Cough in a Child: Causes in Infants and Older Children

A cough is an innate protective reflex. It clears the airways of foreign substances. A cough is a symptom, not a disease in its own right.

Why a child coughs: main causes

Most coughs are caused by a cold or flu. Other causes: smoking and passive smoking, acid reflux, allergies, infections such as bronchitis or COVID-19, and postnasal drip. Cough is one of the most common reasons for seeing a doctor: it accounts for 30–40% of visits in general practice. In 10–38% of cases the cause of the cough cannot be identified.

Common causes also include asthma, sinusitis with postnasal drip, pneumonia or acute bronchitis. Less often, cough is associated with certain blood pressure medications.

A cough is rarely a sign of something serious, such as lung cancer. The mechanism of cough is as follows: irritation of airway receptors triggers a forced exhalation through the mouth.

Cough in a child without fever

A cough without fever occurs with allergies, asthma, reflux and postnasal drip. A dry, tickly cough occurs when the airways are irritated.

By duration, cough is divided into acute (less than two weeks), prolonged (2–4 weeks), subacute (4–8 weeks) and chronic (more than two months). Cough can be morning, evening (with pneumonia, bronchitis), or nighttime; in spring and autumn — with allergies.

Cough in an infant and newborn

You should see a doctor if a child under 3 months of age is coughing. In a newborn and infant, the cough reflex is part of the airways' defense.

The doctor examines the ears, nose, throat and chest. They assess when the cough started, its sound, and whether there are other symptoms.

Types of childhood cough: dull, chesty, frequent

A cough can be dry (non-productive) or wet (productive), when sputum is coughed up. Sputum can be mucous, purulent, or viscous. By timbre, a barking, ringing chesty, hoarse, muffled and soundless cough are distinguished. Cough also occurs when inhaling dust, gases, smoke, and when a foreign body enters the airways.

A cough that rapidly worsens, or a hacking cough, is a reason for an urgent medical consultation. A dull cough is described as muffled.

• A dry cough is not accompanied by sputum.
• A wet cough brings up sputum.
• A muffled cough is one of the varieties by timbre.
• A whistling sound on inhalation is called stridor.

How a doctor determines the cause of a child's cough

The doctor listens to the chest with a stethoscope and may take a sputum sample. An X-ray, allergy tests or a lung function test may be ordered. Blood tests and swabs from the nose or throat are possible. If necessary, the doctor will refer the child to a specialist in a hospital setting, but this is rare.

Antibiotics are usually not prescribed for a cough. They are given only for a bacterial infection.

Warning signs: when to see a pediatrician

You should see a doctor if the cough lasts longer than 10–14 days, or with weight loss, night sweats, hemoptysis, or fever. Also if a child under 3 months of age is coughing.

A cough by itself is not a reason to call an ambulance. Call 103 or 112 for shortness of breath or difficulty breathing, or swelling of the face or throat with difficulty swallowing.

This material is for reference and does not replace a doctor's consultation.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer