- Why is your child coughing?
- Why is your child wheezing?
- How your child’s GP can help
- What to do if your child’s symptoms get worse
- How other parents cope with cough and wheeze
“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 may make asthma more likely:
- You’ve noticed they’re coughing at night or early in the morning
- Their cough won’t go away or keeps coming back
- They’re coughing after doing exercise or being active
- There are other symptoms too, such as wheeze, breathlessness or a tight chest/tummy ache
- The cough seems to be triggered by things such as crying, pollen, house dust mites, mould or being around pets.
Children can have as many as eight colds in a year. Their immune system is 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.
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 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 can cause mucus to drip from the back of your child’s nose into their throat which can make them cough. If your child has hay fever they may be more likely to wheeze, or to go on to develop asthma.
Wheezing is another typical asthma symptom. The British Thoracic Society describes 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 may find it helpful to record or video your child wheezing to play back to your GP or asthma nurse.
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. However, some babies and children who wheeze in childhood are more likely to develop asthma later in life, especially if their wheezing has been caused by a virus.
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 may 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 stop in two to three days once your body has fought off the virus. It’s worth taking your child along to your GP, especially if they’re not feeding or sleeping well or seem irritable,” says Dr Andy Whittamore, Asthma UK’s in-house GP.
Here are some signs to look out for that may make asthma more likely:
- There are other symptoms too such as cough and breathlessness
- Your child wheezes when they have a virus and when they don’t have a virus
- You’ve noticed it’s triggered by things like running about, crying, pollen, house dust mites, mould or being around pets.
If you’ve noticed your child coughing or wheezing, or both, take them to your GP. They can tell you what’s most likely to be causing it, and may be able to prescribe your child medicines to ease their symptoms. Over-the-counter cough mixtures and medicines are not suitable for children under six, and should only be used for children aged six to 12 if recommended by your GP or pharmacist. If your child is over one, you can try a warm honey* and lemon drink. (*Honey shouldn’t be given to babies under the age of one because of the risk of infant botulism.)
If your GP thinks your child could have asthma they 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 is getting the medicine they need.
If your child has been prescribed a blue reliever inhaler and they need to take it three or more times per week this is a sign that 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 and you should take the following steps as asthma attacks are an emergency:
- Call 999.
- Help them to sit up – don’t let them lie down. Try to be calm.
- Help them take a puff of their reliever inhaler (usually blue), with their spacer, if they have it every 30 to 60 seconds up to a total of 10 puffs.
- If they don’t have their blue inhaler, it’s not helping or if you are worried at any time, call 999 straightaway.
- While you wait for an ambulance, your child can use their blue reliever again, every 30 to 60 seconds (up to 10 puffs) if they need to.
We know from our 2017 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 uses the blue inhaler and this helps day or night − I can usually notice a difference within a few minutes. I try to 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, 2
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 the Asthma UK Helpline on 0300 222 5800 or messaging them via WhatsApp on 07378 606 728 (Monday-Friday, 9am-5pm).
Last updated July 2019
Next review due July 2022