Cough/colds (over 1's)

Advice for professionals

Cough is extremely common in children and usually gets better by itself with no specific treatment, although the cough often takes 2 to 3 weeks to disappear. Occasionally, children with a cough can sometimes develop a chest infection.

Symptoms of a chest infection:

  • Prolonged fever
  • Breathing faster than usual
  • Using extra effort when breathing
  • Being too breathless to feed (young children) or complete sentences (older children)
  • Chest pain when breathing or coughing

It is unlikely that this is linked to Covid-19, but as we are in a pandemic, see this information here. 

When should you worry?

If your child has any of the following:

  • Is going blue around the lips
  • Has pauses in their breathing (apnoeas) or has an irregular breathing pattern or starts grunting
  • Too breathless to feed (eat or drink) or talk/make noise
  • A harsh noise as they breath in (stridor) present all of the time (even when they are not upset)
  • Becomes pale, mottled and feels abnormally cold to touch
  • Becomes extremely agitated (crying inconsolably despite distraction), confused or very lethargic (difficult to wake)
  • Develops a rash that does not disappear with pressure (the 'Glass Test')
  • Is under 3 months of age with a temperature of 38°C / 100.4°F or above (unless fever in the 48 hours following vaccinations and no other red or amber features) 

You need urgent help

Go to the nearest Hospital Emergency (A&E) Department or phone 999

If your child has any of the following:

  • Has laboured/rapid breathing or they are working hard to breathe - drawing in of the muscles below their lower ribs, at their neck or between their ribs (recession)
  • A harsh breath noise as they breath in (stridor) present only when they are upset
  • Seems dehydrated (sunken eyes, drowsy or not passed urine for 12 hours)
  • Is becoming drowsy (excessively sleepy) or irritable (unable to settle with toys, TV, food or picking up) - especially if they remain drowsy or irritable despite their fever coming down
  • Has extreme shivering or complains of muscle pain
  • Is 3-6 months of age with a temperature of 39°C / 102.2°F or above (but fever is common in babies up to 2 days after they receive vaccinations)
  • Continues to have a fever of 38.0°C or above for more than 5 days
  • Is getting worse or if you are worried

You need to contact a doctor or nurse today

Please ring your GP surgery or contact NHS 111 - dial 111 or for children aged 5 years and above visit 111.nhs.uk

Additional advice is also available to young families for coping with crying of well babies – click here

Self care

Continue providing your child’s care at home. If you are still concerned about your child, contact NHS 111 – dial 111 or for children aged 5 years and above visit 111.nhs.uk

This guidance has been reviewed and adapted by healthcare professionals across SYB with consent from the Hampshire development groups.

Causes of cough

Most cases of cough in children (under 5 years of age) are caused by viral infections; your child may also have a runny nose, cough or earache.

Treatment

Most children with coughs/colds do not require treatment with antibiotics. Antibiotics rarely speed up recovery and often cause side effects such as rash and diarrhoea. They will also promote the development of antibiotic resistant bacteria in your child.

 

 

Antibiotics are usually only considered if your child has a high fever for more than 24 hours and is breathing faster than normal plus using extra effort when breathing. If your child has a wheeze and difficulty breathing, they are very unlikely to benefit from antibiotics but may benefit from inhalers.

In addition, if your child has any amber or red features above, they will need to be urgently seen by a healthcare professional who may decide that your child may benefit from additional treatment.

You can help relieve symptoms by:

  • Giving your child paracetamol or ibuprofen if they have a fever
  • Encourage your child to drink plenty of fluids

It can take a few weeks for a child to fully recover from a cough. Children rarely cough up phlegm, but they are still clearing their chest. If you are worried that after an initial improvement, their cough getting significantly worse, or not getting better after 4 weeks, you should take your child to see their GP. Most children make a full recovery from a chest infection with no lasting effects.

If your child is struggling to breath, they need to be urgently seen by a medical practitioner and are likely to need treatment. If your child has Croup (hoarse voice, barking cough, noisy breathing), they will also need to be seen by a medical practitioner.

If your child has a runny nose and breathing difficulties, it is most likely that they have a condition called bronchiolitis. Most children with bronchiolitis get better by themselves with no specific treatment. Bronchiolitis is caused by a viral illness, so antibiotics are not helpful.

Symptoms of Bronchiolitis:

  • Your child may have a runny nose and sometimes a temperature and a cough
  • After a few days your child's cough may become worse and their breathing may get faster/more laboured
  • As breathing becomes more difficult, your baby may not be able to take their usual amount of milk by breast or bottle
  • Your child may vomit after feeding and you may notice fewer nappies than normal

How long does bronchiolitis last?

  • Most children with bronchiolitis will seem to worsen during the first 1-3 days of the illness before beginning to improve over the next two weeks. The cough may go on for a few more weeks
  • Your child can go back to nursery or day care as soon as he or she is well enough (that is feeding normally and with no difficulty in breathing)

Prevention

It is not always easy to avoid catching these infections. However, good hygiene practices can prevent infections spreading

  • Wash your hands regularly and thoroughly
  • Use a tissue when coughing or sneezing and put it in the bin
  • Avoid sharing glasses or utensils with people who are unwell

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