Why Is My Baby Coughing? 8 Possible Causes and When to Worry

Caring for a baby with a wet or dry cough? Listen for wheezing, hacking, or barking first, then read on to find out what's normal and when it's time to worry.

Your baby will cough quite a bit in their first several months of life—and for good reason. Coughs are the body's way of protecting itself. They help 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, explains Howard Balbi, M.D., director of pediatric infectious diseases at Nassau County Medical Center in East Meadow, New York.

But here's where things get tricky: A baby's cough can mean many different things, and it's not as if you can ask them 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.

Wondering what to do for a baby with a cough? We compiled this guide to help you differentiate a wait-and-see cough from one that demands immediate medical attention. The next time you're dealing with newborn or baby cough, stay calm, listen carefully to the sound, and follow the directions below.

Types of Baby Coughs

If your baby has a cough, it's important to break down the details for proper diagnosis and treatment. There are two kinds of coughs that a baby might have: a dry cough or wet cough.

  • Baby Dry Cough: This type of cough is unproductive, meaning it doesn't produce mucus. A dry cough might occur when a baby has a cold or allergies, and it helps clear postnasal drip or irritation from a sore throat.
  • Baby Wet Cough: A wet cough causes phlegm or mucus (which contains white blood cells to help fight germs) to form in the baby's airways. It often results from a respiratory illness accompanying a bacterial infection.

What About Newborn Coughing?

Children younger than 4 months don't cough much, so if they do, it's serious, says Catherine Dundon, M.D., an associate clinical professor of pediatrics at Vanderbilt University Medical School and a pediatrician in Goodlettsville, Tennessee. If a newborn is coughing terribly in the winter, for example, 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, and they often signal nothing more than a cold.

Baby Cough From a Cold

If your baby has a dry cough along with symptoms like a stuffy nose, it could indicate a cold.

What a cold sounds like

A dry hacking cough

Cold symptoms

Signs of a baby cough that may indicate a cold or the flu include a stuffy or runny nose and sore throat. Coughs are usually dry, but depending on the severity of the cold, your baby can have rattling mucus and/or a slight fever at night.

Baby cough remedies for a cold

Try your own parent's "lots-of-fluids-and-plenty-of-rest" routine. Although you may be eager to give your baby cough medicine or cough syrup, the American Academy of Pediatrics (AAP) advises against using these for kids under 6 years because studies have shown that they don't work—and they can have potentially fatal side effects in those younger than 4. It's better to stick to natural baby cough remedies such as honey (for babies over one year), saline drops, and a cool-mist humidifier. Acetaminophen is safe for reducing a fever.

If your child's temperature is 100.4 degrees or higher and they look sickly, call your doctor. Also call your doctor immediately if your baby is 4 months old or younger and they have any signs of fever; even a slight fever is serious in babies.

Baby Cough From Croup

Usually caused by a viral infection, croup makes the lining of the trachea swell up and closes the airways, which leads to breathing difficulties in babies.

What croup sounds like

A barking cough

Symptoms of croup

The most telling croup cough symptom: hearing your baby coughing at night with a barking noise (the sound is hard to mistake) and difficulty breathing. The seal-like barking cough appears when your baby inhales (not on the exhale).

Croup typically affects children under age 5 and often begins with a normal cold or sniffle earlier in the day. After you first hear your baby coughing in sleep, croup should clear up in three or four days; if it doesn't, call your doctor.

Croup treatment

First try to calm your child. Then consider one of the following techniques to ease their breathing:

  • Run the shower, close the bathroom door, and let your child breathe in the steamy air.
  • If it's a mild evening, take them outside; the damp air should make it easier for them to breathe.
  • Have your child breathe the air from a cool-mist humidifier if one is available. Cool air from the fridge or freezer can be helpful as well.

Baby Cough from COVID-19

Babies usually have mild or asymptomatic cases of COVID-19, but they can also develop a wide range of side effects, including a dry or wet cough. Symptoms generally appear within 2-14 days of exposure to the virus, and they often resemble a cold or flu.

What COVID-19 sounds like

Dry and continuous cough—though wet coughs are also possible. Some babies get a barking cough that resembles croup.

Symptoms of COVID-19

The symptoms of COVID-19 vary widely. Aside from cough, babies may experience fever, runny nose, shortness of breath, decreased feeding, changes in behavior, vomiting, diarrhea, or other symptoms. In rare cases, COVID can lead to severe illness that requires hospitalization.

Treatment for COVID cough in babies

Contact your health care provider if you suspect COVID-19; they might recommend getting your baby tested. If they have the coronavirus, isolate them (and their primary caregiver) away from other household members. Seek medical help for worrisome symptoms, such as breathing or feeding difficulties, blue-ish lips, dehydration, or an inability to wake.

Baby Cough That Indicates Bronchiolitis

According to the Centers for Disease Control and Prevention (CDC), bronchiolitis is characterized by inflammation of the small airways in your lungs. Many things can cause constriction of the airways, including environmental factors such as dust. But the vast majority of bronchiolitis cases in babies under age 1 are caused by respiratory syncytial virus (RSV).

RSV usually triggers a simple cold in kids older than 3, but it can penetrate the lungs of infants and can be potentially life-threatening, warns David Rubin, M.D., chief of pediatrics at St. Barnabas Hospital in the Bronx, New York. It may also lead to a wheezing cough in babies.

What bronchiolitis sounds like


Symptoms of bronchiolitis

Bronchiolitis comes on after what seems to be a basic cold, with coughing and a runny nose. Since baby cough or wheezing is associated with both bronchiolitis and asthma, it can be hard to tell them apart. However, bronchiolitis is usually seen in the fall and winter and may be accompanied by a slight fever and loss of appetite.

Baby cough remedies for bronchiolitis

You can treat bronchiolitis at home once your baby's breathing is under control. Give them lots of fluids, plenty of rest, and a cool-mist humidifier, and always keep an eye on your child's respiratory rate. If it gets too high—50 breaths per minute or more—your child is definitely in respiratory distress. Call 911.

Whooping Cough in Babies

This life-threatening bacterial infection was a leading cause of infant illness and death until the DTaP vaccine was created in the 1960s, which practically eradicated it in the U.S. However, whooping cough has been making a comeback and there have been outbreaks in many states in recent years.

What whooping cough sounds like

A loud, rapid whoop

Symptoms of whooping cough

In most cases of whooping cough (pertussis), the baby has no cold symptoms or fever. Signs of whooping cough include:

  • Frequent, alarming coughing spasms
  • Tongue sticking out
  • Bulging eyes
  • Face discoloration

Preventing whooping cough

Make sure your baby has been immunized. And because babies aren't fully protected until they've received multiple doses of the vaccine, it's essential that you and all of your infants' caregivers get vaccinated with the Tdap (tetanus, diphtheria, pertussis) booster.

Treatment for whooping cough

If you suspect your baby is suffering from whooping cough, call 911 immediately. By the time the coughing fits develop, the infant must be hospitalized so they can receive oxygen during coughing spells, according to Ruffin Franklin, M.D., of Capitol Pediatrics and Adolescent Center in Raleigh, North Carolina.

Your baby—as well as every member of your household—will also be prescribed an antibiotic to prevent the spread of this very contagious disease. After the initial attack, whooping cough will need to run its course, which can take months.

Pneumonia Baby Cough

Pneumonia is a viral or bacterial infection of the lungs brought on by a number of conditions, including the common cold. A cough that indicates pneumonia will most likely sound wet and mucousy.

What pneumonia sounds like

Wet and phlegmy

Symptoms of pneumonia

A baby with pneumonia will be very fatigued. They will also have a "productive" wet baby cough, bringing up everything imaginable in shades of green and yellow.

Treatment for pneumonia

Treatment depends on whether the cause is viral or bacterial, so call your doctor, especially if the baby has a fever. Bacterial pneumonia is usually more dangerous and is most commonly brought on by strep pneumoniae.

Asthma Baby Cough

Because asthma involves a narrowing of the airways, a baby's cough with asthma will sound like wheezing. Doctors generally agree that asthma is not common in children younger than 2, unless the baby has had bouts of eczema and there's a family history of allergies and asthma. Until there's an absolute diagnosis of asthma, a tightening of baby's airways resulting in wheezing is referred to as Reactive Airway Disease.

What asthma sounds like


Symptoms of asthma

In the case of severe asthma symptoms, your baby will be suffering from retractions (a sucking in and out of the chest and diaphragm). Your infant might also display other symptoms like fast breathing, panting, difficulty eating or sucking, and tiredness, according to the Asthma and Allergy Foundation of America.

Treatment for asthma

Whatever the case, it's always best to call your doctor when you hear your infant wheezing. Even without a definitive diagnosis of asthma, doctors often use asthma medication to treat a bout of wheezing. Your doctor may prescribe a liquid form of albuterol to open the airways. If the asthma attacks are very severe, albuterol is administered via a nebulizer—a special device that delivers the medicine in a fine mist—sometimes used with an infant-sized face mask so baby can inhale the drug more easily.

If a young baby has a terrible cough or one that worsens after a day or two, and their breathing becomes labored, call your pediatrician immediately. As with bronchiolitis, keep an eye on your child's respiratory rate. If it gets too high—50 breaths per minute or more—your child is definitely in respiratory distress. Call 911.

Baby Cough That Indicates Foreign Object

Small toys and food, such as a piece of carrot or hot dog, are the most common causes of choking. If a baby starts gasping or coughing suddenly while eating or playing with small toys, look in their mouth for an obvious culprit. They can usually cough it out themselves. A cough without any noise may indicate a complete obstruction and is a medical emergency.

What it sounds like

Small, persistent cough or gasping

Symptoms of a stuck foreign object

Since babies are always sticking things in their mouths, it's possible to miss something that's been stuck for days. Symptoms of a baby cough from a foreign object include:

  • An initial coughing spell followed by a persistent cough or slight wheezing over a period of days afterward—without any other cold symptoms and no recent history of cold or fever
  • Pneumonia can also be a result of food that got swallowed the wrong way and stuck in a baby's lungs—peanuts are very common culprits, says Catherine Dundon, M.D., an associate clinical professor of pediatrics at Vanderbilt University Medical School and a pediatrician in Goodlettsville, Tennessee.

If the object has totally blocked your baby's airway, they would exhibit the following symptoms:

  • Appearing to be in obvious distress
  • Making no sound at all
  • Turning pale or blue

Treatment for an object stuck in baby's throat

If you suspect a totally blocked passageway, turn the baby over and immediately deliver five back blows between their shoulder blades. If you're unable to dislodge the foreign object, call 911.

In the case of a partially lodged object, try to help your baby cough it up by tilting their head down and giving them a few gentle pats on the back. If you suspect your baby is suffering from a partially lodged object, but they don't appear able to cough it up, they'll need a chest x-ray. If a bit of food is indeed stuck, the doctor will refer you to a specialist who can perform a bronchoscopy. During the procedure, the child is put under general anesthesia, and a tiny fiber-optic tube with tweezers at the end goes down the airway and picks out the foreign body.

Baby Cough: When to Worry

Call your doctor if your baby has:

  • Any cough, and they're younger than 4 months
  • A dry cough related to a cold (a runny nose but no fever) that lasts more than five to seven days
  • A dry or wet cough with a cold and a fever of 100 degrees or more
  • Mild, light wheezing
  • Fits of coughing

Call 911 if your baby is:

  • Wheezing rapidly
  • Grunting
  • Unable to catch their breath
  • Turning blue
  • Rapidly retracting and expanding their stomach
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