What is a cough?

A cough is a sound and movement made by the body to clear the lungs, large airways, and throat of mucus or irritating substances. It is common for your child to have a cough if they have a mild illness. If your child just has a cough and no other symptoms it is not a sign of a more serious illness.

Other symptoms that your child may have with a cough will help you know if your child should see a doctor. Make note of other symptoms, such as fever, difficulty breathing, nasal congestion, and exposure to possible infections or irritating substances.

A cough can sound wet, dry, or barky. A cough that lasts less than 2 weeks is called an acute cough. A cough that lasts longer than 4 weeks is called a chronic cough. The cause of the cough will determine how long it lasts. If your child only has a cough or a cough and a runny nose, he usually gets better within 1 to 2 weeks. 

Causes of cough

A cough is the body's natural way of clearing mucus and irritating substances from the lungs and airways. It prevents substances other than air from entering the lungs. It is a natural process.

The most common cause of a cough is a viral respiratory infection such as the common cold. This can lead to congestion of the nose and throat. When your child has a congested nose, mucus can drip from the nose into the throat. This causes a cough reflex. The cough stops mucus from entering the lungs.

Infections in the ears (such as swimmer’s ear), sinuses, and lungs (such as pneumonia​) can also cause your child to have a cough. A cough can also be caused by exposure to things that irritate the airway. For example, cough is common in children exposed to family members who smoke.

There are receptors or signals in your nervous system that are activated when your body needs to cough. A viral infection can cause these receptors to be very sensitive. After a viral infection these receptors can remain and continue to be sensitive. This causes a chronic cough.

A chronic cough can also be caused by exposure to an irritant or a persistent respiratory condition. 

Types of coughs

Children with asthma, croup, or pertussis

Children with asthma often have a cough that includes wheezing and fast breathing.

Children with croup​ have a cough that sounds like a bark. When they take a breath in it sounds noisy. Breathing may be normal when your child is not coughing.

Children with pertussis (whooping cough) often have forceful spasms of coughing. These coughs have a "whoop" sound. Coughing makes it difficult for your child to breathe. Breathing may be normal when your child is not coughing.

Foreign objects in the airway

Young children who have swallowed a small object or choked on a small piece of food may have a sudden onset of severe coughing and/or difficulty breathing. This is a medical emergency.

Sometimes a child may have a persistent cough that can last for weeks or months because a foreign object is stuck in the airway. Your child's doctor will be able to identify and treat the problem.

Taking care of your child at home

Adjust your child’s sleeping position

Babies with a cough caused by congestion in the nose and back of the throat may have difficulty sleeping on their tummies or backs. They may be more comfortable asleep in someone’s arms or in a semi-upright position. Older children may be more comfortable sleeping with their head raised on a pillow.

Rest when needed

During a cough, your child may have difficulty sleeping. At night, his breathing is slower and shallower. He may cough more to keep his lungs clear of mucus. This means he may need to rest more during the day.

Saline solution

Use a nasal saline solution (Salinex or other brands) to help relieve the congestion.

Offer small glasses of fluid often

Encourage your child to drink fluids. This will help him feel better.  If your child is vomiting (throwing up) after coughing, encourage him to drink small amounts of fluids more often.

Never stop breastfeeding because your child has a cough.

You do not need to eliminate milk from your child's diet. It does not create or increase mucus. Your child may have any type of solid food or liquids. 

Humidified air

Dry air tends to make coughs worse. A cool mist vaporizer or humidifier in your child's bedroom may help. Change the water and clean any filters at least once a day.

A barky cough may get better after your child is exposed to humidified air, such as the steam from a shower. Going outside in the cold air can also help your child feel better.

Cough medications are not recommended

Over-the-counter cough and cold medicines should not be used for children under 2 years of age. They are NOT recommended for children under the age of 6. Cough syrups have side effects. They can be dangerous, even fatal in small children because of certain ingredients. They can also cause poisoning in young children. For children over the age of 6, these medications have not been proven to make the cough last a shorter time. Home remedies are also not recommended.

In children over 1 year, give 1 to 2 teaspoons (5 to 10 mL) of pasteurized honey as needed. Honey can be soothing and has been shown to ease the cough. Do not give honey to babies under 1 year of age.

Avoid smoky places

Keep your child away from smoky places and other environmental irritants. Exposure to cigarette smoke can make coughs worse.

When to see a doctor

Make an appointment with your child's doctor if:

  • your child has a cough and mildly noisy breathing and a fever

  • your child has a cough that lingers for over 2 weeks

Go to your nearest Emergency Department or call 911 if:

  • your child is unable to feed due to cough or is vomiting often because of a cough

  • your child has a barky cough and noisy breathing

  • your child has difficulty breathing that does not settle with exposure to cold air, humidified air, or steam

  • your child has blue lips or skin

  • your child has trouble catching her breath because of cough

  • your child has a persistent cough, finds breathing difficult, or is choking on food or some other object

Key points

  • Cough is a common symptom in children.
  • Most coughs are due to the common cold and do not require treatment.
  • Over-the-counter cough and cold medications are NOT recommended for children under the age of 6.
  • Some symptoms that may accompany cough, such as fever, noisy breathing, poor feeding, or quick breathing, can help you know when to take your child to a doctor.
  • Any cough with noisy breathing (such as wheezing) or a fever should be seen by a doctor.

Beth Gamulka, MDCM, FRCPC

Janine A. Flanagan, HBArtsSc, MD, FRCPC