Cough & Breathing
Persistent cough isn’t normal.
An effective cough is important way to keep lungs healthy. Repeated coughing every day however isn’t normal and may be a sign of poor lung health or irritation. A persistent cough lasting more than three to four weeks ought to be carefully explored and, where appropriate, treated.
Cough is a common symptom in young children. Most often this is the result of viral upper respiratory infections which may occur repeatedly causing recurrent or prolonged respiratory illness. Other common causes are allergy, asthma, gastro-oesophageal reflux and sometimes habit.
Persistent cough may be a sign of more serious lung conditions including bronchitis, bronchiectasis, cystic fibrosis, congenital airway conditions or other underlying lung disease/damage.
Assessment includes learning about the child and cough’s history, physical examination and, where appropriate, staged testing. Where the cause or treatment isn’t clear, trials of therapy, further tests and/or sometimes a careful watch and wait approach may be appropriate. In young children, whilst taking care to maintain safety, time can be a useful tool.
Not all wheeze is asthma.
Wheeze is a particular kind of noisy breathing that generally indicates narrowing of the breathing passages within the lungs. Wheeze may occur by itself or in association with other symptoms such as cough or difficulty breathing.
Whilst not normal it isn’t uncommon for pre-school children to get transiently wheezy with otherwise ordinary viral upper respiratory infections. This isn’t generally considered asthma, often doesn’t need specific treatment, and most children will grow out of this tendency in time.
If your child is breathless or having difficulty breathing seek urgent medical attention (ambulance, after hours health centre or hospital emergency department as appropriate).
If wheezy episodes are more severe, frequent, persistent, or occurring even without apparent viral infections then a more careful assessment is needed. Asthma and asthma treatment may be considered. Other lung conditions associated with wheeze or breathing difficulty ought also be explored.
Other breathing concerns
A healthy child’s lungs are well equipped to support their growing needs and cope with the usual infections and environmental exposures. Some children are born with or develop vulnerabilities that make breathing harder or leave them prone to infections. A child with persistent or recurrent respiratory symptoms, without adequate explanation, ought be assessed for underling vulnerabilities.
Some things that make a child more vulnerable include:
cold damp housing
tobacco smoke exposure
over-crowding
premature birth
underlying immunodeficiency
congenital or acquired lung or airway damage
swallowing difficulties
neuromuscular or developmental disorders
genetic disorders
If you are concerned about your child’s respiratory health see a medical professional.