Coughs, colds and breathing difficulties

A PDF version of Coughs, Colds & Breathing Difficulties Pathway Guidance for Parents & Carers is available. If you would like to print out the Pathway information - please do so from this document.

  • What should I do if my child has a high temperature?

    A normal temperature is less than 37.5◦C


    0-3 months: Temperature above 38⁰C – seek help

    3-6 months: Temperature above 39⁰C – seek help

    Babies and children 6 months and older

    A high temperature alone is not a good guide to working out how ill your baby or child is.

    For further information see the High Temperature pathway

    Please note that very small babies may have low temperatures which may be worrying

  • My baby has a cold and is not feeding well
    • Offer smaller and more frequent feeds
    • If your baby is taking less than half their usual feed (over a 12 hour period) seek help
    • Repeated dry or damp nappies, dry lips or mouth, sunken eyes or fontanelle (soft spot on top of babies head) are signs of dehydration: seek urgent help
    • Saline nose drops before feeds may help clear the mucous in the nose these can be purchased from a pharmacy
  • Preventing respiratory illness

    Children who live in a smoky atmosphere are more likely to suffer from illness such as coughs, colds and asthma.

    Protect you and your family by avoiding smoking and smokey areas.

    Contact your local NHS stop smoking service or your GP surgery/pharmacy for help to quit smoking.

    Cough medicines are NOT recommended for children under the age of 6 years.

    Breastfeeding can help prevent respiratory illness, so try to continue.

    Encourage the whole family to eat a healthy balanced diet.

    Encourage the whole family to wash their hands regularly to prevent colds spreading.

    The majority of children do not require antibiotics.

    Catch it – Bin it – Kill it

  • Emergency

    Call 999 if your child show signs of a life threatening illness which may include:

    • Your child’s colour becoming extremely pale or blue or both
    • Your child becoming unresponsive or you are unable to rouse your child
    • Several long pauses in your baby or child’s breathing lasting 10 seconds
    • Your child is struggling to speak or drink because of breathing difficulties
  • It's common for babies and children to get a lot of coughs and colds

    Parents and carers can usually manage babies and children at home with:

    • A blocked nose
    • Cough
    • Sneezing
    • Sore throat
    • Earache
    • Feeding a little less than usual
    • Occasional vomit after coughing
    • General aches and pains
  • When should I seek help?
    • Coughs lasting more than 3 weeks
    • Fast, or short shallow breathing
    • Noisy breathing 
    • Forced or strained breaths
    • Chest and neck muscles pulled in with each breath
    • Sucking in under the rib cage
    • Raised temperature: see Page C overleaf
    • Less wet nappies: see Page B overleaf
    • Breathing makes baby’s head bob
    • Breathing makes nostrils widen
    • Difficulty speaking or drinking
    • Vomiting frequently after coughing
    • Having less than half of usual feeds
    • Pale or mottled skin (blotchiness, with different shades and colours)
    • Very restless, or very agitated, or very sleepy
  • People I can turn to for help
    • Friends and Family
    • Health Visitors
    • GP
    • Pharmacists
    • Out of Hours doctor
    • 111
    • NHS Choices Website
    • Children’s community nursing team

    If your child is seen by a hospital doctor or by the Emergency Department they will inform your GP surgery, health visitor or school nurse.

  • What the health professional will do

    With you they will reach a clear understanding of your child’s needs by:

    • Listening to you and your child’s concerns
    • Taking the full history including previous episodes or patterns
    • Observing and assessing your child 

    With you they will agree a plan

    The plan will depend on:

    • If your child is less than 6 months old
    • If there are signs of an illness that needs treatment
    • The need for further assessment
    • If there is a long term condition. e.g. asthma

    * The most common outcome for children with coughs, colds and breathing difficulties is to get better at home.

  • The Plan

    The plan will include :

    • Where to look after your child – most will stay at home
    • Advice on home care – including when to ask for help again
    • Expected length of illness and likely outcomes
    • If and when a review of your child is necessary

    For some the plan will include advice on:

    • Further assessment or tests
    • A named key contact
    • Attending nursery and school
    • Long term conditions
    • Further helpful information
  • How will I know my child is better?
    • Breathing will be back to normal
    • Drinking, eating, weeing and sleeping will start to improve
    • The cough will start to reduce within 3 weeks
    • The temperature will be normal (37.5oC or less) within 5 days