If coughing hangs on, with little sign of improvement, your child may have what is known as a chronic cough – a condition that is generally defined as a cough persisting longer than four weeks. Treating such a condition is generally only successful once the underlying cause is identified and, because various conditions can be responsible, this is usually done through a painstaking process of elimination.

For parents and carers, any childhood illness - even those as seemingly mundane as a cold, is taxing as it can have a dramatic effect on quality of life.
Personally, after many sleepless nights, I made several trips to our local healthcare professional and undertook a lot of research to discover that chronic cough, although stressful, is not altogether uncommon. It can occur in kids for a variety of reasons:

Here is a list of some of the more common causes and a brief explanation of each:

Bacterial bronchitis
In a study of 108 children at the Royal Children’s Hospital in Brisbane, later published in the medical journal Chest, bacterial bronchitis was the most common cause for chronic coughs. Parents should be aware that persistent bacterial bronchitis in children is often misdiagnosed as asthma (although the two can coexist) due to similar symptoms.
 
Childhood asthma
Although common in kids, asthma affects people of all ages, causing difficulty breathing that often – although not always, is accompanied by wheezing. Common triggers include exposure to cold air, environmental pollutants and cigarette smoke. Sometimes, the sole symptom is a persistent cough - known as cough-variant asthma but usually, the signs include some or all of the following:

• A whistling or wheezing sound when breathing out
• Shortness of breath – which may limit play or exercise
• Chest congestion or tightness
• Chest pain - particularly in younger kids
• Trouble sleeping – perhaps due to shortness of breath, coughing or wheezing
• Bouts of coughing or wheezing that get worse with a respiratory infection

Post-nasal drip
Post-nasal drip generally occurs when excessive mucus is produced and drains from the back of the nose into the throat. It can be caused by conditions such as rhinitis or inflammation of the nasal mucous membranes, sinusitis or sometimes can be due to allergies. Along with coughing, a tickling at the back of throat and sinus congestion are common symptom.

Aspiration of foreign object and habitual coughs
Although fairly rare, accidental inhalation of a foreign object like a small toy, can cause a persistent cough. It most commonly occurs in children aged two to four years old.  Children of any age can also develop a habitual cough that is typically dry sounding and occurs only while the child is awake, not asleep. Habit coughs may persist for weeks or months and sometimes there may be no clear physical cause.

Coughs and colds are amongst the most common childhood ailments and they are often not a major source of concern. But it is important that a distinction between acute and chronic conditions is made and, when symptoms persist for more than four weeks at a time, expert medical advice is sought and appropriate action taken.

References available on request

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