Coughs lead to more than 30 million doctor visits a year and can last for weeks on end. Why do coughs linger for so long? Is a child’s cough different than yours? And when is that doctor’s visit necessary?
We turned to Paula Brito, MD, a pediatrician at the Fairview clinic in Brooklyn Park, and Jenikka Soyring, a nurse practitioner at our Edina clinic, for answers.
While bonfire smoke or cold winter air can cause a cough or two, longer bouts are typically a symptom of another condition, from the cold or the flu to a host of other illnesses.
“The main issue with a cough is to find out and treat the cause of the cough,” says Dr. Brito. “For example, is your child coughing because they have pneumonia, or because of post-nasal drip? Do they have an ear infection, or do they have asthma?”
A cough is a medical emergency and you should go to the emergency room if it produces blood or pink or frothy mucus, comes with notable chest pain or a high fever, or if it causes significant trouble breathing or swallowing.
In the case of a child’s cough, Dr. Brito recommends parents listen to their gut.
“There are many causes of cough, so it is hard to generalize when you should make an appointment,” Dr. Brito says. “I always advise parents to follow their instincts. Do not wait to see a doctor if you think your child needs to be seen.”
It’s time to make a clinic appointment if your child’s cough lasts more than a week. Come in sooner when a cough is harsh and barking or accompanied by:
“You can schedule an appointment any time you have any concerns,” Soyring says. “We are always more than happy to discuss the typical course of the illness and what to expect.”
How long the cough lasts depends on what’s causing it and what you can do to treat that condition. Because the majority of coughs are caused by a virus, medications won’t heal the cough itself.
As long as you’re treating the cause of the cough, there are some ways to soothe your coughing symptoms. Cough medicine, however, is not recommended.
For young children, cough medicine can be dangerous. The American Academy of Pediatrics does not recommend using over-the-counter medicines to treat coughs for children younger than 4 years old due to their possible side effects. Many experts, including Dr. Brito, preach more caution.
“I actually do not recommend any over-the-counter medication for my patients,” says Dr. Brito. “We need to treat why the child is coughing and not just sedate the cough."
While cough medicines aren’t dangerous for adults, Soyring says they’re not very effective either.
“Cough medications actually work rather poorly, because coughs are very complex,” Soyring says. “There are different cough medications that either decrease the urge to cough or thin the secretions that can produce a cough, both of which do not provide much relief.”
As long as you’re treating the cause of the cough, you can soothe coughing symptoms without medicine.
A teaspoon of honey helps with a cough, as long as the person is older than 1 year old. Honey is not recommended for children younger than that. For a child, you can also try:
For adults, while herbal remedies like elderberry and Echinacea don’t heal a cough, you may experience other benefits.
"Elderberry and Echinacea do actually work fairly well for shortening the length of symptoms and decreasing the severity of a cold. I have several patients who swear by this," Soyring says. "Of course, nothing is perfect. But anything to help take the edge off is usually welcomed!"
Getting over the initial condition that causes the cough doesn’t mean the cough goes away with it.
In general, coughing is a response to a blockage or irritation in your airways. While the condition you have causes the cough, a long bout of coughing also causes more irritation itself — ironically leading to more coughing. The healing process for the respiratory system can be slower than in other parts of your body, too.
“Coughs can last longer due to something called post-viral syndrome,” Soyring says. “After a viral infection, tissues and chemicals in the body are out of balance and can cause a cough to last for up to three months.”
If you’re still coughing but feel better, good news: Coughs aren’t contagious in and of themselves. You can return to regular activities if you’ve identified what’s causing your cough and that it's no longer contagious.
For children, check with your school’s policies on when to return to school following an illness.
“I normally tell parents to keep children with a cough home until they have been at least 24 hours without fever,” says Dr. Brito. “For unvaccinated children, there is the risk that they have pertussis or whooping cough. In that case, it is very contagious.”
For adults, the advice is similar.
“The viruses that cause a cough are most contagious in the first three or four days of the illness. After that, there’s less risk,” Soyring explains. “Going back to work depends on the job, but usually we recommend being fever-free for 24 hours or at least waiting it out the first four days.”