Cough/colds (over 1's)

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 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
When should you worry?

If your child has any of the following:

  • Has blue lips
  • Has pauses in their breathing (apnoeas) or has an irregular breathing pattern or starts grunting
  • Severe difficulty in breathing -too breathless to talk or eat/drink
  • 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')

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.
  • 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
  • Continues to have a fever of 38.0°C or above for more than 5 days
  • Is getting worse of 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

If none of the above features are present

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

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 no 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.

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

This guidance is written by healthcare professionals from across Hampshire, Dorset and the Isle of Wight.

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