Nighttime coughing is not considered normal in babies and is usually worse at night because of Baby's sleeping position as he lies facedown. Nighttime cough can be indicative of several health conditions.
"When a cough is primarily at night, it may also be triggered by mucus running across the gag reflex," says Hai Cao, M.D., a pediatrician in Brooklyn. If your baby is sick, the act of coughing itself works to clear the throat and upper passages from mucus and congestion. Another cause might be gastroesophageal reflux disease (GERD), in which stomach contents leak backwards into the esophagus.
But "the most important thing to establish about a cough is whether or not it's related to the lungs," says Dr. Cao. If the cough is from the lungs, the visual signs of breathing trouble will be evident. "The abdomen will go in and out, and the muscles in between the ribs will contract with each breath," Dr. Cao says. "The throat will also go in and out with each breath, and the nostrils flare like a horse's."
If those visual signs are absent, the cough is likely from postnasal drip and can be addressed by keeping the upper airways clear.
For Coughs Related to Colds
If your baby's cough is due to a cold and it's bad enough to keep him awake for much of the night, there are ways to make him more comfortable. Clear your baby's airways with over-the-counter saline drops or a saline spray, suggests Dr. Cao, or use a suction, provided by a doctor, to help drain the nasal passages. Make sure to keep a humidifier in your baby's room, which allows for smoother and less irritating airflow, according to Dr. Cao.
Babies under 12 months can be given a teaspoon of corn syrup to help with a cough that is caused by a cold, suggests David L. Hill, M.D., a pediatrician and author of Dad To Dad: Parenting Like A Pro. Any other cold remedies or medications are not recommended.
"Cold medications, like cough suppressants and decongestants, have never been shown to actually work and can be risky for children under the age of 2," Dr. Hill said. After the U.S. Food and Drug Administration (FDA) recommended that over-the-counter cough and cold products be avoided for children under the age of 2, manufacturers complied and went further, voluntarily restricting their labeling to children 4 and under, as there is a high risk for overdose, especially in children under 2.
If your baby is old enough to have pillows in bed, add an extra one for nights when her cough is especially bad. Keeping your child's head elevated can help with nasal drainage.
For Coughs Related to GERD
But no matter what the cause is, if any nighttime cough lasts more than a few weeks and/or is accompanied by fever, shortness of breath, or rapid breathing, call your pediatrician right away.
For Coughs Related to the Lungs
If you suspect your baby's cough is coming from his lungs, this is a serious condition. Contact your pediatrician right away for the best treatment.
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