Decoding Baby's Cough

A baby's cough can mean very different things, and it's not as if you can ask your baby what's wrong. Sometimes it's hard to know if you should call your doctor for advice, make an appointment, or head straight to the emergency room.

Coughs are the body's way of protecting itself, explains Howard Balbi, MD, director of pediatric infectious diseases at Nassau County Medical Center in East Meadow, New York. Coughing serves as the method the body uses to keep the airways clear, ridding the throat of phlegm, postnasal drip (nasal mucus that drips down the back of the throat), or a lodged piece of food. There are two kinds of coughs that serve this purpose:

• Dry cough: This occurs when a baby has a cold or allergies. It helps clear postnasal drip or irritation from a sore throat.
• Wet cough: This results from a respiratory illness accompanying a bacterial infection. This causes phlegm or mucus (which contains white blood cells to help fight germs) to form in baby's airways.

Children younger than 4 months don't cough much, so if they do, it's serious, says Catherine Dundon, MD, an associate clinical professor of pediatrics at Vanderbilt University Medical School and a pediatrician in Goodlettsville, Tennessee. In the winter, if an infant is coughing terribly, it could be respiratory syncytial virus (RSV), a dangerous viral infection for infants. Once your child is older than age 1, coughs are less alarming. In most cases, chances are your baby's cough is nothing more than a cold.

To help you tell a wait-and-see cough from one that demands immediate medical attention, stay calm, listen carefully to the cough, and follow the directions on the following pages.