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What is a paediatric ineffective cough?

A cough occurs when the throat needs to be cleared of excess mucus or dust. An effective cough clears the airway. An ineffective cough is when the child cannot clear the mucus or dust. This can cause problems such as increasing the chance of infection and making it difficult for the child to breathe.

What causes an ineffective cough in children?

An ineffective cough can be due to pain in the throat. If the child’s throat is infected and inflamed then it can be painful to cough and this creates reluctance for the child to cough. This means the cough is not as strong as it needs to be to clear the airway which means it is ineffective.

Another cause can simply be that the child’s cough is not strong enough to clear their airway which means it is ineffective.

What are the symptoms of an ineffective cough in children?

A cough is a symptom itself and is usually due to:
  • Mucus build up in throat
  • Dust in throat
  • Sore throat
  • Breathlessness

What can physiotherapy do to help children with an ineffective cough?

Physiotherapy is aimed at teaching the child to produce an effective cough. The main technique used is called the Active Cycle of Breathing Technique which helps to stimulate an effective cough. This technique can be difficult for a child to learn so manual techniques are often required. This involves percussion and vibration to loosen mucus and positioning to try and move the mucus. Suction can then be used to manually remove the mucus if the child cannot cough any up.

If coughing is painful for the child then a supported cough can be taught to brace the child and make coughing less painful. There is also come equipment that can be used to help to stimulate an effective cough.

Advice is also given to the child’s parents or carers so that they can help to manage the child’s chest when the physiotherapist is not present.


It is important that a child is taught how to cough effectively so that they can clear their airway. Physiotherapy treatment focuses on teaching the child how to stimulate an effective cough and manually removing mucus. Advice is also given to the child’s parents or carers. Physiotherapy can help a child to cough effectively.

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