Unlike adults, infants and young children are still developing their respiratory systems, making them far more vulnerable to infections, inflammation, and environmental triggers.
Yet, many parents don’t realise that a large number of childhood breathing problems are preventable or at least manageable—with early intervention, the right environment, and timely medical care. According to Dr Su Siew Choo, Consultant Paediatric Respiratory, understanding what’s normal, what’s not, and when to seek help can make a world of difference to a child’s long-term lung health.
When is a cough “Just a cough”?
Coughing is one of the most frequent concerns that parents bring their children to the clinic. “Not every cough means something serious, but not every cough should be ignored either,” Dr Su explains.
“In children, common respiratory conditions include asthma, acute bronchiolitis, preschool wheezing, post-viral coughs, upper and lower respiratory tract infections, allergies such as allergic rhinitis, and chronic wet cough caused by protracted bacterial bronchitis. Some children also experience sleep-related breathing disorders like obstructive sleep apnea. Less common respiratory conditions include chronic suppurative lung disease, bronchiectasis, chronic lung disease of infancy, including bronchopulmonary dysplasia, congenital airway and pulmonary anomalies and chronic sequelae from severe respiratory infections, including pulmonary tuberculosis,” said Dr Su.
The challenge is that symptoms often overlap. A common cold typically presents with symptoms such as a runny or blocked nose, sneezing, a sore throat, and a mild cough—without accompanying wheezing or chest tightness. Allergies may cause sneezing, itchy eyes, and post-nasal drip, but typically no breathing difficulty unless asthma is triggered.
Asthma, however, can look deceptively mild at first. “An asthma attack often includes wheezing, persistent coughing, shortness of breath, or chest tightness,” Dr Su says. These symptoms may worsen with exercise, allergens, or viral infections. Even when a child seems well, a dry nighttime cough or cough after exertion may signal poorly controlled asthma.
The hidden dangers of self-medicating
When a child coughs, many parents instinctively reach for over-the-counter cough syrups. While well-intentioned, this habit can be risky.
“Children are not small adults,” Dr Su emphasises. Some cough syrups contain antihistamines, decongestants, or codeine-based ingredients that can cause excessive drowsiness, agitation, rapid heart rate, or even breathing problems, especially in younger children. Worse still, masking symptoms at home may delay the diagnosis of conditions like pneumonia, asthma, or severe allergies.
“Respiratory medicine doesn’t just chase the cough,” Dr Su explains. “We ask why the child is coughing. When we address the root cause, we reduce hospital visits, improve quality of life, and help children thrive.”
Navigating haze and infection waves
In Malaysia, parents are no strangers to haze seasons and waves of respiratory infections such as influenza, respiratory syncytial virus (RSV), or COVID-19. Protecting young lungs during these periods requires both vigilance and routine.
During poor air quality days, keeping indoor air clean is key. Windows and doors should be closed, and HEPA-filter air purifiers should be used in bedrooms or main living areas. Indoor pollutants like cigarette smoke, incense, or candles should be avoided entirely. Outdoor play should be limited when the air pollution index is unhealthy, especially for children with asthma.
In infection seasons, simple habits go a long way. Frequent handwashing, good respiratory etiquette, cleaning high-touch surfaces, and keeping sick children at home help reduce the spread. For older children in crowded indoor spaces, wearing a good-quality mask may offer extra protection. Maintaining regular sleep, balanced nutrition, hydration, and up-to-date vaccinations, including the annual flu vaccine, also strengthens immunity.
Smoke, vapes, and small lungs
“One of the most damaging yet preventable risks to a child’s lungs is passive smoke exposure. Children exposed to secondhand cigarette smoke face higher rates of bronchitis, pneumonia, ear infections, asthma development, and more severe asthma attacks. Long-term exposure can even impair lung growth, leading to reduced lung capacity that persists into adulthood,” said Dr Su.
Vaping, often mistaken as a safer alternative, is not harmless either. Vape aerosols contain nicotine, ultrafine particles, heavy metals, and chemicals that irritate and inflame young airways. Children exposed to vaping are more likely to develop chronic cough, wheezing, and airway inflammation similar to early asthma.
“A smoke-free and vape-free home is one of the most effective ways to safeguard your child’s lung health,” Dr Su explains.
Turning your home into a haven for lungs
Healthy lungs begin at home. Dr Su recommends keeping indoor spaces well-ventilated when outdoor air quality allows, using HEPA air purifiers, and monitoring humidity to prevent mould growth. Regular cleaning reduces dust and allergens, while pets should be kept out of children’s bedrooms if allergies are suspected. Strong fragrances from air fresheners to cleaning products should also be minimised.
Equally important is preventing the spread of infections within the household through hand hygiene, surface cleaning, and good ventilation when someone is unwell.
Advanced care for growing lungs
For children who need specialised care, Pantai Hospital Kuala Lumpur offers comprehensive paediatric respiratory services. These include the diagnosis and management of asthma, recurrent chest infections, chronic lung disease, bronchiectasis, congenital or acquired airway disorders and sleep-related breathing disorders.
The team also provides long-term support for children with severe respiratory conditions, including non-invasive or invasive ventilation, home oxygen therapy, and follow-up for premature infants with chronic lung disease such as bronchopulmonary dysplasia. Sleep-related breathing disorders are assessed through home or in-hospital sleep studies and overnight oximetry, with emergency and inpatient care available for serious illnesses such as severe pneumonia.
Paediatric Lung Function Services
We offer a dedicated paediatric lung function service, designed specifically to meet the unique needs of infants, children, and adolescents. Recognising that children are not simply “small adults,” our assessments are delivered in a child-friendly environment by clinicians and nurses experienced in working with young patients and their families.
Our comprehensive service includes impulse oscillometry (IOS), spirometry, and fractional exhaled nitric oxide (FeNO) testing. Impulse oscillometry (IOS) is a child-friendly lung function test that plays an important role in both diagnosis and long-term management of breathing disorders. It measures how easily air flows through the airways by sending gentle pressure waves into the lungs while the child breathes normally through a mouthpiece. Because it does not require deep breaths or complex instructions, IOS is especially useful for young children (typically from age three), those who struggle with traditional spirometry, or children with anxiety or developmental differences—allowing doctors to detect early airway problems and track treatment response more accurately over time.
These complementary techniques allow us to assess airway function and inflammation accurately across a wide age range, including children who may find traditional breathing tests challenging. Together, they support early diagnosis, treatment monitoring, and personalised management of conditions such as asthma and other paediatric respiratory disorders.
By offering paediatric lung function testing separately from adult services, we ensure age-appropriate care, clear communication, and high-quality results that clinicians and families can trust.
“Early intervention matters,” Dr Su notes. Because when little lungs struggle, the right knowledge and the right care can help them breathe easier, grow stronger, and keep up with childhood’s endless adventures.
