Cough and wheeze

Coughing and wheezing are both quite common in babies and young children. Usually they’re due to a virus such as a cold.

But how can you tell if it’s their asthma, or if they’re coughing and wheezing because of a cold or virus they’ve picked up?

Coughing or wheezing is more likely to be your child’s asthma if:

• they’re coughing or wheezing more at night or early in the morning
• their cough or wheeze won’t go away or keeps coming back
• they wheeze without other cold symptoms
• they have a dry cough
• they cough or wheeze after running around, laughing or being in the cold 
• they have other symptoms too, such as breathlessness, a tight chest or a tummy ache
• they cough or wheeze more when they come into contact with triggers like pollen, dust mites, pets, or pollution.

Not yet diagnosed? Coughing and wheezing are typical symptoms of asthma, and often the first one parents notice. Find out more about how asthma is diagnosed.

Colds and viruses

Children can have as many as eight colds in a year. Their immune system is still developing and colds often bring coughs along with them. This is because when your child has a cold, mucus can run down into their throat and coughing is a way to clear it.

Most coughs due to colds and viruses are not serious and clear up within about three weeks. But see your child’s GP if the cough goes on for longer, your child has long coughing bouts several times a day, or they vomit when they cough.

‘Viral wheeze’

The most common reason why children wheeze is colds and viruses. GPs call this ‘viral wheeze.’

As long as your child is not distressed or struggling for breath, this is usually nothing to worry about. It should stop in two to three days once your child’s fought off the virus.

But if your child’s not sleeping well, they’re off their food and drink, or they seem irritable, call your child's GP and ask for a same-day appointment.

Croup

Croup is a viral infection of the larynx (voice box) which causes a distinctive barking cough and a harsh, grating sound on breathing in (known as stridor). Your child may also wheeze.

Babies and toddlers (under three) are more likely than older children to get respiratory infections like croup.

Bronchiolitis

Bronchiolitis is caused by a virus that makes the airways in the lungs swell and narrow – which is why your child will cough and wheeze. They’ll also need to make more effort to breathe.

Bronchiolitis is more common in babies and young children. It is very infectious, and your child may have a cough or be wheezing for some weeks following infection.

Hay fever 

Hay fever can cause mucus to drip from the back of your child’s nose into their throat which can make them cough. It is an allergic reaction to pollen, so you may notice your child coughs more during early spring and summer when the pollen count is higher.

Cigarette smoke

Don’t smoke, or allow others to smoke, around your child. Secondhand smoke increases your child’s risk of coughing and wheezing going on for longer, and getting infections like common coughs and colds, bronchiolitis and croup.

Cigarette smoke also puts them more at risk of developing asthma, and having an asthma attack.

Find out more about support available to help you quit.

Babies and children who often have viral wheeze, hay fever, croup or bronchiolitis may be more likely to develop asthma in the future. It’s not always clear why this is, and more research is needed to explain the link, but it's thought that:

• some children’s immune systems are sensitive to pollen, and other allergies and they go on to develop asthma as part of this
• viral infections like bronchiolitis may share factors that make both bronchiolitis and asthma more likely such as family history or living conditions.

If your doctor does think your child has asthma, you can feel reassured that asthma treatments can make a real difference to your child’s symptoms.

Once your child is in a good routine of using their asthma preventer inhaler, and following an asthma action plan, you should notice they’re not coughing or wheezing any more.

"Try to get familiar with your child’s usual asthma symptoms and when they get them, like at night, or if they’ve been running outside in the cold. Then you’ll be more able to recognise times when it’s their asthma or not", says respiratory nurse specialist Debby Waddell.

Manage your child’s cough and wheeze by:

• making sure they take their asthma medicines every day as prescribed and watching while your child uses their inhalers so you can be sure they're getting the medicine they need
• asking your child’s GP or asthma nurse to show you the best way to use their inhalers or watching our inhaler technique videos
• tracking your child’s cough and wheeze, and any other symptoms, on a symptom calendar, so you can see when they’re coughing, how often, and what else was going on at the time
• using an asthma action plan so you know what to do if their asthma symptoms get worse.

Your child’s GP or asthma nurse will be able to tell you whether your child's cough is caused by their asthma flaring up or something else.

• They'll be able to detect wheezing - as whistling sound in your child's chest - using a stethoscope as it can be hard to hear.
• They can review your child’s medicines and triggers if they think your child’s coughing or wheezing is because of their asthma, and look at ways to get their symptoms under control.
• If your GP thinks your child could have asthma, they may suggest a trial of treatment with asthma preventer medicines or an inhaler to see if it helps, and further tests to help diagnose asthma or find out other causes.
• If the cough is caused by something else, they can recommend over-the-counter medicines, such as anti-histamines, nasal drops, paracetamol or cough mixtures (not for children under 6).
• In some cases they may refer to a specialist if they think there’s another reason for your child’s cough or wheeze.
• They can signpost you or anyone in the family to stop smoking services if cigarette smoke at home is making your child’s symptoms worse.

If your child has severe asthma, you may need extra help and support.

Find out more about understanding your child’s asthma symptoms.