Coughs and colds
Coughs and colds are extremely common in young children. Over the first year of life, your child is likely to have up to eight of these episodes. Coughing is the body’s natural way of clearing infection.
Most of these are likely to be caused by a virus, which means that antibiotics are of no benefit (and may actually result in side effects such as rash and diarrhoea, as well as increasing the risk of them developing antibiotic resistance). See the video on antibiotic awareness below.
Having green snot or a noisy chest does not mean that your child has an infection requiring antibiotics.
It can sometimes be harder to identify the cause of a cough. In general, if it is associated with a runny nose, red eyes, ear pain or a wheeze, it is far more likely to be viral. Noisy chests are also common in young children with viral infections.
Coughing can wake a child in the night but does not mean the illness is more severe.
Children requiring antibiotics usually appear more unwell, with difficulty breathing, drowsiness, cold hands and feet and possibly blue lips – your child may need urgent medical attention if any of these features are present. Use the guidance below to help you decide what to do.
Check if your child has any red symptoms:
- Your child has laboured / rapid breathing or they are working hard to breathe – drawing in the muscles below their lower ribs, at their neck or between their ribs (recession)
- Your child is going blue around the lips.
- Has pauses in their breathing (apnoeas) or has an irregular breathing pattern or starts grunting.
- A harsh breath noise as they breathe in (stridor) present all of the time (even when they are not upset).
- Too breathless to talk, eat or drink.
- 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’).
Actions to take if your child has any red symptoms
- Your child may require emergency treatment.
- You should call 999 or take them to your NEAREST Emergency Department where they can be assessed.
If there are no red symptoms, check if your child has any amber symptoms:
- A harsh breath noise as they breathe in (stridor) present only when they are upset.
- Seems dehydrated (sunken eyes, drowsy or not passed any urine for 12 hours).
- Is becoming drowsy (excessively sleepy) or irritable (unable to settle them with cuddles, toys, TV, food or snacks) – especially if they remain drowsy or irritable despite their fever coming down.
- Extreme shivering or complains of muscle pain.
- Is three to six months of age with a temperature of 39°C / 102.2°F or above (please note fever is common in babies up to two days after they receive vaccinations) – how to take your child’s temperature.
- Continues to have a fever of 38.0°C or above for more than five days.
- Is getting worse or if you are worried.
Options if your child has any amber symptoms
Your child does not need to be taken to the Emergency Department immediately, but you should seek medical advice today.
- ring your GP surgery during their usual opening hours
- contact the out of hours GP if the surgery is closed
If symptoms continue for four hours or more and you have not been able to speak to your GP or the out of hours GP, consider going to your nearest Emergency Department.
If your child develops any of the red symptoms above, go to your nearest Emergency Department.
If no red or amber symptoms are present:
- your child does not seem to have any symptoms of serious illness or injury
- you can get general advice on the NI Direct website or from your local pharmacy
If your child develops any of the red or amber symptoms above, follow the advice in these sections.
- Keep your child well hydrated by offering them lots of fluids.
- Most children with coughs / colds do not require treatment with antibiotics. Coughs and colds generally improve without the need for antibiotics in otherwise healthy, vaccinated children.
- You should not use antibiotics when they are not needed. This will only lead to the development of antibiotic resistance in your child, which will make it more difficult to treat your child in future. Antibiotics can also cause side effects and they should only be used when the benefits are greater than the potential harm from the side effects. The Public Health Agency has this information on antibiotic awareness
- Try children’s paracetamol and / or ibuprofen – cough syrup does not tend to help with coughs.
- Try using saline nose drops or spray if your baby has a blocked nose.
- For children over one year old, a spoon of honey (perhaps in a warm drink) half an hour before bed may help them to wake less often in the night because of cough.
- For children over two years old, vapour rubs (containing camphor, menthol and / or eucalyptus) may help them sleep better.
- If it is non-urgent, speak to your local pharmacist or health visitor.
- Alternatively, you can contact your GP practice and a qualified member of the clinical team will check whether your child needs to be seen urgently. Out of hours GP details are available here.
- You should only call 999 or go your nearest Emergency Department in critical or life-threatening situations.
- See our section: How does the Children’s Emergency Department Work?