If your child has a bad cough

If your child has a bad cough, it’s important to recognise it early. A persistent wet cough can lead to the development of lung diseases such as bronchiectasis.

Cough-free – the way to be

Wairingi Koopu (rugby league star): Can you hear that? This is the sound of a child with chronic persistent wet cough. Scary, isn’t it? Whānau, this is a serious warning sign and should not be ignored. Your child needs urgent medical attention.

What is chronic persistent wet cough?

Dr Cass Byrnes (paediatric respiratory specialist, Starship Hospital): A chronic persistent wet cough is a mucousy phlegmy fruity-sounding cough. It sounds like the children have got mucus down in their chest and it usually occurs most days and can go on for weeks at a time.

Here is an example.

This cough is not normal and may be a sign that your child has a serious chest infection. It is important that your child sees a doctor as they could develop a serious lung disease.

What happens if chronic persistent wet cough is not treated?

If a chronic persistent wet cough is not treated it can go on for weeks and even months, and it’s a sign that there’s an ongoing chest infection in the lungs and it essentially is causing some permanent scarring in the lungs.

Wairingi Koopu: Chronic persistent wet cough if left untreated can lead to lung damage and disease such as bronchiectasis.

What is bronchiectasis?

Bronchiectasis is a chest disease in which the breathing tubes called bronchi in the lungs become damaged and enlarged. Tiny hairs called cilia line the inside of these breathing tubes. These hairs help to collect any phlegm or mucus from the lungs.

When your child has bronchiectasis their lungs make more mucus than normal. The tiny hairs that should clear the mucus stop working properly and the mucus gets stuck in the breathing tubes. It is within this extra mucus that germs grow and cause infection.

These infections cause damage and scarring to the breathing tubes and lungs. The breathing tubes become baggy and holes form in the lungs. Once this has happened the scarring and damage cannot be fixed.

What causes bronchiectasis?

Dr Cass Byrnes: Bronchiectasis is a type of permanent lung scarring which is caused by having ongoing infection in your lungs. That mucus means that there’s mucus and bugs down there and it’s breaking up some of the lung walls and doing lung damage.

What are the symptoms of bronchiectasis?

Wairingi Koopu: Children with bronchiectasis will feel well most of the time but the main symptom to look out for is the chronic persistent wet cough. This cough produces a build-up of phlegm which may be yellow or green in colour and smelly, showing signs of infection. It is important that you seek medical attention if your child has these symptoms.

What happens if we ignore this symptom?

Dr Cass Byrnes: Ignoring the chronic persistent wet cough means that you’re going to go on and develop more and more lung scarring. That cough shows that there are problems in the lung. It shows that there is a build-up of mucus, that there is infection and the more and longer that that goes on, the more damage that that lung is going to have permanently lifelong, and set the child up for recurrent further infections.

How can bronchiectasis be prevented?

Wairingi Koopu: By:

  • not smoking during pregnancy
  • breastfeeding our tamariki
  • early detection and treatment of chest infections in childhood
  • improving living conditions
  • eating a healthy balanced diet
  • immunisation.

We visit the Hiko whānau who deal daily with the effects of having tamariki with bronchiectasis.

Henrietta Hiko (mother of twins): The illness has changed our lives immensely. I have to give up everything pretty much to go back and forth to the hospital when the girls are sick. They’re sick at the moment but they don’t look it, but I know that they’re sick.

How can a parent manage bronchiectasis? What can they do?

Kimberley Taylor (physiotherapist, Hawkes Bay District Health Board): Some easy ways that parents can help to manage their tamariki’s bronchiectasis are to get them more active. Exercising outside, running around, on the trampoline, anything that makes them huff and puff, because when you’re huffing and puffing you’re getting air circulating all the way down to the bottom of your lungs and that helps to shift the mucus.

Other things that are really good to help with managing bronchiectasis are to keep your whare auahi kore – so keeping your tamariki smoke-free and telling your whānau to keep outside of the whare when they’re smoking and out of the waka when they’re smoking.

Wairingi Koopu: If you are concerned about your child’s health, please seek medical attention.

For more information please visit the Asthma Foundation website.

This video was produced by the Ministry of Health together with Health TV.

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