Cough and wheeze

COUGH AND WHEEZE ARE TYPICAL ASTHMA SYMPTOMS. BUT THERE ARE OTHER REASONS WHY CHILDREN COUGH AND WHEEZE TOO

If your baby or child has been coughing and/or wheezing a lot, here’s what you need to know and how your GP can help. 

Why is your child coughing?

“Her main symptom is a cough. It's constant and draining. It would make a massive difference to know if the cough is definitely asthma or something else.” - Response from the Parent 0-6 survey 2017

Hearing your child cough can be worrying and frightening, especially if it’s in the middle of the night, or when it feels like they’ve been coughing non-stop for ages. So how do you know if your child’s cough is serious, and whether it’s a sign of asthma or something else?

Is your child's cough because of asthma?

Coughing is a typical symptom of asthma, and often the first one parents notice. But if your child is still young, and particularly if they’re under five, it can be hard to tell if their cough is due to asthma or not. Until your child is over five, it’s likely that you’ll be told they have ‘suspected asthma’ or that your child’s symptoms are being ‘treated as asthma’ because it’s too soon to be able to give an asthma diagnosis. This can be confusing, but it’s the best way to keep your child well until they’re old enough to have a diagnosis confirmed.

Here are some signs to look out for that might make asthma more likely:

What else could be making my child cough? 

Colds

Children can have as many as eight colds in a year. Their immune systems are still developing and colds often bring coughs along with them. This is because when your child has a cold, mucus can run down into their throat and coughing is a way to clear it. Most coughs due to colds are not serious, and clear up within about three weeks.

Croup

Babies and toddlers (under three) are more likely than older children to get respiratory infections like croup. Croup is a viral infection of the larynx (voice box) which causes a distinctive barking cough and a harsh, grating sound on breathing in (known as stridor). A croup attack can look a bit like an asthma attack. If your child has repeated bouts of croup they may be more likely to develop asthma.

Bronchiolitis

Bronchiolitis is also more common in babies and young children. This is caused by a virus that makes the airways in the lungs swell and narrow – which is why your child will cough and wheeze. They’ll also need to make more effort to breathe. Babies with bronchiolitis can go on to have repeated episodes of wheezing and could be more likely to develop asthma.

Hay fever

Hay fever can cause mucus to drip from the back of your child's nose into their throat which can make them cough. If you’re child has hay fever they may be more likely to wheeze, or to go on to develop asthma.

Why is your child wheezing?

Wheezing is another typical asthma symptom. Wheezing is common in babies and young children because their airways are still small. If your baby or child is wheezing it doesn’t necessarily mean they have asthma: it’s often due to a cold or virus, and will go away when your child is better.

In fact, nearly one-third of young children will wheeze at some point usually due to a virus, such as a cold. Croup and bronchiolitis which are both very common in babies and small children also cause wheezing or noisy breathing. GPs sometimes call this ‘viral wheeze’. By the age of six many children stop wheezing. Cigarette smoke will make your child’s wheeze worse and last for longer.

“If there’s a bit of wheezing but your child is not distressed or struggling for breath you might be told your child is a ‘happy wheezer’. This kind of wheeze is often due to a mild virus such as a cold and should go in two to three days once the virus has settled. It’s worth taking your child along to their GP, especially if they’re not feeding or sleeping so well, or seem irritable.” Dr Andy Whittamore, Asthma UK’s in-house GP.

What does wheezing sound like?

The British Thoracic Society describe wheezing as ‘a continuous high-pitched musical sound coming from the chest’. But each child is different, so it’s important to know what to listen out for in your child and whether they wheeze when breathing in or breathing out. Parents describe their child’s wheeze in different ways, for example:

“A whistling noise coming from his lungs every time he breathes out. You can only hear it when you’re really close – the best way for me to check is to put my ear next to his chest,” - Shakeela, mum to Sami, 6 and Salis, 12.

“A high-pitched squeaky sound. And if she takes a big breath in the middle of a sentence when she’s talking, that’s how I know she needs a puff of her blue inhaler,” - Jayne, mum to George, 14 and Lena, 12.

If you’re struggling to describe your child’s wheeze you might find it helpful to record or video your child wheezing to play back to your GP or asthma nurse. 

When is wheezing a sign of asthma?

Here are some signs to look out for that might make asthma more likely:

  • there are other symptoms too such as cough, and breathlessness
  • there’s no sign of a cold or virus
  • you’ve noticed it’s triggered by things like running about, crying, pollen, house dust mites, pets or moulds or being around pets   

How your child’s GP can help with coughing and wheezing

If you’ve noticed your child coughing or wheezing, or both, take them to their GP. Your child’s GP can tell you what’s most likely to be causing it, and may be able to prescribe your child medicines to ease their symptoms. These might be antibiotics if they suspect a chest infection, or antihistamines if they think your child has hay fever. Over the counter cough mixtures and medicines are not suitable for children under six, and should only be used for children aged six to twelve if recommended by your GP or pharmacist. If your child is over one you can try a warm honey and lemon drink.

If the GP thinks your child could have asthma your GP may suggest a trial of treatment with asthma preventer medicines or an inhaler to see if it helps. You can help symptoms like coughing and wheezing by making sure your child takes their asthma medicines as prescribed. Your child’s GP or asthma nurse can show you how to use the inhalers in the best way so you can be sure your child’s getting the medicine they need.

What to do if your child’s symptoms get worse

If your child’s been prescribed a blue reliever inhaler and they need to take it three or more times per week this is a sign their asthma may be getting worse and they need help. You should make an appointment to see their doctor or nurse to review their treatment.

If you notice your baby, child or toddler wheezing or coughing more and finding it harder to breathe, it could be that they’re having an asthma attack. You need to call 999 – asthma attacks are an emergency.

“Coughing, wheezing and difficulty breathing could all mean your child is having an asthma attack and you need to call 999. If your child has already taken their blue reliever inhaler, and it’s not helping, call 999 for an ambulance. If they have not been prescribed a blue reliever inhaler and are struggling with their breathing, coughing or wheezing, seek medical attention straight away or, if you’re worried, call 999 for an ambulance.” Dr Andy Whittamore, Asthma UK’s in-house GP.

Coping with cough and wheezing

We know from our recent survey that parents find the stress of their child coughing or wheezing, especially at night, very difficult:

“Five months of a chronic, life-disrupting cough; I’ve had minimal sleep in all this time.”

“I can’t sleep without watching her… I worry she will stop breathing.”

If your child’s symptoms get worse at night this can affect their sleep, and yours. Stress and sleepless nights can have a knock-on effect on family life. 

The good news is there are lots of things you can do to help manage your child’s coughing and wheezing, and other asthma symptoms.  

“If he's coughing a lot he has the blue inhaler and this helps day or night -  I can usually notice a difference within a few minutes. l try and get him to sleep more upright as well, either in a chair or his pram, or with plenty of pillows in bed and this seems to help.” Karen, mum to Riley aged 2.

“If my sons are coughing at night due to their asthma, warm honey* and water usually helps. And I find that peppermint tea helps to unstick any phlegm or mucus so they cough it up. We’ve learnt that if Salis is coughing at night because of his asthma, the bedroom temperature needs to be constant – if it’s too hot, he can’t breathe. If it’s too cold he gets really wheezy.” - Shakeela, mum to Salis, 12 and Sami, 6.

*Honey shouldn't be given to babies under the age of one because of the risk of infant botulism.

If your child has severe asthma you may need extra help and support. 

You can talk to one of our friendly asthma nurse specialists about your child’s symptoms by calling our Helpline on 0300 222 5800 (9am - 5pm; Mon - Fri)

Find out how other parents are coping with asthma symptoms 

Last updated July 2017