Lots of children have coughs at this time of year caused by viruses or hay fever.
But if their cough persists, there’s a chance it could be sparked by the most common long-term condition among children – asthma.
On World Asthma Day (May 2), Asthma + Lung UK (A+LUK) points out that around 1.1 million children and young people in the UK are currently being treated for asthma – that’s around two children in every classroom.
“Children can cough for a variety of reasons, so it’s important to look at the whole picture,” stresses Deborah Waddell, a respiratory specialist nurse at A+LUK. “All children will have a cough at some point in their lives when they get a cold or virus, particularly when they first start mixing with other children at nursery or school.
“Talking to a doctor or nurse about the nature of the cough – such as whether it’s wet or dry, when it happens, or what makes it worse or better – can help provide important clues as to why they may be coughing.
“However, children with asthma are likely to have some or all of the characteristic features of asthma.”
A typical asthma cough in a child, says Waddell, may be “a dry cough which can wake them up and interrupt their sleep”. Such coughs either won’t go away or keep coming back, and are common at night or in the early morning.
And Dr Atul Gupta, a consultant in paediatric respiratory medicine at King’s College Hospital, London, adds: “Frequent dry coughing that worsens with a viral infection, occurs during sleep or is triggered by exercise or cold air is a common asthma symptom.”
A common symptom of asthma is wheezing, and Waddell explains: “A wheeze is a high-pitched whistling sound coming from the chest, usually on the out breath. These symptoms may come and go.”
Waddell says children with asthma may say their chest feels tight, and adds: “Young children may describe this as a tummy ache.”
Shortness of breath
A cough, chest tightness and wheezing may be accompanied by shortness of breath or difficulty breathing, says Waddell.
“A doctor may suspect asthma when the characteristic symptoms of cough, wheeze, chest tightness and difficulty breathing are happening at a time when the child doesn’t have a cold or virus,” she suggests.
What else you need to know
The doctor or nurse will ask questions about family history of asthma and allergies – particularly on the maternal side – and whether the child has had any eczema or allergies in the past, explains Waddell.
“They’ll look carefully at the child’s medical history to assess how likely it is that the cough is asthma,” she says, pointing out that once a child is over five years old, medical staff will usually be more able to do lung function testing to confirm a diagnosis.
Of course, at this time of year children’s coughs may also be caused by seasonal pollen. Waddell says seasonal allergic rhinitis (hay fever) affects around 10-15% of children in the UK, and it can trigger asthma symptoms in children with diagnosed asthma.
She explains that children with allergies to pollen such as tree or grass may struggle with mucus running down the back of their throats from the nasal passages, which can make them cough. This may sound like a wet cough and be accompanied by a stuffy nose, throat clearing, mouth breathing and other allergy symptoms such as itchy, watery eyes.
A+LUK recommends parents who suspect their child’s cough may be asthma should make an appointment with their GP, and keep a symptoms diary. Waddell says: “Include what the symptoms are, when they happen, and what makes them better or worse. Be prepared with information about family history too in case the doctor needs it.”
In addition, it can be useful to film your child when they’re coughing. “If it’s safe to do so, then filming your child when they have symptoms like coughing, or making a recording of how their cough sounds, makes it easier to show the doctor what your child’s symptoms are like,” explains Waddell. “This can be useful if he or she isn’t having symptoms at the time of the appointment.
“The doctor will assess the likelihood of asthma based on the discussion and examining the child, and they may start a trial of asthma medicines to see if they make a difference. Continue to keep a symptom diary and review it to see if these medicines have helped in six to eight weeks.”
For more information about asthma and coughing, call the Asthma + Lung UK helpline on 0300 222 5800.