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Coughs and colds are extremely common in young children. Over the first few years of life, your child might have these every month.

  • 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 don’t help. Antibiotics might cause side effects such as rash and diarrhoea, or increase the risk of developing antibiotic resistance.
  • Having green snot or a noisy chest does not mean that your child has an infection needing antibiotics
  • Coughing can wake a child in the night but does not mean the illness is more severe

Please see Red-Amber-Green tables for advice on when and where to seek care for your child.

Related topics: asthma, bronchiolitis, croup, difficulty breathing

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Thanks to Dr Oliver van Hecke for permission to use this infographic. They were developed as part of a study funded by a National Institute for Health and Care Research School for Primary Care Research grant (reference number: 439)

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Thanks to Dr Oliver van Hecke for permission to use this infographic. They were developed as part of a study funded by a National Institute for Health and Care Research School for Primary Care Research grant (reference number: 439)

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Thanks to Dr Oliver van Hecke for permission to use this infographic. They were developed as part of a study funded by a National Institute for Health and Care Research School for Primary Care Research grant (reference number: 439)

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Thanks to Dr Oliver van Hecke for permission to use this infographic. They were developed as part of a study funded by a National Institute for Health and Care Research School for Primary Care Research grant (reference number: 439)

When should you worry?

RED

If your child has any of the following:

  • Breathing very fast or breathing that stops or pauses
  • Makes a grunting noise every time they breathe out
  • A harsh noise as they breathe in (stridor) present all of the time (even when they are not upset)
  • Becomes pale, blue, mottled and / or unusually cold to touch
  • Difficult to wake up, very sleepy or confused
  • Weak, high-pitched, continuous cry or can’t be settled
  • Has a fit (seizure)
  • Is under 3 months old with temperature more than 38°C or under 36°C (unless fever in the 48 hours following vaccinations and no other red or amber features)
  • Has a rash that does not go away with pressure (the glass test)

You need urgent help.

Go to the nearest Hospital Emergency (A&E) Department or call 999 - dial 999.

AMBER

If your child has any of the following:

  • Working hard to breathe, drawing in of the muscles below the ribs
  • A harsh noise as they breathe in (stridor) only when upset
  • Dry skin, lips or tongue
  • Not had a wee or wet nappy in last 8 hours
  • Poor feeding in babies (less than half of their usual amount)
  • Irritable (Unable to settle them with toys, TV, food or hugs even after their fever has come down)
  • Is 3-6 months old with temperature 39oC or above (unless fever in the 48 hours following vaccinations and no other red or amber features)
  • Temperature of 38oC or above for more than 5 days or shivering with fever (rigors)
  • Temperature less than 36°C in those over 3 months
  • Getting worse and I am still worried

You need to contact a doctor or nurse today.

Please contact your GP surgery or call NHS 111 - dial 111.

If symptoms persist for 4 hours or more and you have not been able to speak to either a member of staff from your GP practice or to NHS 111 staff, recheck that your child has not developed any red features.

AMBER
Green

If your child has none of the above

  • Watch them closely for any change and look out for any red or amber symptoms
  • Additional advice is also available for families for help cope with crying in otherwise well babies
  • If your child has a long term condition or disability and you are worried please contact your regular team or follow any plans that they have given you.

Self care

Continue providing your child’s care at home. If you are still concerned about your child, speak to your health visitor, local pharmacist or call NHS 111– dial 111.

Children and young people who are unwell and have a high temperature should stay at home. They can go back to school, college or childcare when they no longer have a high temperature, and they are well enough to attend.

Self care and Prevention

What should you do?

  • Keep your child well hydrated by offering them lots to drink.
  • Most children with coughs and colds do not require treatment with antibiotics.
  • If your child seems to be in pain or discomfort, you can give your child Paracetamol or Ibuprofen, following the instructions on the container.
  • Do not give cough syrup. It is not recommended for children under 6 years. It can make children sleepy and does not help.
  • Try using saline nose drops or spray if your baby has a blocked nose.
  • For children over 1 year, a spoon of honey (perhaps in a warm drink) half an hour before bed may help them to wake less often in the night.
  • For children over 2 years, vapour rubs (containing camphor, menthol and/or eucalyptus) may help children sleep better.

How long will your child's symptoms last?

  • Coughs and colds can continue for weeks before they get better.
  • Over the winter, children are likely to get one viral infection after another, which can make you think that they are never well. Things will get better in the summer months.
  • Having a cough for 2 or 3 weeks does not mean that your child needs antibiotics.
  • Children under 2 years of age with breathing difficulty may have bronchiolitis. This is a common condition that usually starts as a runny nose and cough, but their breathing may get worse over the next 2-3 days.
  • If your child has noisy breathing, they might have croup.

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