What Causes Persistent Cough in Children and How to Treat It
A persistent cough in children can be frustrating and worrying, especially when it lingers for weeks with no obvious explanation. While most coughs are harmless and linked to temporary infections, some cases point to deeper respiratory or ENT-related concerns that need specialist care.
Understanding what causes chronic cough, how to recognise the symptoms, and when to seek help can make a significant difference in your child’s recovery and overall well-being. This article outlines the key reasons behind long-lasting cough in children and explains what you can do to manage it effectively.
How Do You Know If a Cough Is Persistent?
Coughs in children are often caused by viral infections and usually resolve within one to two weeks. However, if your child has been coughing continuously for more than four weeks, it is considered a persistent or chronic cough.
In addition to duration, parents should watch for other red flags:
- Coughing that worsens at night or with activity
- Difficulty sleeping or concentrating during the day
- Signs of wheezing, breathing discomfort or fatigue
- No improvement despite over-the-counter medication
If any of these are present, it is advisable to consult an ENT specialist to rule out more serious conditions.
What Are the Common Medical Causes of Persistent Cough in Children?
Several health conditions can lead to ongoing coughing in children, some of which are ENT-related or affect the airways. Identifying the root cause is essential to prescribing the right treatment.
Asthma
Asthma is a frequent cause of chronic cough in children, especially if the cough becomes worse with exercise, laughter, or cold air. Wheezing or shortness of breath may also accompany it. In some children, a cough is the only symptom, known as “cough-variant asthma.”
Allergies and Post-Nasal Drip
Children with environmental allergies often suffer from a nasal drip, where mucus trickles down the throat and triggers coughing. This is commonly linked to allergic rhinitis and may occur seasonally or year-round, depending on the allergen.
Sinusitis
Chronic sinus infections can lead to a persistent, dry cough caused by mucus draining into the throat. Other symptoms include a blocked nose, facial pain and frequent colds that don’t seem to clear.
Gastroesophageal Reflux (GERD)
In some cases, stomach acid may travel up the oesophagus and irritate the throat, causing a cough. GERD-related cough often appears after meals or when lying down.
ENT Issues and Airway Obstruction
Enlarged adenoids, chronic nasal congestion or persistent tonsil inflammation can all contribute to chronic coughing. These conditions often lead to noisy breathing or snoring and are typically managed by a paediatric ENT.
To explore ENT-related causes in detail, visit our dedicated persistent cough in children page for additional guidance.
How Is Persistent Cough Diagnosed?
Diagnosis begins with a full review of your child’s medical history, including symptom patterns, environmental triggers and any prior treatments. An ENT specialist may also ask about your child’s sleeping habits and exposure to allergens.
Tests and Examinations That May Be Recommended:
- Nasal endoscopy to assess for sinus or adenoid issues
- Lung function tests to evaluate asthma
- Allergy testing for suspected environmental sensitivities
- Chest X-rays to rule out infection or structural problems
Early and accurate diagnosis helps avoid unnecessary medications and ensures your child receives the right treatment as quickly as possible.
Our Kids ENT service provides a comprehensive approach to paediatric ENT conditions, including persistent cough.
What Treatments Are Available for Chronic Cough in Children?
Once the underlying condition is identified, treatment is tailored to your child’s needs.
Medical Treatments:
- Inhalers or asthma medications for airway inflammation
- Antihistamines and nasal sprays for allergy-related cough
- Antibiotics for bacterial sinus infections
- Acid suppressants for reflux-induced cough
Home Care and Lifestyle Support:
- Using a humidifier in dry or air-conditioned rooms
- Keeping the child away from smoke and airborne irritants
- Elevating the child’s head while sleeping
- Encouraging hydration and rest
In some cases, if anatomical issues like enlarged tonsils or adenoids are identified, your doctor may discuss the option of minor surgery to improve breathing and reduce chronic coughing.
If symptoms persist despite initial care, don’t hesitate to reach out to our team for further evaluation.
When Should You Be Concerned Enough to See a Specialist?
You should book an appointment with an ENT specialist if your child:
- Has been coughing continuously for more than four weeks
- Struggles to sleep due to coughing
- Shows signs of breathing difficulties or noisy breathing
- Has had multiple unexplained infections in a short period
Seeking professional help early can save time, prevent complications and reduce stress for both the child and parents.
Conclusion
Persistent cough in children is not something to ignore. While it can be caused by something as mild as allergies or a past cold, it may also be linked to asthma, reflux, or ENT conditions that require targeted care. Understanding the causes and getting the right diagnosis is the first step to long-term relief.
If your child’s cough isn’t going away, consider seeking specialist support. With the right medical approach and a bit of patience, most children can return to normal activity and comfort without long-term issues.
Frequently Asked Questions
Persistent cough in children can stem from various conditions. Common causes include asthma, where inflammation narrows the airways; allergic rhinitis, leading to postnasal drip; sinusitis, causing mucus accumulation; gastroesophageal reflux disease (GERD), where stomach acid irritates the throat; and protracted bacterial bronchitis, a prolonged infection of the bronchial tubes. Less frequently, conditions like whooping cough (pertussis), exposure to environmental irritants, or structural abnormalities in the airways may be responsible.
A typical cough from a cold or mild infection usually resolves within one to two weeks. However, if your child’s cough persists beyond four weeks, worsens at night, is accompanied by wheezing, breathing difficulties, or affects their daily activities and sleep, it’s advisable to consult a healthcare professional. Persistent coughs may indicate underlying conditions that require specific treatments.
To determine the cause of a persistent cough, doctors may begin with a thorough medical history and physical examination. Depending on the findings, they might recommend tests such as chest X-rays to visualise the lungs, spirometry to assess lung function, allergy testing, or nasal endoscopy to examine the nasal passages and sinuses. These tests help in pinpointing the exact cause and guiding appropriate treatment.
Treatment depends on the underlying cause. For asthma-related coughs, inhaled corticosteroids and bronchodilators are commonly prescribed. Allergic rhinitis may be managed with antihistamines and nasal sprays. Bacterial infections like protracted bacterial bronchitis often require antibiotics. GERD-related coughs might be treated with dietary modifications and acid-suppressing medications. It’s essential to follow a healthcare provider’s guidance to ensure effective management.
Yes, environmental factors can play a significant role. Exposure to tobacco smoke, air pollution, mould, or allergens like dust mites and pet dander can irritate a child’s airways, leading to chronic coughing. Ensuring a clean living environment, using air purifiers, and minimising exposure to known irritants can help reduce the frequency and severity of coughs related to environmental factors.