Chronic Cough in Children: Causes, Diagnosis, and Recommendations By Dr. Narmin Azizova & Dr. Ali Guliyev

Öskürəklər Xəbərlər
06 May 2025

What is a cough and why does it happen?
Coughing is a protective reflex that helps clear the airways of foreign particles and secretions and prevents aspiration (inhalation of food or objects into the lungs). It is part of the body’s natural defense system. Even healthy children may cough up to 11 times a day on average.

When is a cough considered chronic?
Cough is categorized by its duration:

  • Acute cough: Lasts up to 4 weeks
  • Subacute cough: Lasts 4–8 weeks
  • Chronic cough: Persists for more than 8 weeks

Note: The American College of Chest Physicians defines chronic cough as lasting more than 4 weeks, while the British Thoracic Society considers it chronic only after 8 weeks.

Common causes of chronic cough in children

  • Infections: RSV, adenovirus, Mycoplasma, Chlamydia, whooping cough, tuberculosis
  • Bronchial asthma
  • Postnasal drip syndrome
  • Gastroesophageal reflux disease (GERD)
  • Foreign body aspiration
  • Cystic fibrosis, Primary ciliary dyskinesia (PCD)
  • Immune deficiencies
  • Congenital airway anomalies
  • Neurological or psychogenic causes

Age-specific common causes

Infants: GERD, protracted bacterial bronchitis (PBB), cystic fibrosis, tracheomalacia
Preschool-aged children: Asthma, viral infections, foreign body aspiration
School-aged children: Asthma, psychogenic cough, bronchiectasis

Key clinical clues for parents and physicians

  • Sudden onset: May suggest foreign body aspiration
  • Worsens during sleep, exercise, or cold air: Possible asthma
  • Worsens after meals or when lying down: Could indicate GERD
  • Present in the morning but not at night: Could be psychogenic cough
  • Family history of illness or night sweats: Suspect tuberculosis
  • Persistent cough after pneumonia: Risk of bronchiectasis

Recommendations for parents

  • If your child’s cough lasts more than 4 weeks, a doctor’s evaluation is necessary.
  • If you suspect your child has inhaled a foreign object, do not delay – it can cause serious damage.
  • Avoid using cough suppressants without knowing the cause – they may be harmful in some cases.
  • Treatment should always be tailored to the underlying cause.
  • Follow-up evaluations are essential, as the root of the problem may not be found on the first visit.