Somatic cough syndrome, or tic cough or habit cough in children
What is somatic cough syndrome, or tic cough or habit cough
Somatic cough syndrome, or tic cough or habit Cough in Children is a type of chronic cough that continues even after the original cause (often a viral infection) has gone. It is one of the more common reasons children are referred for ongoing cough when tests and examinations are normal. This type of cough is not dangerous, but it can be very disruptive and worrying for families.
Habit cough is a type of ongoing cough that continues even after the original infection or irritation has gone. It is not dangerous, but it can be disruptive and worrying for families. Habit cough often begins after a simple cold and becomes a pattern the body gets “stuck” in. Children with habit cough are not doing it deliberately—the cough becomes automatic and difficult to stop without support.
Typical Features
Habit cough usually has a recognisable pattern:
- Dry, repetitive or “honking” cough
- Much worse during the day
- Disappears or improves during sleep
- Reduces with distraction (talking, playing, focusing on an activity)
- Child otherwise appears well, with normal tests
- These features help distinguish it from coughs caused by infection, asthma, or lung disease.
Why the Cough Persists
After a viral illness, coughing can irritate the throat. This becomes a cycle:
Irritation → coughing → more irritation → more coughing
A useful way to explain this to children is the “rash analogy”:
Coughing is like scratching an itchy rash. The more you scratch, the worse it gets.
How Habit Cough Is Diagnosed
A doctor will:
- Ask for a detailed history
- Examine your child
- May carry out basic tests (e.g., chest X-ray, breathing tests)
If these are normal and the pattern fits, habit cough becomes the likely explanation. Repeated or invasive tests are usually not needed.
How to Help the Cough Settle
Medicines (such as antibiotics or inhalers) rarely help. Instead, treatment focuses on re-training the cough reflex and calming the throat.
Education and Reassurance
Understanding that the cough is harmless – and can be controlled – is often the most powerful part of treatment.
Cough-Suppression Techniques
These methods help break the cycle:
Chin-tuck swallow or sipping water
Gently tuck the chin down and swallow, or take small sips of water using the same chin-tuck position. This helps settle irritation in the throat.
Buteyko “stop cough” technique
When your child feels a cough coming:
- Place a hand firmly over the mouth
- Swallow once
- Pause and try not to breathe for a moment
- Then take a small breath in and out through the nose
- Continue slow, gentle nose-breathing for about 30 seconds
Repeat as needed. This technique helps calm the urge to cough
Sipping water with Controlled breathing
- Take a few hard swallows of water
- Sniff in quickly through the nose 2–3 times (this warms and moistens the air)
- Blow out gently through pursed lips as if blowing through a straw
This protects the voice box (vocal cords) and reduces irritation
Suggestion therapy (good for “habit cough”)
This works well when the original infection has gone, but the cough has become a habit.
- Reassure the child that the cough can stop.
- Explain that the cough started after an infection, but now the cough itself is keeping the throat irritated
- Ask the child to delay coughing for short periods (e.g. 1 minute), gradually increasing the time
- Use distractions such as sipping warm water or sucking sugar-free lozenges
- Tell them that every extra second they delay a cough makes it easier to control next time
Once the child manages to suppress a few coughs (usually within 10 minutes), praise them and reinforce that they have control.
Improve Breathing Habits
Encourage:
- Nasal breathing rather than mouth breathing
- Slower speech to avoid large breaths that can irritate the throat
- Good hydration
Explain that the nose warms, moistens, and filters the air – helping calm the throat and reduce coughing.
Reduce Triggers
- Avoid smoke exposure
- Avoid allergens where possible
- Reduce caffeine (it dries the throat)
- Keep a simple cough diary to spot patterns
How Well Do Children Recover?
With the right support, most children improve quickly. Studies show:
- 82% make a full recovery
- 15% improve significantly
- Many recover within weeks to months
Recovery is fastest when families understand the diagnosis and practise the suppression techniques regularly.
Treating Postnasal Drip and Allergies
Many children cough because of mucus dripping down the back of the throat. To help:
- Use nasal rinses to wash out mucus
- Use nasal sprays or antihistamines if advised
- Teach the child to blow their nose properly
- Avoid known allergens (e.g. dust mites, pollen, pets, mould)
Education for Families
Coughing and throat clearing bang the vocal cords together, irritating them. The throat becomes sore, producing more mucus to protect itself. The feeling of mucus then triggers more coughing – creating a vicious cycle.
A useful way to explain this is the “rash analogy“:
Coughing is like scratching a rash – the more you scratch, the worse the rash becomes. The more the child coughs, the more irritated the throat gets.
We explain to children that they can break this cycle by trying to stop the first cough and choosing a different response (swallowing, sipping water, breathing through the nose).
Avoiding Triggers
- Keep a simple diary noting when the cough happens—this may reveal patterns
- Avoid places with dust, smoke, or poor air quality
- Avoid active and passive smoking
- Cut down caffeine (e.g. cola, iced tea, energy drinks), as it dries out the throat
Encouraging Nasal Breathing
- Breathing through the nose keeps the air warm, moist, and clean before it reaches the throat
- Breathing through the mouth dries the throat and can worsen cough
- Fast or loud talking can cause quick breaths in, which irritate the throat
- Teaching calm, gentle nasal breathing can help settle coughing over time
Other Helpful Tips
- Sugar-free lozenges can soothe the throat (use with caution in young children due to choking risk)
- Relaxation helps: stress increases stomach acid, which can rise up and irritate the throat, leading to more coughing
- Simple calming activities—slow breathing, reading, warm drinks—can help break the cough cycle
When to Seek Medical Advice
- The cough lasts more than four weeks
- Your child is otherwise well but continues to cough
- Tests for asthma or infection are normal
- The cough improves during sleep or with distraction
A specialist can confirm the diagnosis and teach effective, evidence-based techniques to help the cough settle.
Habit Cough in Children (Paediatrics and Child Health Journal)
Need Support or Further Advice?
If you’re concerned about your child’s breathing or coughing, please contact your GP, or respiratory specialist. Early management can make a big difference.
Located in London | Infants to young adults seen
Request a referral or book an appointment with Professor Gupta today.
