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What causes a cough?
Coughing is a natural reflex designed to protect your child's airways from getting blocked. The body coughs to:
- Clear the throat and chest of irritants, such as mucus, dust, or smoke.
- Because of inflammation in the airways or lungs from an infection.
Most coughs are caused by the common cold, but there are several other reasons your baby might have a cough, including allergies, asthma, and a sinus infection.
Baby cough: When to worry
Coughs are common in young children, and usually not dangerous. Coughing in newborns is less common. If your baby is under 4 months old, a cough could be a sign of something serious.
In general, it's time to call the doctor if your child has a cough and:
- Is younger than 4 months old
- Is breathing more rapidly than usual or looks like he's working harder to breathe
- Is wheezing
- Is coughing up mucus that's yellow, green, or blood-streaked
- Refuses to drink anything for multiple feeds
- Has a fever and is not acting like himself
- Has a chronic illness, such as heart or lung disease
- Coughs so hard that he vomits
- Gets a persistent cough after choking on something
- Has a cough that doesn't get better after about two weeks.
And, of course, if your child ever seems to be having serious trouble breathing, call 911 right away.
Types of baby cough
There are two types of cough that help keep your child’s airways clear and sometimes the cause of both of these types of cough can be the same:
- Baby wet cough
A wet cough, also called a productive cough, will typically bring up mucus or phlegm, which is a mixture of mucus, debris and cells from the lungs.
- Baby dry cough
A dry or nonproductive cough does not bring up mucus.
Baby cough symptoms, and what they mean
There are many reasons your child might have a cough. Below are some of the most common causes of coughs, and telltale symptoms to look out for.
Baby cough with stuffy nose
Likely cause: The common cold
- Watery eyes
- Little or no appetite
- Low fever
What to do: Colds are the most common cause of coughs in children. If your child has a cold:
- Don't give him medicines to suppress the cough. Coughing is an important way for him to clear his airways.
- Try honey if child is over 1 year old. You can give him 2 to 5 milliliters of honey or corn syrup to thin the mucus and loosen the cough (but never give honey to a child that is under 1 year old because it can cause infant botulism, a rare but potentially fatal illness).
Baby cough with cold and labored breathing
Possible cause: Respiratory syncytial virus (RSV)
What it is: RSV is most common in babies and young children, though children of any age can get it. Usually RSV only causes cold-like symptoms in healthy children. But it can lead to more serious respiratory illnesses, such as bronchiolitis (inflammation of the small breathing tubes) and pneumonia (inflammation of the lungs), especially in babies less than a year old. RSV usually strikes between November and mid-March
Other symptoms (if RSV may be leading to bronchiolitis or pneumonia):
- Worsening cough
- Fast breathing
- Extreme fatigue
- Bluish or gray lips and fingernails (because of decreased oxygen in the bloodstream)
What to do: Most children recover from RSV without treatment, but call the doctor if you suspect that your child may be developing bronchiolitis or pneumonia.
Baby cough with fever and trouble breathing
Possible causes: Pneumonia or bronchitis
What it is: Many cases of pneumonia, an infection in the lungs, start out as a cold. Bronchitis results when the bronchi (tubes that carry air to the lungs) become infected, often after a cold or flu. It can cause a nagging cough for several weeks.
- Body aches
What to do: If your child has symptoms of pneumonia or bronchitis, call his doctor for an appointment. Your child may need an antibiotic to clear up the infection and cough. (If the infection is viral, he'll get better without antibiotics.)
Baby barking cough
Likely cause: Croup
What it is: Croup is usually caused by an infection of the vocal cords (larynx), windpipe (trachea), and bronchial tubes (bronchi) that results in swelling. Coughing through the swollen vocal chords produces a sound similar to a barking seal.
- Cough gets worse at night
- Stridor (a high-pitched whistling sound) when your child breathes in.
What to do: As horrible as this cough can sound, in most cases it's not too serious and can be treated at home. Here are some tips:.
- Comfort your child to keep him calm and help him breathe better if he wakes up coughing.
- Keep your child hydrated. Make sure your child is getting plenty of fluids.
- Elevate her head. If your child is more than a year old, you can try elevating her head a bit while she sleeps, to help ease her cough. (Don't use pillows with babies, as this increases the risk of SIDS.)
- Use a cool-mist humidifier or take your child into a steamy bathroom. This may help reduce swelling of the airways, although it's not scientifically proven.
For more ideas see our article on croup in babies.
If your child’s croup doesn’t seem to be improving, call your doctor for advice. She may want you to bring in your child for an examination.
Baby cough that won't go away
Possible causes: Allergies, asthma, environmental irritants, and sinusitis
What they are:
- Allergies are reactions of the body, such as a hacking dry cough, that are usually caused by an overactive immune system.
- Asthma causes the linings of the tubes that carry air to the lungs to become inflamed even if symptoms, that can include a cough, are not present.
- Environmental irritants can include things like cigarette smoke or pollution.
- Sinusitis is an inflammation of the lining of the nose and sinuses. It can be either viral or bacterial.
- Stuffy or runny nose with clear mucus
- Coughing after running around, at night, or after exposure to cold (if it's asthma)
- Cough and a runny nose that has lasted for at least 10 days with no sign of improvement, and the cough tends to get worse at night (a sign of sinusitis)
What to do:
- If you suspect the cough is caused by allergies, asthma, or sinusitis make an appointment with your child’s doctor for a diagnosis. (If the doctor determines that your child has bacterial sinusitis, she'll prescribe an antibiotic. The cough should stop after the sinuses are clear again).
- When an environmental irritant is suspected, you'll want to identify and eliminate the problem right away.
Baby cough with no other signs of illness
Possible cause: Swallowing or inhaling an object
Why: A cough that has persisted for a week or more without any other signs of illness (like runny nose, fever, or lethargy) or allergies (clear discharge) could mean that your child has something stuck in his throat or lungs. This scenario is more common among small children who are mobile, have access to small objects, and like to put things in their mouth.
What to do: If your child's doctor suspects that a foreign body is causing the cough, she'll order a chest X-ray. If it shows something trapped in the lungs, the object will have to be removed surgically.
Baby cough followed by "whoop" sound
Likely cause: Whooping cough, also known as pertussis.
What it is: Whooping cough is a highly contagious respiratory tract infection caused by a bacteria called pertussis. It's become less common thanks to widespread use of the DTaP vaccine, but outbreaks still occur. More than 15,000 cases were reported in the United States in 2018.
- A child with whooping cough typically coughs nonstop for 20 or 30 seconds, and then struggles to breathe before the next coughing spell starts.
- Cold symptoms, such as sneezing, runny nose, and a mild cough, for up to two weeks before more severe coughing spells begin.
What to do: If this sounds like what your child has, call his doctor right away. Whooping cough can be severe, especially in babies younger than a year old. If your child has whooping cough, your doctor will probably prescribe antibiotics. Some babies need to be hospitalized.
Baby cough with thick yellow or green mucus
Possible cause: Cystic fibrosis
What it is: Cystic fibrosis affects about 1 in 3,000 children in the United States, and a constant cough with thick yellow or green mucus is one of the strongest indications that a child may have inherited the condition.
- Recurrent pneumonia and sinus infections
- Not gaining weight
- Salty-tasting skin
- Large, greasy stools.
What to do: If a doctor confirms a cystic fibrosis diagnosis, antibiotics are used to treat the accompanying lung infections and various techniques are used to help cough out the thick secretions in the lungs.
This is unlikely in a baby, although sometimes babies cough to test their voice or to get attention. However, sometimes a toddler or older child develops a cough from an illness and continues to cough out of habit, even after he's otherwise healthy. If your child is coughing out of habit, he won't do it while he's sleeping, and it will rarely interfere with his eating or speaking. However, it can be disruptive (in a classroom, for example).
What to do: Usually, if you wait it out, your child will stop coughing of his own accord. If your child is 4 or older, you can try giving him lozenges or cough drops to distract him from coughing.
Can I give my baby cough medicine?
No, babies should not be given cough medicine.
If you have an older child, ask the doctor before giving him over-the-counter cough or cold medicine. These medicines are generally not recommended for young children, and the American Academy of Pediatrics says you can treat coughs and colds without them.
Here are recommendations by age:
- Under age 4: Do not give cough or cold medicine to your child.
- Ages 4 to 6: Use these medications only if your child's doctor recommends it.
- Ages 6 and older: You can give your child an over-the-counter cough or cold medicine – just make sure it's appropriate for his age and measure each dose exactly according to the directions. Also, never give your child more than one type of cough or cold medicine at a time. They often include multiple ingredients, and you wouldn't want to give your child a double dose of any of them.
See our age-by-age guide to children's medicine for more on medication safety. For tips on other ways to soothe your child's cough and cold symptoms, see our article on safe home remedies.
- Test your knowledge with our quiz: What is your child's cough telling you?
- Hear what a cough sounds like with croup or whooping cough
- Review our age-by-age guide to children's medicine
- Get tips on how to protect your family from colds and flu
- Learn the truth about 13 cold and flu myths