Coughing and wheezing in children

Coughing and wheezing are common symptoms of childhood illness. They do not usually mean your child has a serious condition, although they can sound awful and may be distressing for you and your child. Coughing is a normal, healthy and important reflex that helps clear the airways in the throat and chest.

In most cases, you can relieve the symptoms of coughing and wheezing at home. However, your child may need urgent medical attention if the symptoms become more serious, as a child can stop breathing during a severe respiratory attack. If your child becomes distressed or their symptoms do not settle, take them to your doctor or children’s hospital straight away.

If your child suddenly starts to cough without being unwell first, check whether they are choking. Choking requires immediate emergency treatment.

Smoking in the home or car increases the risk of respiratory problems in children.

Causes of coughing and wheezing in children#

There are different reasons why your child may cough or wheeze. Possible causes include:

• Colds and other viruses – a very common cause of coughing. Cough and wheezing are common when young children have colds and chest infections, and this usually does not mean they have asthma.
• Choking – the coughing is sudden and the child has not been unwell. This requires immediate emergency treatment.
• Croup – tends to cause a barking, hoarse cough.
• Bronchiolitis – a chest infection that can cause coughing and wheezing.
• Smoke – smoking around children can cause them to cough and should be avoided.
• Hay fever allergy – this can cause coughing after exposure to specific substances such as dust mites, animal hair or molds. As well as coughing, other symptoms may include sneezing and a runny nose.
• Asthma – coughing tends to be worse at night or after exercise, and the child may also wheeze.
• Whooping cough – a contagious infection that causes a sudden onset of cough, high fever and fast breathing. It can be prevented by immunization.
• Pneumonia.

Cough and wheezing are usually not asthma#

It is often difficult to tell whether very young children have asthma, as they have narrower airways and tend to get a lot of colds. Most doctors do not diagnose asthma in babies until after 12 months of age, once the muscles around the airways in the lungs have matured. Sometimes a doctor may prescribe asthma medication before the baby is 12 months old, to see whether the symptoms respond to that treatment.

When to seek immediate medical help#

Children can stop breathing during a severe respiratory attack. If the coughing and wheezing do not settle, or if your child becomes more distressed or unwell, take them to your doctor or children’s hospital straight away.

Seek immediate medical help if:

• your child is having difficulty breathing
• their breathing becomes rapid or irregular
• their breathing is noisy when they are not crying
• their skin turns blue or they become very pale
• they seem unusually tired
• they have a fever
• they refuse food or drink
• your child suddenly starts to cough and has not been unwell, which may indicate choking

Something stuck in the nose#

Having something stuck in the nose can be another cause of breathing difficulty. Symptoms may include:

• complaining about a strange smell that no one else can detect
• a one-sided runny or blocked nose
• a whistling noise when breathing through the nose
• nose bleeds
• tenderness around the nose

If you think your child may have something stuck in their nose, take them to see a doctor.

Home care for mild coughing and wheezing#

Generally, you can relieve mild coughing and wheezing at home, and the coughing will usually clear up in a few days to a couple of weeks. If mild coughing goes on for three weeks, see your doctor. Suggestions include:

• comfort your child and try to keep them calm, as a cough and a noisy wheeze can frighten children, and breathing is more difficult when they are upset
• offer frequent drinks – drinking smaller amounts more often may be easier if they are blocked up from a cold
• avoid smoking in the home or car, as it increases the risk of respiratory problems in children

Medicines such as antibiotics do not help viral infections such as colds, flu, bronchiolitis or croup. Over-the-counter cough medicines are not suitable for infants and young children without specific advice from your child’s doctor, as there is evidence that they may cause harm to some children and mask symptoms of more serious illness.

Key points#

• Coughing and wheezing are common symptoms of childhood illness.
• Coughing is a normal, healthy and important reflex that helps clear the airways in the throat and chest.
• In most cases, you can relieve the symptoms of coughing and wheezing at home.
• Your child may need urgent medical attention if the symptoms become more serious.
• If your child suddenly starts to cough without being unwell, check for choking, which requires immediate emergency treatment.

Where to get help#