What parents should know first
Watch the chest and abdomen when the child is calm. Fast breathing, pulling in below or between the ribs, grunting, noisy breathing at rest, bluish lips or difficulty speaking or feeding require prompt assessment.
What to observe
Note when the cough began, whether it is dry or productive, breathing rate at rest, fever, wheeze or noisy breathing, fluid intake and whether sleep or activity is significantly affected.
Safe supportive measures
Offer fluids, keep the child away from smoke and strong fragrances and use saline or other measures only as advised for age. Over-the-counter cough and cold combinations are not suitable for many young children.
When a clinic visit is useful
Arrange review for persistent cough, repeated night symptoms, wheeze, fever, ear pain, vomiting with cough, poor sleep, reduced activity or recurrent episodes.
Seek urgent medical help for
- Chest pulling in, grunting or obvious struggle to breathe
- Bluish or grey lips or face
- Pauses in breathing, collapse or poor responsiveness
- Unable to feed, drink, speak or cry normally because of breathlessness
- Sudden cough after choking or possible foreign-body inhalation
Emergency note: When a child is severely unwell, use the nearest appropriate emergency service rather than waiting for an online reply or routine appointment.
Questions commonly asked in clinic
Can I judge breathing by the cough sound alone?
No. Breathing effort, rate, colour, alertness and feeding are more important than the sound of the cough by itself.
Is steam safe for children?
Hot steam can cause burns. Avoid direct steam exposure and seek age-appropriate advice.
When should a cough be examined?
Persistent, recurrent or worsening cough, wheeze, fever, breathing difficulty or reduced feeding and activity should be assessed.