Cough: causes, how long it lasts, treatment and when to see a GP

Colds are common in pregnancy. The UK Teratology Information Service (UKTIS), which runs the Best use of medicines in pregnancy (BUMPS) leaflets, says colds are usually mild, get better after a few days and will not harm the baby, and can usually be treated at home with paracetamol and self-care such as rest and plenty of fluids.

UKTIS says ibuprofen and decongestant nasal sprays, drops or tablets should be avoided in pregnancy, and that some over-the-counter cold remedies contain a decongestant, so ask a pharmacist. This matters because the general NHS advice on coughs mentions ibuprofen and herbal medicines, and the NHS itself notes that some medicines and herbal treatments are not safe for everyone, for example if you are pregnant. Always check the leaflet or speak to a pharmacist before taking them.

Flu is less common than colds, but UKTIS says pregnant women are slightly more prone to flu complications such as pneumonia and are more likely to need hospital care. Pregnant women who think they might have flu should speak to a doctor, who may offer antivirals. UKTIS notes that flu vaccination is offered in pregnancy. The NHS also says that if you are pregnant and have been in contact with someone with whooping cough you should ask for an urgent GP appointment or call NHS 111, and that it is important for anyone who is pregnant to get vaccinated against whooping cough.

NHS inform says treatment is not always necessary for short-term coughs, because they are likely to be a viral infection that will get better on its own within a few weeks. The NHS says there is usually no need to see a GP and advises you to rest, drink plenty of fluids, and try to stay at home and avoid contact with other people if you have a high temperature or do not feel well enough to do your normal activities.

You can also try paracetamol or ibuprofen for any pain, hot lemon and honey, or a herbal medicine called pelargonium (suitable for people aged 12 or over). The NHS points out that there is limited evidence that hot lemon and honey and herbal medicines help ease a cough.

A pharmacist can advise about cough syrup, cough medicine and cough sweets. The NHS says these will not stop your cough but may help you cough less, and that decongestants and cough medicines containing codeine will not stop your cough. If your cough has a specific cause, NHS inform says treating that cause may help, as in the table below.

The NHS says a cough will usually clear up on its own within 3 to 4 weeks. NHS inform says most coughs clear up within 3 weeks. A cough that lasts more than 3 weeks is called a persistent cough, and both the NHS and NHS inform say to see a GP about it.

Some infections cause a cough for longer. The NHS says whooping cough may cause a cough that lasts for several weeks or months. NHS inform notes that often the cause of a persistent cough is unknown, and that sometimes it is due to asthma, an allergy, smoking, bronchiectasis, reflux or a prescribed medicine.

The NHS suggests a hot lemon and honey drink as a home remedy. To make it, squeeze half a lemon into a mug of boiled water and add 1 to 2 teaspoons of honey, then drink it while still warm. Do not give hot drinks to small children, and do not give honey to babies under 1 year old.

NHS inform says over-the-counter cough and cold medicines should not be given to children under 6, and that children aged 6 to 12 should only use them on the advice of a pharmacist or doctor. It says there is no evidence that cough medicines work.

• Rest and drink plenty of fluids.

• Take paracetamol or ibuprofen for pain if suitable for you (check the leaflet; ibuprofen is best avoided in pregnancy, per UKTIS).

• Try hot lemon and honey (not for babies under 1).

• If you smoke, quitting is likely to help your cough (NHS inform).

• Ask a pharmacist before taking any cough medicine or herbal remedy.

The NHS says most coughs are caused by a cold or flu, and that a cough is rarely a sign of something serious like lung cancer. NHS inform describes causes of short-term and persistent coughs.

NHS inform says a dry cough is tickly and does not produce any mucus (phlegm). A chesty cough means phlegm is produced to help clear your airways. In most cases, it says, a doctor will want to know if you are producing much more or darker phlegm than usual.

A new continuous cough is also one of the symptoms of COVID-19, which the NHS lists alongside other causes such as bronchitis.

NHS inform says coughs in children can be caused by respiratory tract infections, asthma or GORD. Causes that are more common in children than adults include bronchiolitis, which usually causes cold-like symptoms, croup, which causes a distinctive barking cough and a harsh sound called stridor when the child breathes in, and whooping cough, which causes intense, hacking bouts of coughing, vomiting and a whoop sound after coughing.

The NHS says some cough medicines should not be given to children under 12 years old, so ask a pharmacist. NHS inform says over-the-counter cough and cold medicines should not be given to children under 6. Occasionally, NHS inform says, a persistent cough in a child can be a sign of a serious long-term condition such as cystic fibrosis.

The NHS says that whooping cough is serious in babies under 6 months, who have an increased chance of dehydration, breathing difficulties, pneumonia and seizures, and advises urgent help if a baby under 6 months has symptoms. Call 999 if a child's lips, tongue, face or skin suddenly turn blue or grey, they find it hard to breathe, or they have seizures.

A cough itself is a symptom, but most coughs are caused by infections such as colds and flu, which spread to other people. The NHS advises trying to stay at home and avoid contact with other people if you have a high temperature or do not feel well enough to do your normal activities.

Whooping cough spreads very easily. The NHS says you are contagious for up to 3 weeks after the coughing starts, that antibiotics given within 3 weeks of the cough starting help stop it spreading, and that you should stay off school, work or nursery until 48 hours after starting antibiotics.

The NHS and NHS inform give the following advice. See a GP if you have had a cough for more than 3 weeks, you are losing weight for no reason or you have a weakened immune system, for example because of chemotherapy or diabetes. NHS inform also says to speak to your GP practice if breathlessness is not improving or symptoms are affecting your daily life.

• Ask for an urgent GP appointment or call NHS 111 if your cough is very bad or quickly gets worse (for example a hacking cough or you cannot stop coughing), you feel very unwell, you have chest pain, the side of your neck feels swollen and painful, you find it hard to breathe or you are coughing up blood.

• Contact your GP practice urgently (NHS inform) if you are more short of breath than usual, have pain when breathing in or coughing, feel confused, dizzy or lightheaded, are being sick, have heart palpitations, are peeing less than usual or have a very high or low temperature.

• Call 999 or go to A&E (NHS inform) if you have severe difficulty breathing, severe chest pain in the middle of your chest that is not going away, pain that spreads to your arms, back, neck and jaw, you feel more drowsy than usual or find it more difficult to wake up, or your lips or skin are turning very pale, blue or grey.

The NHS says that to find out what is causing your cough the GP might listen to your chest with a stethoscope, take a sample of any mucus you cough up, or order an X-ray, an allergy test or a test to see how well your lungs work. It says referral to hospital to see a specialist is rare. NHS inform adds that breathing tests and an analysis of a sample of phlegm to check for infection may be requested.

The NHS says antibiotics are not normally prescribed for coughs, and that a GP will only prescribe them if you need them, for example if you have a bacterial infection or are at risk of complications.

Most coughs can be managed at home with advice from a pharmacist. Your NHS GP practice can assess a cough lasting more than 3 weeks and arrange tests such as a chest X-ray if needed. If the cause is not clear, a GP may refer you to a specialist.

Private GP services and chest clinics offer assessment and tests, sometimes with quicker access. The NHS advice on warning signs and when to call 111 or 999 is the same whichever route you use.