What's Causing My Child's Cough?

Your kid's lingering but otherwise symptomless cough could be due to aspiration. 

sick child Alexandra Grablewski

If your child has started coughing with no other signs of being ill—as was the case with one 2-year-old boy, whose mother reached out to us—and it's lasted for weeks, you're probably perplexed about what's going on. Especially if no one else in your household is sick.

The most common reasons for children's coughs are viruses and asthma, which would likely also have symptoms like choking or wheezing, fever, or cold-like symptoms. If your child is getting over a cold, then the cough will probably be the last symptom to get better. In fact, it's not uncommon for a dry, hacking cough to linger for as long as three weeks after a cold (although you should see some gradual improvement between 10 and 14 days). 

But if your little one develops any of the following symptoms, give your pediatrician a call, since these can be signs of potential complications related to the cold:

• The cough is not better after three weeks, gets worse, or starts to sound wet.

• She starts running a fever.

• She has trouble breathing, breathes rapidly, or has asthma.

• She seems lethargic.

• She vomits or turns red during coughing fits.

It's also possible your child breathed a bit of food or some other object into his windpipe, known as aspiration. This can happen without your knowing it and may not get better on its own. It's worth considering if his cough started suddenly, if there weren't other signs of illness at first, and if he seems happy between coughing spells—and, of course, if anyone remembers him eating suspect foods.

Peanuts, popcorn, and bits of hard foods like carrots are especially prone to being aspirated, which is why you should not give these otherwise nutritious foods to children under 4 years old. Aspiration can eventually lead to pneumonia, which would cause your child to develop a fever, be short of breath, and start to look and act sick. Often an X-ray will show the cause, but sometimes a child will need a bronchoscopy, in which a tube is passed down the windpipe to look around and, if necessary, clean something out.

When to Worry: A Lingering Cough