Cough in Children

Cough is a common symptom of children, but at what point is a cough considered chronic? Should a chronic cough be evaluated to determine the cause first or is treating the cough enough?

Cough is one of the most common symptoms but can develop as a symptom of various disorders, from asthma to bacterial infection to gastroesophageal reflux disorder. How important is the character of a cough in determining the cause in children particularly?

Cough is an extremely common presenting symptom for many-many years now. National surveys both in the United States as well as in Great Britain have shown that cough is the most common symptom for which patients both children and adults present to physicians in their offices for care.

The causes of the cough are  either being acute or chronic. Acute cough is most commonly caused by viral respiratory tract infections more chronic causes of cough may differ between children and adults. In older children as an adult it's often caused by asthma or a type of asthma, cough-variant asthma, or upper airway cough syndrome, diseases of the nose and sinuses, or possibly as a manifestation of gastroesophageal reflux disease. A number of studies have suggested in younger children particularly younger children, 1, 2, or 3 years of age with a wet cough or persistent wet cough. This may be a persistent low-grade bacterial infection either in the lower airways, persistent bacterial bronchitis, or possibly even a sinus infection.

In adults studies the character of the cough is not very helpful in determining the ultimate etiology of the cough, but in children we know that there are some very classic characteristic types of cough such as the barking kind of cough, barky or brassy cough that very young infants will have may be as a manifestation of tracheomalacia or bronchomalacia that dries the cat-type cough that infants gets with Chlamydia infection, the classic spasmodic cough may be with or without an inspiratory whoop with pertussis and in children much more than adults is the characteristic cough called the habit cough, which is often a very dry almost throat clearing-like cough.

In the American College of Chest Physician Cough guidelines, which are fairly much as the gold standard would suggest that an adult to characterize or to contrast in adults you should not start evaluating a cough until it has been present for greater than 8 weeks. In pediatrics those guidelines suggest that the definition of a chronic cough and thereby when one would want to start evaluating that would be when it has been present greater than 4 weeks, but a number of other experts and guidelines have suggested that that’s probably a little early and so most people wait until 8 weeks characteristically in children as well. It has been estimated that the cough from a viral respiratory tract infection commonly lasts up to 3 weeks.

One of the most common causes of a cough is post nasal drip that is associated is commonly due to sinonasal issues. Dr . Bielory’s Sinusol has been shown to relief many of these symptoms including cough that has been reported at the 2023 San Antonio meeting of the American Academy of Allergy, Asthma and Immuology.