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When To Be Worried About Cough In Your Child

April 5, 2022

What comes to mind when your child has a cough that just won’t go away? Coughs in children are among the commonest reasons for anxious consultations. In this post, we look at what conditions could be present depending on the duration and type of cough.

Updated July 2023

Young child of african background holding her arm stretched out - image for coughs in children.

A cough is an automatic (involuntary) action to clear your airways.

When your child is coughing, their cough reflex is trying to protect their airways and lungs.

However, cough is also a sign of illness – some more severe than others.

It is always important to seek advice about a cough from your medical provider, especially if it is frequent or continuous, not getting better or is related to other ill health.

When is a Cough Abnormal?

As a parent, you may pick up signs that there is a problem with the cough your child has:

How often are they coughing?

What does it sound like?

How long have they been coughing?

Does it happen at any particular time of the day or night?

Does the cough happen with other symptoms of ill health – like a fever, breathing difficulty, chest pain?

In younger children, there may be a change to a pattern of activity, feeding, sleeping more, rapid breathing etc.

So these are possible observations you could make about the nature of the cough that could give a clue towards its cause.

Causes of Cough in Children

Coughs can be caused by several reasons – both infectious and non-infectious. The reasons for the cough could also be common or rare.

Amongst the common causes, we can further categorise coughs by how long they have lasted (duration) – this can be in three ways:

  • ‘Acute’, meaning it lasts for less than three weeks.
  • ‘Subacute’ if it lasts for three to eight weeks.
  • ‘Chronic’, meaning it lasts for longer than eight weeks.

Acute, Infectious Causes

  • Among the infectious causes, upper respiratory infections are the most common – they are mostly viral in nature.
    • Examples are the common cold that causes cough, runny nose, and ear or throat infections.
  • Other infectious causes are lower respiratory tract infections – like pneumonia which could also be caused by viruses (such as Covid 19), bacteria or fungi.

Acute Non-infectious coughs

  • In this category are causes of cough lasting under 3 weeks, like Asthma. This reversible condition is caused by inflammation and hypersensitivity in the airways, but it could extend beyond 3 weeks in duration.
  • Coughs could also be caused by irritants – smoke or chemical fumes that one breathes in may irritate the airways.

Sub-Acute Infectious Causes

These are coughs lasting 3-8 weeks and usually arise from infectious causes.

  • Commonly, coughs from acute respiratory illness may persist after the infection.
    • In this case, the germ (virus or bacteria) has gone, but the inflammation caused by the germ to the lungs/airways still remains, making them swollen and irritable.
    • This is also known as Airway Hyper-Responsiveness.
  • Infections that cause longer-lasting coughs – like Whooping Cough or Tuberculosis – could also extend beyond an 8-week period in some cases.

Chronic Non-Infectious Causes

Chronic coughs (lasting over 8 weeks) are most often of non-infectious causes:

  • Allergies, hayfever and nasal polyps are conditions that cause excess mucus in the nose to drip down the back of the throat (postnasal drip).
    • This can cause a persistent and irritating cough.
  • Undiagnosed asthma
  • Irritants like cigarette smoke
    • Children living with parents who smoke usually inhale the smoke passively, contributing to a persistent cough.

Rare/Less Common Causes of Cough

  • A foreign body.
    • Food can go down the windpipe instead of the food pipe. Other objects, such as beads, may also be inhaled by accident, particularly in children.
    • Other conditions include heart disease; or Cystic fibrosis (an inherited condition that affects the lungs and causes chronic cough).

So these are the possible causes of cough in children – and the way your doctor will consider the symptoms to arrive at the treatment.

Remember to discuss any episodes of cough that you are worried about with your doctor.

Seek urgent medical help for coughs associated with:

  • High body temperature
  • Change to breathing/ fast breathing/difficulty breathing
  • Altered activity/feeding/choking episodes
  • Skin rash
  • Feeling faint or dizzy.

Do you want to learn more about this topic? Ask Here.

More Reading

Editing by AskAwayHealth Team


All AskAwayHealth articles are written by practising  Medical Practitioners on various healthcare conditions to provide evidence-based guidance and help promote quality healthcare.
The advice in our material is not meant to replace the management of your specific condition by a qualified healthcare practitioner.
To discuss your condition, please contact a health practitioner or reach us directly.

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