Key points about coughing in children
- coughing is common in tamariki, especially in preschoolers
- causes of cough include colds, asthma and chest infections
- being around smoking and vaping often causes tamariki to cough even when they are well
- many tamariki will keep coughing for about 2 to 3 weeks after a cold
- a cough that lasts more than 4 weeks may be a sign of more serious disease
- see a health professional if your child has had a cough and a fever, is having trouble breathing, or the cough has lasted more than 4 weeks
Cough in children
Coughing is common in tamariki, especially in preschoolers.
Tamariki can cough for about 2 to 3 weeks following a cold.
Types of cough
A cough is usually wet or dry.
Wet cough
A wet cough sounds 'chesty'. You may hear or feel a ‘rattle’ when your child coughs.
Dry cough
A dry cough can sound irritated, harsh or barking. It’s less likely to produce mucus (phlegm).
Common causes of cough
Colds (upper respiratory tract infections)
Young tamariki can have several colds each year. Tamariki can keep coughing for 2 to 3 weeks after a cold.
Asthma
An asthma-related cough is usually dry and happens at night, with activity, or in the early morning. Tamariki with an asthma-related cough usually have other symptoms such as wheeze. They may also have eczema or hay fever, or a history of asthma and allergy in the family.
Being around smoking and vaping
Being around smoking and vaping can cause tamariki to cough even when they are well. Make sure your child's environment is smoke-free and vape-free.
If you want to give up smoking or vaping:
- call the free Quitline on 0800 778 778 or text 4006
- check out the Quitline - Me Mutu website
- ask your health professional
Chest infections
If your child has a wet, chesty, rattly cough and a fever, it is likely to be a chest infection.
Whooping cough
Whooping cough causes long episodes of continuous coughing. 'Whoop' describes the sound that some tamariki make after coughing, when they catch their breath.
Whooping cough can cause very serious illness in pēpi and young tamariki. Older tamariki usually get a less severe disease but the cough can be very distressing.
The best protection against whooping cough is vaccination.
- whooping cough vaccination is free during pregnancy and helps protect pēpi in their first weeks of life
- vaccinating pēpi when they turn 6 weeks old helps keep them protected
Croup
Croup may cause a harsh or barking cough.
When to get medical help for a cough
Call Healthline or see a health professional
Call Healthline on 0800 611 116 or see a health professional if your child has a cough and:
- is having trouble breathing
- is breathing fast
- has a temperature higher than 38 degrees Celsius
- is having trouble speaking
- is wheezing
- you think they could be having an allergic reaction
- you’re worried
If your child has had a daily cough for longer than 4 weeks, take them to a health professional.
A daily cough for more than 4 weeks is not normal and may be a sign of more serious disease.
See a health professional urgently
See a health professional urgently if your child has a cough and:
- is under 3 months old
- is struggling to breathe
- can’t finish a whole sentence
- is struggling to feed
- you think they’ve choked on something
- you're worried
Call 111
Call 111 within New Zealand (use the appropriate emergency number in other countries) and ask for urgent medical help if your child:
- is blue around the mouth
- is unable to breathe
- is hard to wake
- is choking and can’t breathe
- is floppy
- you're worried
Wet cough lasting more than 4 weeks
If your child has a wet cough lasting more than 4 weeks, they may have a more serious disease such as bronchiectasis. It's very important to recognise this early. Take your child to a health professional.
Watch this video featuring former Warriors rugby league player Wairangi Koopu. It focuses on recognising the signs of infection that can lead to bronchiectasis, and acting on them.
A long-lasting wet cough can lead to the development of lung diseases such as bronchiectasis. See a video narrated by former Warriors rugby league player Wairangi Koopu. It focuses on recognising the signs of infection that can lead to bronchiectasis, and acting on them.
Source: Ministry of Health and Health TV
transcribeTranscript
Wairingi Koopu (rugby league star):
Can you hear that? This is the sound of a child with chronic persistent wet cough. Scary, isn’t it? Whānau, this is a serious warning sign and should not be ignored. Your child needs urgent medical attention.
What is chronic persistent wet cough?
Dr Cass Byrnes (paediatric respiratory specialist, Starship Hospital):
A chronic persistent wet cough is a mucousy phlegmy fruity-sounding cough. It sounds like the children have got mucus down in their chest and it usually occurs most days and can go on for weeks at a time.
Here is an example.
This cough is not normal and may be a sign that your child has a serious chest infection. It is important that your child sees a doctor as they could develop a serious lung disease.
What happens if chronic persistent wet cough is not treated?
If a chronic persistent wet cough is not treated it can go on for weeks and even months, and it’s a sign that there’s an ongoing chest infection in the lungs and it essentially is causing some permanent scarring in the lungs.
Wairingi Koopu:
Chronic persistent wet cough if left untreated can lead to lung damage and disease such as bronchiectasis.
What is bronchiectasis?
Bronchiectasis is a chest disease in which the breathing tubes called bronchi in the lungs become damaged and enlarged. Tiny hairs called cilia line the inside of these breathing tubes. These hairs help to collect any phlegm or mucus from the lungs.
When your child has bronchiectasis their lungs make more mucus than normal. The tiny hairs that should clear the mucus stop working properly and the mucus gets stuck in the breathing tubes. It is within this extra mucus that germs grow and cause infection.
These infections cause damage and scarring to the breathing tubes and lungs. The breathing tubes become baggy and holes form in the lungs. Once this has happened the scarring and damage cannot be fixed.
What causes bronchiectasis?
Dr Cass Byrnes:
Bronchiectasis is a type of permanent lung scarring which is caused by having ongoing infection in your lungs. That mucus means that there’s mucus and bugs down there and it’s breaking up some of the lung walls and doing lung damage.
What are the symptoms of bronchiectasis?
Wairingi Koopu:
Children with bronchiectasis will feel well most of the time but the main symptom to look out for is the chronic persistent wet cough. This cough produces a build-up of phlegm which may be yellow or green in colour and smelly, showing signs of infection. It is important that you seek medical attention if your child has these symptoms.
What happens if we ignore this symptom?
Dr Cass Byrnes:
Ignoring the chronic persistent wet cough means that you’re going to go on and develop more and more lung scarring. That cough shows that there are problems in the lung. It shows that there is a build-up of mucus, that there is infection and the more and longer that that goes on, the more damage that that lung is going to have permanently lifelong, and set the child up for recurrent further infections.
How can bronchiectasis be prevented?
Wairingi Koopu:
By:
not smoking during pregnancy
breastfeeding our tamariki
early detection and treatment of chest infections in childhood
improving living conditions
eating a healthy balanced diet
immunisation.
We visit the Hiko whānau who deal daily with the effects of having tamariki with bronchiectasis.
Henrietta Hiko (mother of twins):
The illness has changed our lives immensely. I have to give up everything pretty much to go back and forth to the hospital when the girls are sick. They’re sick at the moment but they don’t look it, but I know that they’re sick.
How can a parent manage bronchiectasis? What can they do?
Kimberley Taylor (physiotherapist, Hawkes Bay District Health Board):
Some easy ways that parents can help to manage their tamariki’s bronchiectasis are to get them more active. Exercising outside, running around, on the trampoline, anything that makes them huff and puff, because when you’re huffing and puffing you’re getting air circulating all the way down to the bottom of your lungs and that helps to shift the mucus.
Other things that are really good to help with managing bronchiectasis are to keep your whare auahi kore – so keeping your tamariki smoke-free and telling your whānau to keep outside of the whare when they’re smoking and out of the waka when they’re smoking.
Wairingi Koopu:
If you are concerned about your child's health, please seek medical attention.
For more information please visit the Asthma Foundation website.
Treatments for cough in children
Most tamariki with a cough don't need medical treatment. The cough usually gets better within 2 to 3 weeks.
Avoid cough medicine
Cough medicines are not useful for treating cough. Avoid giving your child cough medicine unless recommended by your health professional.
Antibiotics don't help coughing caused by a viral infection
Antibiotics are not helpful for a cough caused by a viral infection. If the cause of your child's cough is a bacterial infection in the throat or chest, your health professional may prescribe antibiotics.
Honey may be helpful
Honey may be helpful for a cough caused by a cold. But, wait until your baby is at least 12 months old before giving them honey - it can make young pēpi (babies) sick.
Paracetamol if needed
You can give paracetamol if your child is in discomfort or miserable with a fever. You must follow the dosage instructions on the bottle or packet. It is dangerous to give more than the recommended dose.
Keeping children well
There are some things you can try to reduce your child’s chances of becoming unwell with a cough.
Breastfeeding
Breastfeeding pēpi protects them from illness by boosting their immune system. Breastfeeding beyond 4 months of age offers the best protection.
Smoke-free and vape-free environment
Make sure your child’s environment is smoke-free and vape-free.
If you want to give up smoking or vaping:
- call the free Quitline Me Mutu on 0800 778 778 or text 4006
- check out the Quitline - Me Mutu website
- ask your health professional
A warm house
Keeping the house warm and well-insulated will also decrease your child’s chance of becoming unwell with a cough.
Immunisation
Make sure your child is up to date with all their vaccinations. Vaccination can help prevent many coughing illnesses including:
- whooping cough
- pneumonia
- flu
Stay away from people with coughs and colds
Try to keep young pēpi away from people who have coughs and colds.
Hand hygiene
Use hand sanitiser or encourage frequent hand washing with soap and water to reduce the spread of infections.
