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)
Too breathless to feed (eat or drink) or talk/make noise
A harsh noise as they breathe 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 noise as they breathe 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
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This guidance was last reviewed 20/12/2024.
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.
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.
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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