Why Respiratory Problems Are Rising Among Children

 Asthma, Allergies, Cough and More. Poor Ventilation, Pollution and Urban Living May Be Playing a Role

Respiratory problems among children appear to be increasingly common, with parents reporting frequent colds, coughs, wheezing, allergies and asthma-like symptoms. According to paediatric pulmonologist and paediatric allergy specialist Dr C. Suman Kumar of Ankura Hospitals, changing lifestyles and living environments could be contributing to the problem.

The doctor points to congested housing, inadequate ventilation, increasing apartment living, traffic pollution and poorly ventilated schools as some of the factors that can influence respiratory health.

In homes where windows remain closed for long periods or air-conditioning is used continuously, air circulation can be limited. Similarly, classrooms without adequate ventilation can allow respiratory infections to spread more easily from one child to another.

Urbanisation and Pollution: A Growing Concern

Increasing urbanisation, traffic congestion and pollution are creating a combination of environmental challenges for children. The discussion also highlights a shift in the pattern of respiratory illness: while respiratory infections remain common, allergies are becoming an increasingly important concern.

Most respiratory infections in children involve the upper respiratory tract, resulting in symptoms such as a runny nose, throat congestion and cough. In some cases, infections affecting the upper airways can also be followed by lower respiratory symptoms.

When Should Parents Worry About Fever, Cold and Cough?

Not every episode of cold, cough and fever requires immediate medical intervention.

The doctor explains that if a child remains active between fever episodes, continues to take at least a reasonable amount of food and fluids, passes urine normally and becomes active again when the fever subsides, parents can generally observe the child closely.

However, breathing difficulty, repeated vomiting, inability to eat or sleep, marked weakness or significant disruption of the child's normal activities are warning signs that warrant medical attention.

For many viral infections in young children, fever may be more prominent during the first few days, followed by increasing cold and cough symptoms. The fever generally begins to settle around the fourth or fifth day, while cough and cold symptoms may take several more days to disappear.

Antibiotics Are Not the Answer to Every Fever

One of the strongest messages from the discussion is against unnecessary antibiotic use.

The doctor explains that most childhood fever-and-cold episodes are viral, and antibiotics work against bacteria rather than viruses. Therefore, antibiotics should not be started simply because a child develops fever or cough.

The choice of an antibiotic depends on several factors, including the child's age, the suspected organism, the site of infection and the child's exposure history. In some situations, testing may also be required before deciding on treatment.

There is also no single antibiotic, dose or treatment duration that is suitable for every infection. Depending on the infection, treatment may differ considerably.

Stopping Antibiotics Early Can Promote Resistance

Another concern is stopping an antibiotic as soon as the fever comes down.

According to the doctor, antibiotics may take time to act against a bacterial infection. If treatment is stopped prematurely, surviving bacteria may become resistant to the medicine. Repeated inappropriate use can contribute to antibiotic resistance, potentially making future infections more difficult to treat.

For this reason, parents should not reuse leftover antibiotics or decide on antibiotic doses and duration on their own.

Is Every Cough Bad?

Cough itself is not necessarily a disease. It is often the body's mechanism for clearing irritation or secretions from the airways.

The doctor cautions against the idea that every cough must immediately be suppressed with medication. Treatment should instead focus on identifying the reason for the cough and determining whether the child is experiencing significant discomfort or breathing difficulty.

Night-time cough can become more troublesome because the airways naturally become narrower during sleep. If the airways are already inflamed because of an infection or allergy, this narrowing can contribute to increased coughing, wheezing or breathing difficulty at night.

Cough Syrups and Nebulisation: Don't Self-Medicate

Parents often turn to cough syrups or nebulisation when a child develops cough or breathing symptoms. However, the doctor stresses that these treatments should not be used routinely without medical advice.

Nebulisation has specific indications and is not appropriate for every cold or cough. It is particularly important that parents do not start nebulisation simply because a child develops a cough.

The doctor also cautions against indiscriminate use of cough syrups in very young children. According to the discussion, cough medicines have little role in children below one year, while cold medicines are not recommended for infants below six months.

Premature Babies May Have a Higher Respiratory Risk

Premature babies can have an increased susceptibility to respiratory problems because their airways and lungs may not be fully mature at birth.

However, being born prematurely does not automatically mean that a child will develop asthma. The risk can vary depending on factors such as the child's age, respiratory problems around birth and whether respiratory support was required.

Persistent Cough Can Sometimes Be a Sign of Asthma

Asthma does not always present with the classic wheezing sound.

In young children, cough may be a more prominent symptom. A child who repeatedly coughs without fever, particularly at night or after running, crying or physical activity, may require evaluation for asthma.

Wheezing may also be difficult for parents to recognise in very young children because their airways are smaller and the sounds may not always be clearly audible.

A family history of allergies or asthma can also increase suspicion, although the presence of cough or wheezing alone does not automatically establish an asthma diagnosis.

When Is Allergy Testing Necessary?

Allergy testing is not necessarily required for every child who has occasional cold, cough or respiratory symptoms.

According to the doctor, testing becomes more useful when symptoms are difficult to control, when a child requires higher doses of medication, or when multiple possible triggers are involved.

The purpose of identifying an allergy is primarily to help control the condition and, where possible, reduce exposure to relevant triggers.

Parents should also be careful about interpreting allergy-test reports. A positive test does not automatically mean that a particular food must be removed from a child's diet. The child's actual clinical history and symptoms need to be considered before eliminating foods unnecessarily.

Healthy Children Are Not Defined by Weight Alone

The discussion also addresses another common parental concern: whether a child is gaining enough weight.

The doctor emphasises that a child's health should not be judged by body size alone. Activity levels, learning and mental development, and physical growth are important indicators of overall wellbeing.

A child who is active throughout the day, learns and develops appropriately and continues to grow may be healthy even if they appear thin compared with other children.

Screen Time: Why Active Parenting Matters

The interview also touches on children's increasing exposure to screens.

The doctor argues that completely eliminating screens may be difficult in today's digital environment, but responsible and limited use, under parental guidance, is important. More importantly, screen time should not replace interaction with parents, grandparents, peers, outdoor activity and real-world experiences.

The discussion stresses that young children need opportunities to observe their surroundings, ask questions, interact with people and learn through physical activity and social experiences. Excessive passive screen exposure may interfere with these opportunities.

The Bigger Message for Parents

Children are naturally exposed to infections as they grow, and completely preventing every cold or cough is neither realistic nor necessary. The focus should instead be on creating healthy environments, maintaining good ventilation, encouraging active lifestyles and recognising symptoms that genuinely require medical attention.

At the same time, unnecessary antibiotics, cough medicines and nebulisation should be avoided. Persistent or recurrent respiratory symptoms, breathing difficulty or symptoms suggestive of asthma or allergies should be evaluated by a qualified paediatrician or specialist.

As respiratory infections decline in some settings, allergies may become a more prominent concern, making awareness and appropriate medical evaluation increasingly important for parents.