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Cough/colds (under 1's)

Advice for professionals

Coughs and colds are extremely common in young children and tend to occur more frequently over the autumn and winter months. They are usually caused by an infection and most children get better by themselves. In general, antibiotics do not make them better more quickly. If they are finding it hard to breathe or are too breathless to feed, they may need to be looked after in hospital.

It is unlikely that this is linked to Covid-19, but as we are in a pandemic, see this information here. 

When should you worry?

If you child has any of the following:

  • Is going blue around the lips
  • Has pauses in their breathing (apnoeas) or has an irregular breathing pattern or starts grunting
  • A harsh noise as they breathe in (stridor) present all of the time (even when they are not upset)
  • Seems dehydrated (sunken eyes, drowsy or not had a wee or wet nappy for 12 hours)
  • Too breathless to feed (eat or drink) or talk/make noise
  • 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) 
  • Is between 3-6 months of age with a temperature over 39°C

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 had a wee or wet nappy for eight hours)
  • Is becoming drowsy (excessively sleepy) 
  • 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)
  • Has a fever of 38°C or above for more than 5 days
  • Seems to be getting worse or if you are worried

You need to contact a doctor or nurse today

Please ring your GP surgery or call NHS 111 - dial 111

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, call NHS 111 – dial 111

This guidance has been reviewed and adapted by healthcare professionals across Shropshire, Telford and Wrekin with consent from the Hampshire development groups.

 

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.

 

  • Keep your child well hydrated by offering them lots of fluids. If your child is not feeding as normal, offer smaller feeds but more frequently
  • Cough syrup does not tend to help with coughs
  • You can try using saline nose drops or spray if your baby has a blocked nose

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.

Symptoms of Bronchiolitis:

  • 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 wet 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