A qualified nurse, author and first aid trainer with over 30 years’ healthcare and teaching experience

Autumn is the prime time for colds, coughs, sneezes and sniffles.

As the weather steadily becomes colder and damper, existing breathing issues such as asthma can become unstable and need more careful management.   

Added to which, infections and viruses such as bronchiolitis and croup can adversely affect a child’s ability to breathe, even without underlying issues such as asthma. 

Watching anyone struggle for breath is scary. As any parent will know, it is exceptionally distressing to watch your child struggle for breath.

Following our expert tips will help you know how to best respond to a situation where you child experiences difficulty breathing. Feeling empowered about how to help, allows you to stay as calm as possible, which benefits both the situation and your child.


When someone has asthma their airways go into spasm, causing tightness of the chest; the linings of the airways become inflamed and produce phlegm leading to extreme difficulty in breathing. There are 1.1 million children in the UK with asthma. 

If your child has an asthma attack: 

  • Stay as calm as you can and encourage them to stay calm too. 
  • Sit them down, loosen any tight clothing and encourage them to take slow, steady breaths. 
  • If they do not start to feel better, they should take 2 puffs of their reliever inhaler – or follow the instructions as they have been prescribed. Ideally using a spacer.
  • If they do not start to feel better after taking their inhaler as above, or if you are worried at any time, call 999/112. 

They should keep taking the reliever inhaler whilst waiting for the paramedics to arrive, up to a maximum of 10 puffs (or as directed on their inhaler)

Learning to spot early warning signs can help you anticipate and possibly avoid an asthma attack.  

These are:  

  • using the reliever inhaler three or more times a week,  
  • finding the reliever inhaler is not controlling symptoms for more than 4 hours,  
  • coughing or wheezing at night or in the morning,  
  • breathlessness when talking,  
  • struggling to keep up with friends, because of breathlessness developing a cold or being exposed to flu like symptoms 

EXPERT TIP: Help your child prepare a Personalised Asthma Action Plan (PAAP) with their asthma nurse or GP. This contains information on triggers, how and when to take preventers and relievers, and a clear action plan in the case of an asthma attack. 

Research shows children without a PAAP are four times more likely to end up in hospital than those with one, yet less than 25% of children with asthma have one. 

If your child has a PAAP share a copy with the school or activity clubs your child attends and store a copy on your phone to share with caregivers, friends or family who may look after your child 


Bronchiolitis is a common lower respiratory tract infection affecting babies and young children under 2 years old.  It is caused by a virus known as the respiratory syncytial virus (RSV)Around 1 in 3 children in the UK will develop bronchiolitis during their first year of life.  

It spreads through tiny droplets from coughs or sneezes of an infected person and causes inflammation of the smallest airways in the lungs – the bronchioles. This reduces the amount of air entering the lungs, making it difficult to breathe. 

Treatment: There is no medication to treat the virus, so at-home care is normally sufficient. Give your child paracetamol or ibuprofen if they have a temperature. Keep them hydrated. 

Always get medical advice if your child is struggling to breathe. 

Most cases of bronchiolitis aren’t serious, but see your GP or call 111 if: 

  • you’re worried about your child 
  • your child has taken less than half of their usual amount of feed over the last 2 or 3 feeds, or they haven’t had a wet nappy for 12 hours or more 
  • your child has a persistent high temperature of 38C or above 
  • your child seems very tired, irritable or unwell 

Dial 999 for an ambulance if: 

  • your baby is having difficulty breathing 
  • your baby’s tongue or lips are a dark purple or blue colour  
  • there are long pauses in your baby’s breathing 

CROUP is a common viral condition that affects the airways of babies and young children, it can be alarming, but is usually self-limiting. 

Croup starts with cold-like symptoms such as a temperature, runny nose and cough. Further symptoms develop after a few days are often worse at night. These include:  

  • difficulty breathing  
  • a rasping sound when breathing in 
  • a barking cough that sounds like a seal  
  • a hoarse voice  

TreatmentDO sit your child upright to ease symptoms. Comfort them if they are upset as crying can exacerbate symptoms. Keep them hydrated. DON’T give your child cough/cold medicines. 

Steam can help the symptoms but is no longer recommended because of the high risk of burns and the possibility that the moist air could help spread the infection. 

Call an ambulance if your child is seriously struggling to breathe, using accessory muscles to help them breathe and you are worried. 


Whooping Cough is a highly contagious bacterial infection of the airways which starts with a sore throat, runny nose and slight fever. Within 2 or 3 days a cough develops causing the sufferer to produce lots of thick and sticky phlegm. This leads to bouts of a choking cough that can cause children to vomit and panic as they have difficulty breathing. The choking attacks of coughing can last a couple of minutes and can happen up to fifty times a day.  

Young babies under six months of age are at a particularly increased risk of complications of whooping cough. 


Stay at home, get plenty of rest and plenty of fluids. Clean away mucus and sick from your or your child’s mouth. Take painkillers such as paracetamol and ibuprofen if your child is feeling unwell. 


You can’t completely avoid infection, but you can’t minimise your exposure to germs by following our nine top hygiene tips. 

  • wash your hands and your child’s hands frequently  
  • wash or wipe toys and surfaces regularly with a disinfectant spray 
  • keep infected children at home until their symptoms have improved  
  • cover your child’s mouth or nose with a tissue when coughing or sneezing 
  • use single use tissues and dispose of used tissues immediately 
  • keep new born babies away from people with colds or flu  
  • don’t share cups, glasses dishes or cutlery 
  • avoid touching your eyes, nose or mouth  
  • avoid smoking around your child, and don’t let others smoke around them 

When to call your GP 

  • If you are worried  
  • If your child’s symptoms are getting worse. 

When to call for an ambulance or head to A&E  

  • If your child is struggling to breathe. 
  • If their lips or skin start to look purple or blue 
  • If your child seems listless and disengaged, irritable and unwell 

Written by Emma Hammett for First Aid for Life

It is strongly advised that you attend a fully regulated Practical or Online First Aid course to understand what to do in a medical emergency. Please visit https://firstaidforlife.org.uk or call 0208 675 4036 for more information about our courses.

First Aid for Life is a multi-award-winning, fully regulated first aid training provider. Our trainers are highly experienced medical, health and emergency services professionals who will tailor the training to your needs. We specialise in paediatric first aid training for schools, nurseries and childcare professionals and offer a full range of courses for parents too. Courses for groups or individuals at our venue or yours.

First Aid for life provides this information for guidance and it is not in any way a substitute for medical advice. First Aid for Life is not responsible or liable for any diagnosis made, or actions taken based on this information.

Little girl with the flu – isolated

Emma Hammett

Emma Hammett is a qualified nurse, author and first aid trainer with over 30 years’ healthcare and teaching experience. Emma is the Founder of three multi-award-winning businesses; First Aid for Life, Onlinefirstaid.com, First Aid for Pets and her social cause StaySafe.support. She has published multiple books and is an acknowledged first aid expert and authority on accident prevention, health and first aid. Emma writes for numerous online and print publications and regularly features in the press, on the radio and on TV. She is the first aid expert for the British Dental Journal, British Journal of School Nursing, the Mail online and Talk Radio with Eamonn Holmes. She is a member of the Guild of Health Writers and Guild of Nurses.

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