Cough

What’s “normal” — and when a cough becomes “persistent”

• Many coughs after viral infections gradually settle, but the cough can take 2–3 weeks to fully fade. 

• If a cough lasts longer than ~3 weeks, it’s reasonable to speak to a clinician for advice.

• In paediatrics, we often describe chronic cough as >4 weeks, and many children will still improve with time — but this is the point where we start thinking more systematically. 

 

Common reasons children cough for weeks

The pattern of the cough (dry vs wet, day vs night, with exercise, after colds, etc.) often points us in the right direction.

Common causes include:

• Post-viral cough (airways are “irritable” after infection) 

• Asthma or cough-variant asthma (often with exercise, at night, or with triggers)

• Upper airway cough (nasal congestion/post-nasal drip)

• Protracted bacterial bronchitis (PBB) (typically a wet cough that persists)

• Reflux (in some children, especially if symptoms fit)

 

What you can do now (simple, sensible steps)

• Keep a short “cough diary” for 7–10 days: when it’s worst, what triggers it, whether it’s dry/wet, any wheeze/breathlessness, sleep disturbance, fevers, or reduced exercise tolerance.

• Focus on hydration, gentle measures, and avoiding irritants (especially smoke/vapes).

• If your child uses inhalers already: check spacer/inhaler technique — it makes a huge difference. 

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Red flags — when to seek urgent help

Seek same-day medical advice (or urgent care) if your child has:

• Breathing difficulty, struggling to speak/cry in full sentences, or significant “work of breathing”

• Blue lips/face, unusual drowsiness, or episodes of collapse

• Coughing up blood

• Persistent high fever, severe chest pain, dehydration, or you are seriously worried

If you think your child is severely unwell, call 999.

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How SPRClinic helps

Our aim is to replace uncertainty with clarity and a plan. Typically, we will:

• Take a careful history (including triggers, infection pattern, sleep, exercise)

• Examine your child and review any previous letters/investigations

• Consider tests such as spirometry (breathing test) where age-appropriate

• Decide whether a period of watchful waiting is appropriate, or whether we should investigate/treat promptly

• Leave you with clear safety-netting and a written next step

 

Helpful links (reliable, parent-friendly)

• NHS advice on coughs/colds and when to seek help 

• Healthier Together (NHS) safety-netting for cough/colds