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Child Health Guideline Identifier


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This guidelines outlines the investigation of chronic cough and /or confirmed Bronchiectasis


Cough is a common symptom in children that is usually short-lived. Children without a recent cold may cough between 1 and 34 times a day. However, a chronic cough of 3 weeks or longer is unusual. Daily cough for greater than 4-6 weeks may mean there is an underlying lung disease. A comprehensive clinical history and examination together with appropriate investigations and follow up are recommended. The reader is referred to review articles on the topic (see References)

What questions to ask?

What is the cough like?

  • Is it a dry cough?
  • Is it a wet cough?

Does the child produce spit or phlegm?

When does the child cough?

  • At night?
  • With exertion?
  • Early in the morning?

Are there any other associated respiratory symptoms?

  • Wheeze?
  • Whistling in the chest?
  • Fast breathing?
  • Shortness of breath?


The following charts show investigations commonly performed by the Paediatric Respiratory Service at Starship in the assessment of children with chronic cough or confirmed bronchiectasis. These investigations are usually undertaken serially depending on the clinical setting. The investigations seek to define not only aetiology but also disease severity.

Investigations - Stage I

Stage 1

Investigations - Stage 2

Cough Stage 2

Information for Families

Link to the video - Cough Free: the way to be featured on the Kidshealth website


Pattemore PK. Persistent Cough in Children. NZFP. 2007; 34 (3):432-6.

Chang  AB, Landau LI, Van Asperen PP, Glasgow NJ, Robertson CF, Marchant JM, et al. Chronic cough in children: Definitions and clinical evaluation. Position statement of the Thoracic Society of Australia and New Zealand. Medical Journal of Australia. 2006;184(8):398-403.

Munyard, Bush. (1996). How much coughing is normal? Arch Dis Child, 74: 531-4. 

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Document Control

  • Date last published: 01 August 2008
  • Document type: Clinical Guideline
  • Services responsible: Paediatric Respiratory
  • Author(s): Elizabeth Edwards
  • Editor: Greg Williams
  • Review frequency: 2 years

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