Coughing and wheezing in children

Coughing and wheezing are common symptoms of childhood illness. They do not usually mean your child has a serious condition, although they can sound awful and may be distressing for you and your child. Coughing is a normal, healthy and important reflex that helps clear the airways in the throat and chest.

In most cases, you can relieve the symptoms of coughing and wheezing at home. However, your child may need urgent medical attention if the symptoms become more serious.

A child can stop breathing during a severe respiratory attack. If your child becomes distressed or their symptoms don’t settle, take them to your doctor or children’s hospital straight away.

If your child suddenly starts to cough without being unwell first, check whether they are choking. This requires immediate emergency treatment.

Smoking in the home or car increases the risk of respiratory problems in children.

Causes of coughing and wheezing in children

There are different reasons why your child may cough or wheeze. Possible causes include:

• colds and other viruses – this is a very common cause of coughing
• choking – the coughing is sudden and the child has not been unwell
• croup – this tends to cause a barking, hoarse cough
• bronchiolitis – this is a chest infection, which can cause coughing and wheezing
• smoke – smoking around children can cause them to cough and should be avoided
• hay fever – this may be caused by dust mites, animal hair or moulds. As well as coughs, other symptoms may include sneezing and a runny nose
• allergy – this can cause coughing after exposure to specific substances
• asthma – coughing tends to be worse at night or after exercise. The child may also wheeze
• whooping cough – a contagious infection, which can be prevented by immunisation
• pneumonia – this causes a sudden onset of cough, high fever and fast breathing: it can be prevented by immunisation.

Cough and wheezing are usually not asthma

Cough and wheezing are common when young children have colds and chest infections. It usually does not mean they have asthma. It is often difficult to tell whether very young children have asthma, as they have narrower airways and tend to get a lot of colds.

Most doctors do not diagnose asthma in babies until after 12 months of age, once the muscles around the airways in the lungs have matured. Sometimes, they may prescribe asthma medication before the baby is 12 months old, to see if the symptoms respond to that treatment.

When to seek immediate medical help for coughing and wheezing in children

Children can stop breathing during a severe respiratory attack. If the coughing and wheezing don’t settle, or if your child becomes more distressed or unwell, take them to your doctor or children’s hospital straight away.

Seek immediate medical help if:

• your child is having difficulty breathing
• their breathing becomes rapid or irregular
• your child’s breathing is noisy when they are not crying
• their skin turns blue or they become very pale
• they seem unusually tired
• they have a fever
• they refuse food or drink
• your child suddenly starts to cough and has not been unwell – this may indicate that they are choking. Choking requires immediate emergency treatment.

Having something stuck in the nose can be another cause of breathing difficulty. Symptoms may include:

• a one-sided runny or blocked nose
• a whistling noise when breathing through the nose
• nose bleeds
• tenderness around the nose
• complaining about a strange smell that no one else can detect.

If you think your child may have something stuck in their nose take them to see a doctor.

Non-urgent treatment for coughing and wheezing

Generally, you can relieve mild coughing and wheezing at home. Usually, the coughing will clear up in a few days to a couple of weeks. If mild coughing goes on for three weeks, see your doctor.

Home care suggestions for mild coughing and wheezing in children include:

• comfort your child – try to keep your child calm. Having a cough and a noisy wheeze frightens children and breathing is more difficult when they are upset
• offer frequent drinks – drinking smaller amounts, but more often, may be easier if they are blocked up from a cold
• avoid smoking – smoking in the home or car increases the risk of respiratory problems in children.

Medicines such as antibiotics don’t help viral infections such as colds, flu, bronchiolitis or croup. ‘Over-the-counter’ cough medicines are not suitable for infants and young children without specific advice from your child’s doctor, as there is evidence that they may cause harm to some children and mask symptoms of more serious illness.

Where to get help

• In an emergency, call triple zero (000)
• Emergency department of your nearest hospital
• Virtual Emergency Care
• Urgent Care Clinics
• Nurse-on-call Tel. 1300 606 024 – for expert health information and advice (24 hours, 7 days)
• Maternal and Child Health Line Tel. 13 22 29 (24 hours)
• Asthma Australia Helpline Tel. 1800 278 462
• Your GP (doctor)
• Your local community health centre