Cough is a very common problem for children. The most common cause of cough is a respiratory tract infection, such as a cold. Young children usually have six to 12 respiratory tract infections per year, usually caused by viruses.
Antibiotics don't help with coughs caused by viruses. Sometimes, children may cough for many weeks after a viral infection – this is called a post-viral cough and, again, antibiotics are usually no help.
Occasionally a cough may be caused by a bacterial infection in the throat or chest. In these cases, antibiotics may be prescribed by your doctor to treat a bacterial infection.
Care at home
If your child is otherwise well, it is unlikely that there will be a serious cause for the cough.
- Cigarette smoke will make the cough worse, so it is essential that you do not expose your child to smoke.
- Cough medicines are not useful in treating cough in children; in fact, recent studies suggest that some cough medicines may be harmful to younger children. Cough medicines should not be used in children younger than six years old.
- Children older than six should only take cough medicines on the advice of a health professional. However, there is no scientific evidence that cough medicines will be helpful.
- There is some evidence that honey may reduce the severity and duration of a cough. As a short-term solution, one to two teaspoons of honey taken 30 minutes before bedtime may be helpful for children older than 12 months. Honey should be avoided in children less than 12 months old, because there may be a risk of a rare condition called botulism, which causes muscle weakness.
When to see a doctor
If your child seems unwell and you are concerned, it is a good idea to take them to your GP. The doctor will check your child for other causes of cough.
If your child has a high fever, difficulty breathing, is not drinking very much or has fewer wet nappies than usual, take them to see the GP.
Some post-viral coughs may be present for many weeks after your child has recovered from the respiratory tract infection, for example, after bronchiolitis. This is normal. If the cough lasts for many weeks and you are worried, your GP may refer you to a paediatrician (specialist children's doctor).
A wet sounding cough, or a cough with phlegm, that casts for four or more weeks as this type of cough could have other causes.
Could it be asthma?
A child who has a persistent cough at night might have asthma. Usually, children with asthma will have other symptoms as well, such as wheeze and difficulty breathing. Many children with asthma also suffer from allergies and eczema. If you are concerned that your child may have asthma, see your GP for an examination and more information.
Key points to remember
- Cough is a very common problem for children, and is usually caused by respiratory tract infections.
- Most young children get respiratory tract infections six to 12 times a year.
- Most coughs don't require treatment, and will not respond to antibiotics.
- Cough medicines are of no proven benefit and may be harmful to children under the age of six years.
- Honey may be helpful, but should only be used in children over 12 months old.
For more information
Common questions our doctors are asked
My child’s cough is keeping them awake at night. What can I do?
If they are over 12 months, consider giving them some honey to soothe the irritation in their throat. If your child coughs mainly at night and less during the day, this may represent asthma and should be investigated by your GP.
Is it OK to send my child to school if they have a cough?
If your child is unwell with a fever, runny nose and cough it is best to keep them home and reduce the chance of spreading their infection to others. However, a cough can last for many weeks after your child has recovered from their infection, and there is no need to keep them home from school for that long. A cough may also represent something else, like asthma, which does not require school exclusion.
There are a lot of different cough medicines in the pharmacy. Do they work?
Some cough medicines work by thinning the mucus produced in the airway. Others reduce your natural cough reflex or may contain similar ingredients to anti-histamines. However, there is no scientific evidence that cough medicines will be helpful, and some may have unwanted side effects, like constipation. Cough medicines should not be used in children younger than six years old, and only used in children over six on the advice of a health professional.
Developed by The Royal Children's Hospital Respiratory department. We acknowledge the input of RCH consumers and carers.
Reviewed August 2020.
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