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
For information on Covid-19, see here.
This content has been developed by healthcare professionals from across the UK in collaboration with the RCPCH.
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 is 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 breathe, 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
What might help
Keeping a sleep diary
A sleep diary can help you understand what may be causing difficulties with sleep. Fill it out every evening and record as much as you can. You can use it to spot patterns and make changes that may help.
The Sleep Charity have templates you can download; one for teenagers and one for younger children.
Seeking advice and help from sleep services
There are organisations that can help you if you are having difficulties with your child’s sleep. There are many national organisations, including those who specialise in sleep for SEND families, and there are also community-based services in Shropshire, Telford and Wrekin. Click the link at the bottom of page to visit our support services page.
Understanding sleep cycles
The circadian sleep cycle is a 24-hour cycle that helps govern essential bodily functions especially the sleep-wake cycle. It plays a vital role in a person’s ability to sleep in one consolidated block of time at night and to stay awake during the day. As the sun sets in the evening, the brain begins producing melatonin, a hormone that induces sleepiness. Core body temperature also drops.
As melatonin and tryptophan (an amino acid which helps produce melatonin) are naturally produced in the body, there are things you can do to help their production. Darkness helps to promote the production of melatonin which is why it is a good idea to put your child to sleep in a darkened room, and light emitting devices such as tablets and phones also can destroy Melatonin so should not be used for at least an hour before bed. New research shows that limiting exposure to screens and increasing physical activity levels during the day has a positive effect on children's overall physical, mental health and wellbeing, including sleep.
Setting a waking time consistently even in holiday times, called ‘anchoring’ the wake time, can help to reset the body clock over time. This should be accompanied with exposure to lots of light on waking to support circadian rhythm.
Melatonin and tryptophan occur naturally in some foods and drinks such as milky drinks and cereals which is why having a milky drink before bed can help settling to sleep. For more information visit Diet & Sleep - The Sleep Charity
Prescriptions of melatonin
Behavioural strategies and practical solutions are the best way to address sleep difficulties, but if they are having a significant impact on your child’s ability to function, a drug form of melatonin is sometimes prescribed for neurodivergent children. As the drug’s function is to re-set sleep and wake cycles, it works best combined with good sleep hygiene practices. It is important that is it taken under medical supervision and not purchased on-line so that it is closely monitored for dosage and side effects. It should be prescribed for the shortest period necessary as the long-term effects of the drug on children’s development are not yet known.
In Shropshire, Telford and Wrekin the Community Paediatric Service and the BeeU Service (CAMHS) can prescribe Melatonin for children and young people who meet ALL of the following criteria.
- the child/young person must be open to and being treated by the service due to a neurodevelopmental/mental health need (diagnosis not required)
- sleep issues are causing significant impact on the child/ young person, for example due to daytime sleeping or behavioural problems that are impacting daily functioning or educational attendance
- behavioural approaches have been tried and failed. These may have been offered by the service (where available) or by community sleep support services.
GPs are unable to prescribe Melatonin although they sometimes issue repeat prescriptions when prescribing has been started by a specialist (such as a paediatrician or child psychiatrist).
Further support
Click on the link below to visit a page with information about
- national websites and sleep organisations
- local community services in Shropshire, Telford and Wrekin.
