Coughing is one of the most common symptoms of illness in children1 and the most common symptoms for which children visit their healthcare provider2. While coughing can cause your child a lot of discomfort, it is an important reflex that helps protect the airways in the throat and chest1,3.

Coughing can disturb sleep for many children, and parents, as well as being highly disruptive to many children’s sport and school activities2.

An acute cough in children can have a different cause than in adults, meaning that a child’s cough needs to be assessed and treated differently4.

There are two main types of cough associated with a viral infection like a cold or flu, namely a wet or dry cough3. Knowing what type of cough it is, and how to describe it can be very helpful3.

A dry, hacking cough is often caused by a viral infection of the upper respiratory tract (nose and throat), such as a cold or flu3. A dry cough can also be an early sign of an infection of the lower respiratory tract, as with bronchitis (the inflammation of the smallest airways in the lungs) or pneumonia (the inflammation of the lung tissue itself). Asthma can also be another cause of a dry cough3.

A wet productive cough can be caused by a viral infection of the lower respiratory tract. It causes excessive production of mucus in the lungs which will need to be removed to prevent further infections3. A child’s cough is often worse when he or she is lying down because the mucus can collect in the back of the throat. Children also tend to swallow the mucus, rather than spit it out which can further cause an upset stomach or vomiting, especially when there is a coughing fit3.

Another common but more serious condition that causes a cough is croup. Croup is an illness that causes a harsh bark sounding dry cough. Croup causes the swelling of the upper airway of the respiratory tract, which can make it difficult for the child to breathe. It is more common in children under the age of 3 and is usually caused by a viral infection1,3,5.

Whooping cough is a cough caused by a bacterial infection1,6. Although it causes symptoms similar to the common cold, the cough becomes identifiable by the “whooping” sound made when a child takes a deep breath 1,3. The cough gradually worsens and can result in severe fits of deep fast coughing, especially at night,3,7.

A new factor for parents to also keep in mind is that a cough, especially when accompanied by a sore throat and a high fever, could also be symptoms of COVID-198,9.  Clinical data has shown that many children are asymptomatic and do not show symptoms of COVID-1910. However, if your child has any of these symptoms, please consult your healthcare practitioner: Fever, exhaustion, a bad headache, trouble breathing, confusion, sore throat, a tummy ache and pain or pressure in the chest8,9.

Distinguishing between cough types and identifying the cause of your child’s cough can be difficult. It. If you are concerned about your child’s cough, speak to your pharmacist or healthcare provider.

DISCLAIMER: This editorial has been commissioned and brought to you by iNova Pharmaceuticals. Content in this editorial is for general information only and is not intended to provide medical or other professional advice.

Name and business address of applicant: iNova Pharmaceuticals (Pty) Limited. Co. Reg. No.1952/001640/07, 15E Riley Road, Bedfordview. Tel. No. 011 087 0000. Further information is available on request from iNova Pharmaceuticals. For more information, speak to your healthcare professional. IN4117/21


  1. What are Coughs? Kid’s Health ( Website accessed on 13 February 2021.
  2. De Blasio et al. An observational study on cough in children: Epidemiology, impact on quality of sleep and treatment outcome (2012)
  3. Cough Symptoms and Treatment. ( ) Website accessed on 13 February 2021.
  4. Worrall, G. Acute cough in children Diagnosing ARIs Series Canadian Family Physician Vol 57 March 2011
  5. What is Croup – Kid’s Health ( Website accessed on 18 June 2018
  6. Difference between whooping cough and croup – Difference Between Net ( Website accessed on 12 March 2021
  7. Whooping cough – Mayo Clinic ( Website accessed on 12 March 2021
  8. Kids Health. The Nemours Foundation. Is It a Cold, the Flu, or COVID-19? (2021. Website accessed on 13 February 2021.
  9. World Health Organisation. Coronavirus Symptoms. Website accessed on 12 March 2021.
  10. Information for pediatric healthcare providers. Updated 30 December 2020. Website accessed on 12 March 2021.