly causes children to cough even when they are well. Make sure your child's environment is smokefree. Ask all visitors and whānau to smoke outside and keep your car smokefree too. 

Support family/whānau and friends to quit smoking. Call Quitline on 0800 778 778. See also why to be smokefree for your kids.

Whooping cough

This can start like a cold or flu, but the cough persists and gets worse with coughing spasms which can last weeks. It is often serious in babies which is why vaccination is so important. Read more about whooping cough.

Croup

This can also start like a cold or flu and after a day or two can lead to a barking cough and raspy breathing. Read more about croup.

Bronchiectasis

If your child has a cough that lasts more than 4 weeks, they should see a doctor. One of the serious conditions to be considered is bronchiectasis. If a wet, persistent cough is left without treatment there is a risk of scarring and permanent damage to their lungs. Read more about bronchiectasis.

Inhaled foreign body

A cough, choking or breathing difficulty that starts suddenly while a child is eating or playing could be due to food or another object (foreign body) being breathed (inhaled) into their lungs. This can be immediately life-threatening so call 111 if your child has difficulty breathing or turns a pale or blue colour.

The following links provide further information about cough in children. Be aware that websites from other countries may have information that differs from NZ recommendations.   

Cough Ministry of Health, NZ
Cough KidsHealth, NZ

Reference

  1. Cough in children Auckland Regional HealthPathways, NZ, 2020

Reviewed by

Dr Alice Miller trained as a GP in the UK and has been working in New Zealand since 2013. She has undertaken extra study in diabetes, sexual and reproductive healthcare, and skin cancer medicine. Alice has a special interest in preventative health and self-care, which she is building on by studying for the Diploma of Public Health with the University of Otago in Wellington.
Credits: Health Navigator Editorial Team. Reviewed By: Dr Alice Miller, FRNZCGP Last reviewed: 12 Jan 2021