An occasional cough wouldn’t bother you. But if your baby coughs continuously and for days together, it is definitely worrisome. They wouldn’t sleep or feed, and can even get breathless. You want to help them in whatever way possible but may not know what to do.
MomJunction tells you about the various reasons for a cough in babies, its causes, and treatment.
Why Do Babies Cough?
Coughing is a natural protective reflex of the body to get rid of any obstructions that block the airways. Coughing helps clear any harmful substances such as dust or food particles that go in accidentally. It also helps remove excess secretions of the respiratory system, such as phlegm (1).
When there are secretions, it is referred to as a wet cough. Otherwise, it is called a dry cough.
What Causes A Cough In Babies?
The symptoms that your baby displays can help you determine the causes of a cough. Here are 11 leading causes of coughing in babies and toddlers.
1. Common cold
It usually begins as a wet cough and then becomes a dry cough as the baby gets better.
- Several viruses are responsible for a common cold, with rhinovirus being the most common one (2).
- Usually, coughs due to cold can persist for up to two months after the baby is cured of the condition (3).
[ Read: Home Remedies For Dry Cough In Babies ]
2. Whooping coughs
This type of coughing is interrupted by a peculiar inhalation noise that sounds like a whoop. The cough is intense and quite distinctive from other coughs.
- The Bordetella pertussis bacteria causes whooping cough, which can last for days or even months together (4).
- Production of toxins by the bacteria can irritate the airways and cause persistent coughing (5).
Croup coughing sounds like barking, almost like that of the water animal seal (6).
- There are several types of croup including viral croup, bacterial croup, and spasmodic croup (7) (8).
- Croup usually comes down within a week and can go away faster if you initiate treatment early on.
4. Lung or sinus infection
Lung infections lead to the formation of phlegm in the lungs, causing a wet cough. Sinus infections also result in a wet cough when the infected fluids from the sinus are pushed into the throat.
- A common lung infection among babies and toddlers is bronchiolitis, where the tiny airways within the lung, called bronchioles, get infected. The most common cause of bronchiolitis is the respiratory syncytial virus (RSV) (9).
- Several viruses and bacteria can cause infection of the sinus. When the infected secretions trickle from the nose to the throat (postnasal drip), they tend to irritate the throat and eventually cause coughing (10).
Coughs due to allergies are usually dry, with very little phlegm if any (11).
- The baby will display other symptoms of allergy such as swelling of the nasal cavity, throat muscles, face, etc.
- A common cause of a cough is allergic rhinitis, which occurs when the baby inhales potential air allergens from dust, dust mites, to pollen, mold or pet dander (12).
[ Read: How To Relieve Cold Symptoms In Babies ]
- Asthma is a genetic condition that can arise due to several triggers including allergens like pollen and dust, chemicals, stress, and even cold weather.
- The condition often persists for a lifetime, since there is no cure for it (14). However, it can be easily managed with medication and by avoiding exposure to triggers.
7. Gastroesophageal reflux
A cough due to this would be wet, but not contain phlegm or mucus. Instead, the infant would spit out small quantities of stomach contents, such as milk, when they cough.
- Coughing due to gastroesophageal reflux happens when the stomach acid is pushed into the esophagus due to a relaxed oesophageal sphincter and reaches as far as the throat (15).
- The baby with gastroesophageal disease (GERD) will display other symptoms such as wet burps, wet hiccups, and arching of the back.
8. Cystic fibrosis
A persistent dry or wet cough, which can bring out a lot of mucus from the lungs (16).
- Cystic fibrosis (CF) is a genetic disease that causes the formation of thick mucus in the lungs, which the body is unable to clear. The mucus becomes a breeding ground for bacteria, thus leaving the child prone to lung infections.
- CF has no cure, but modern medicine helps people with CF to live a normal life without obstacles.
It is a sudden outburst of a cough that usually occurs while eating and drinking when the food or the secretions go down the airways instead of the food pipe. In such cases, the baby or toddler will cough and gag.
- The risk is usually higher when eating solids that can get lodged inside the airways and cannot be expelled easily like liquids. Babies can experience aspiration if they insert a foreign body, like a small toy, in their mouth, which can also lead to choking.
- Existing conditions such as congenital abnormalities in the bones of the skull and GERD can make a baby more prone to the condition (17).
- Babies who drool excessively, due to teething or any other reason, may cough and gag when the saliva trickles into the windpipe (18).
[ Read: Whooping Cough Symptoms In Babies ]
10. Congenital heart and respiratory problems
A dry cough could be a symptom of heart conditions while a wet cough is usually the result of respiratory problems. In both the cases, the baby will present other symptoms like fatigue and poor appetite that supersede the symptom of coughing.
- Coughing is often a collateral symptom of congenital heart and respiratory problems. It presents itself when the child is involved in physical activity.
- Tracheomalacia, a condition where the trachea (windpipe) partially or entirely collapses and makes passage of air difficult, is a congenital respiratory problem that can cause coughs (19).
- Coughing could often be an indicator of heart failure in the case of children with heart defects, thus making it a medical emergency (20).
11. Habitual coughing
They are dry coughs with usually no signs of distress or any other symptoms. The baby/toddler would otherwise be healthy and normal.
- Toddlers living in a dusty environment may cough a lot. They may do it so often that even when they are away from the triggers, the tendency to cough frequently persists.
- An indicator of a habitual cough is that the child does not cough when preoccupied, like in the middle of a game or a movie. Also, he/she will not cough during sleep and will not seem bothered by coughing.
A cough is often one of the significant symptoms of the conditions mentioned above. It can be prominent in some cases and may go unnoticed by the parents in others. Nevertheless, remember that in some scenarios, a coughing baby or toddler needs immediate medical attention.
When To Take The Baby To Doctor For Cough?
Take the baby to the doctor right away if any of the following symptoms accompany coughing:
- Fever, with the temperature above 100.4°F (38°C) (21).
- Lethargy, colic, and extreme fussiness.
- Cough is accompanied by a peculiar noise or/ and is accompanied by wheezing or whistling sounds.
- The baby does not eat properly and has a loss of appetite.
- Coughing expels a lot of phlegm, which is greenish, contains red spots, or has a foul smell.
- The baby becomes semi-consciousness or droopy after a coughing episode.
- The child complains of pain in the lungs or chest after coughing. The chest also hurts when touched, which could be due to a ruptured muscle or fractured rib, resulting from frequent violent coughing.
- Simple activities such as climbing up the stairs, sprinting, and walking outdoors trigger coughing.
- The baby usually vomits after coughing.
- The baby gasps during a bout of coughing and is unable to produce any sound from the mouth.
- The baby’s lips turn bluish after a few moments of coughing.
- The toddler faints after a violent outburst of coughing.
The doctor will suggest the right course of treatment for the baby’s cough, depending on the cause behind it.
[ Read: Symptoms Of Bronchiolitis In Babies ]
How Is Coughing Treated In Babies?
Treatment for coughing could include one or more of the following options.
- An antibiotic course is prescribed when coughing is a result of a bacterial infection. The dose of antibiotics can vary as per the disease, age of the child, and the severity of the infection.
- Analgesic medications such as acetaminophen (brand name Tylenol), are used to alleviate the discomfort associated with coughing, as well as to bring down the fever.
- Preventive medicines are used for persistent conditions such as asthma and cystic fibrosis. These medicines help bring down the intensity of the ailment, which eventually cuts down the coughing. Medications could also be used to bring down the frequency of acid reflux and eventually stop it in the long run.
- Taking rest will help avoid triggers to coughing due to allergies. Rest is also necessary in the case of viral infections, which the immune system has to fight on its own, without the help of medications.
- Surgical intervention is necessary in the case of severe conditions such as congenital heart defects, severe gastroesophageal reflux, and craniofacial abnormalities that could trigger chronic coughing.
Always consult the baby’s doctor for treating cough, and avoid the use of generic, over-the-counter (OTC) cough medicine for the baby.
Can You Give OTC Cough Medicines To The Baby?
No. Never give any OTC cough syrup or tablets to a baby or toddler.
The US Food and Drug Administration strongly advises against the use of cough medicines for children below the age of two years (22). The agency also states that such medicines can adversely affect the child’s health and even cause life-threatening side effects.
The American Academy of Pediatrics states that it is best to stay away from OTC cough medicines until the age of four years (23). Instead of reaching for that bottle of a cough syrup, try a few home natural remedies after consulting the pediatrician. Better yet, try and prevent a cough in babies with the precautions we tell you next.
[ Read: What Causes Croup In Babies ]
How To Prevent A Cough In Babies?
Preventing coughs in babies is all about avoiding things that could trigger or cause a cough. So, here is what you can do.
- Maintain good hygiene: Respiratory illnesses spread when an infected person passes the virus to the others through the air while sneezing or coughing. If someone in the family has cold or lung infection, then keep your baby away from them. Tell them to sneeze or cough into a napkin or tissue. Always wash your hands before handling the baby and the baby’s items to prevent spreading the virus via touch.
- Keep an eye on cough triggers: If your baby tends to cough when exposed to pollutants such as automobile smoke and dust, avoid exposure to them. Some children with asthma should not be taken to open fields with thick vegetation since they can inhale pollen, which can trigger coughing.
- Keep choking hazards away: Infants tend to explore things by putting them in their mouth, which puts them at the risk of choking when tiny objects can lodge in their windpipe. Baby-proof your house and store away small toys, household items, and plastic bags that increase the risk of aspiration-induced coughing.
- Medicines should be kept handy: Timely administration of medication is the best remedy for prevention of a cough caused by genetic diseases such as asthma and cystic fibrosis. Keep medicines handy always, to prevent the onset of coughing on exposure to triggers.
- Be watchful of severe symptoms: Some causes of cough, such as heart diseases, can be subtle and difficult to spot unless the baby has been diagnosed with the condition in the past. Keep an eye on any odd symptoms accompanying the cough and report to the doctor.
While coughs are mostly benign, they become a cause for concern when they persist for too long or are accompanied by other symptoms. If you sense something is wrong with the baby’s coughing, then do not hesitate to take them to the doctor. Early diagnosis and initiation of treatment can play a crucial role in successful treatment and management of several serious illnesses that can trigger a cough.
2. A C. Palmenberg, D. Spiro, R Kuzmickas et al.; Sequencing and Analyses of All Known Human Rhinovirus Genomes Reveal Structure and Evolution; Science (2009)
3. W. Kormos, MD; What causes a cough after a cold?; Harvard Health Publishing (2017)
4. Dr. C Gellner; Whooping Cough Can Kill; University of Utah, Health Sciences
5. K Hays; Pertussis; Austin Community College
6. Dr. C Gellner; Home Treatments For Croup That Will Help Your Child’s Barking Cough; University of Utah, Health Sciences
7. Croup and Your Young Child; American Academy of Pediatrics (2009)
8. D Knutson, A Aring; Viral Croup; Am Fam Physician. 2004
9. Respiratory Syncytial Virus; Children’s Hospital of Philadelphia
10. That nagging cough; Harvard Health Publishing, 2010
11. 8 Causes of Chronic Cough in Kids; Rush University Medical Center
12. N Blanton; Could your seasonal allergy flare ups be allergic rhinitis?; Baylor College of Medicine (2018)
13. Asthma in Infants; Asthma and Allergy Foundation of America (2015)
14. About Asthma; Stanford Medicine
15. Symptoms & Causes of GER & GERD in Infants; NIH, NIDDK (2015)
16. About Cystic Fibrosis; Cystic Fibrosis Foundation
17. Feeding And Swallowing Problems – Aspiration; Vanderbilt Health (2014)
18. J Buchanan; Your Infant is Teething: Know the Signs and Symptoms; Children’s Hospital, Los Angeles
19. Tracheomalacia; Boston Children’s Hospital
20. Heart Failure in Children; Stanford Children’s Health
21. Fever and Your Child; American Academy of Pediatrics (2007)
22. Most Young Children With a Cough or Cold Don’t Need Medicines; USFDA
23. Coughs and Colds: Medicines or Home Remedies?; American Academy of Pediatrics (2018)
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