Causes of Chronic Cough in Children

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A child's persistent cough can be a source of significant worry for parents. Chronic cough in children is a common issue, affecting 5% to 10% of children in the U.S. annually. It's one of the top reasons for pediatric doctor visits, accounting for 30 million office visits each year. But what causes a kid with a constant cough? Let's delve into the common and rare causes of chronic cough in pediatrics.

Causes of Chronic Cough in Children

Understanding Chronic Cough

Coughing is a natural response to an irritant in the airway. When the nerves in the airway sense an irritant, they send a message to the brain to clear the breathing passages. However, when a cough persists for more than four weeks, it's considered chronic and warrants medical attention.

Common Causes of Chronic Cough

Allergies and Sinusitis

Allergic rhinitis and chronic sinusitis are two of the most common causes of a child's cough. Children with allergic rhinitis sneeze frequently, have clear mucus drainage from the nose, and may have itchy eyes. Chronic sinusitis involves more than 12 weeks of symptoms, including thick, yellow-green nasal drainage. Both conditions often lead to post-nasal drip, causing a cough that worsens when the child lies down.


Asthma can present with a chronic cough as the only symptom. A cough that is present after a child falls asleep is suggestive of asthma. During the night, the body's levels of cortisol, a key hormone, naturally decrease, triggering asthmatic bronchospasm, where the air passages become inflamed and narrow.

Whooping Cough

Pertussis, better known as whooping cough, is a bacterial infection that can cause uncontrollable coughing. A cough from pertussis could last for months, and complications can be serious, including pneumonia, seizures, and in some cases, death.

Rare Causes of Chronic Cough

Cystic Fibrosis

In rare cases, a persistent cough may be a sign of cystic fibrosis, a progressive genetic disease that causes persistent lung infections. Symptoms may include loose stools, persistent coughing, recurrent respiratory infections, and prolonged symptoms of bronchiolitis.


Coughing that occurs while eating or drinking could be a sign of aspiration, where swallowed food or liquids pass into the lungs. This can be due to vocal cord paralysis or other neurological conditions that cause decreased sensation in the upper airway.

Acid Reflux

Acid reflux can also contribute to the development of chronic cough in children. Stomach acids are not meant to move upward from the stomach into the esophagus, but when it happens, it can trigger a cough reflex. Reflux-related cough is typically a dry cough that happens more during the daytime when a child is in an upright position.

Airway Blockage

In some cases, chronic coughing could be a sign that a foreign object has become stuck in the child’s airway. If your child has a chronic cough that develops after a choking event, seek medical care immediately.

Habit Cough

Sometimes a cough will develop in response to an irritant in the airway, but persist after the original cause has resolved. Habit coughing is typically "honking" in nature, and it's distractible — if the child is preoccupied, the cough will disappear. The cough is also not present once the child has fallen asleep.

In conclusion, a chronic cough in children can be a symptom of various conditions, from common allergies to rare diseases like cystic fibrosis. If your child has a persistent cough, it's essential to seek medical advice to identify the cause and start appropriate treatment.


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