Coughs in babies

Coughs can be distressing for your baby, but, as long as she’s feeding and breathing normally, they’re usually nothing to worry about (NHS 2018a).

Soothing a coughing baby can be hard work, though. You and your partner may have a few sleepless nights until your baby gets better.

What causes coughs in babies?

Most coughs are caused by a virus, such as one of the many viruses that cause the common cold or flu (RCHM 2018a, Sambrook 2017). Your baby could get seven or more colds in her first year, because her immune system is still learning how to fight off common viruses (NHS 2018a, WebMD 2018, Whelan 2017).

Aside from cold and flu viruses, here are some of the most common causes of coughs in babies and young children:

• Respiratory syncytial virus (RSV), a common virus that causes chest infections. In most cases it’s no worse than a cold. But it can occasionally lead to more serious conditions such as bronchiolitis and pneumonia (BMJ 2019).
• Croup, a viral infection that causes inflammation of the voice box and airways (NICE 2019).
• Whooping cough (pertussis), a bacterial infection of the windpipe and airways that can be very contagious. Getting the whooping cough vaccination in pregnancy and keeping up with your baby’s immunisations will help protect her against whooping cough (NHS 2016a).

Find out what to do if you think your child may have coronavirus.

Coughs can also have non-infectious causes, such as asthma (NICE 2017, RCHM 2018a).

How will a cough affect my baby?

It can be tough to see your little one coughing, and the sounds that she makes may even worry you, particularly the first time. But coughing alone won't harm your baby's lungs (Sambrook 2017).

You may notice that your little one needs a bit more sleep than usual as she fights off the virus (Sambrook 2017), and she'll certainly need plenty of extra love and cuddles to help her feel better.

In some cases, babies can cough so hard that they make themselves sick. Although this can be tough for you and your baby, it isn't usually anything to worry about (Sambrook 2017). Nonetheless, it's worth mentioning it to your child health nurse, or seeing your GP if it happens a lot.

If your baby has the common cold, you may also notice other symptoms, such as:

• general restlessness and irritability
• a runny or blocked nose (congestion)
• sneezing
• a fever
  (NICE 2016)

How can I treat my baby’s cough?

Most coughs go away on their own, and don't need any special treatment. Coughs are usually caused by a virus (Sambrook 2017), which means that antibiotics won't help. Instead, just keep your baby as comfortable as possible until she gets better.

When your baby has a cold, you can help make her feel more comfy by:

• Making sure she gets plenty of rest (NICE 2016).
• Keeping her fluids up (NHS 2018a, NICE 2016) by offering extra breastfeeds. If she’s formula-fed, offer extra drinks of water. If your little one is under six months, boil the water and allow it to cool before offering it to her (NHS 2018d).
• If your baby has a fever and seems miserable or in pain, give her the correct dose of infant paracetamol or infant ibuprofen (RCHM 2018b). Your little one can have infant paracetamol if she’s more than one month old (RCHM 2018b). She can have infant ibuprofen if she’s three months or older (RCHM 2018b).

Don’t use over-the-counter cough and cold medicines, including decongestants. These aren’t suitable for children under seven years old because of the risk of side-effects, and there’s not much evidence that they help soothe symptoms anyway (NICE 2016, TGA 2012).

Avoid using pillows, bedding rolls or wedges to prop your baby up in her cot. Although these might relieve her symptoms a little, they also increase the risk of sudden infant death syndrome (SIDS). It's safest for your baby to sleep on a firm, flat mattress (NHS 2018b).

Don’t give honey to your baby if she’s under one year old because it can cause a rare form of food poisoning, called botulism, in babies (NHS 2018c).

When should I take my baby to the doctor for her cough?

If your baby's cough starts to make it difficult for her to breathe, take her to the nearest hospital emergency department straight away (NHS 2018a).

You should take your baby to the doctor if:

• She‘s under three months old, at the first sign of illness especially if her temperature is 38 degrees C or more (NHS 2016b).
• She’s between three and six months old with a temperature of 39 degrees C or more (NHS 2016b).
• She’s unusually quiet, listless or lethargic (NHS 2017).
• She’s finding it difficult to swallow – you may notice feeding difficulties or more drool (Sambrook 2017).
• She develops other symptoms, such as a rash, chest pains, headache, sore throat, earache or swollen glands (Sambrook 2017).
• Her cough lasts more than 10 days and she has other symptoms, including green, brown or yellow mucus (Sambrook 2017).
• Her cough won’t go away after three or four weeks (NHS 2018a, Sambrook 2017), particularly if it gets worse at night (NHS 2018a).

It's normal for your baby to need a bit more sleep when she's fighting off a virus. But if she's drowsy all the time, it's also worth seeing your GP (NICE 2016, Sambrook 2017).

In general, if you're ever concerned about your baby's health, it's always a good idea to mention it to your child health nurse or see your GP (RCHM 2018a).

If you’re concerned about your baby’s cough, check whether it matches the symptoms of:

• croup
• whooping cough
• bronchiolitis
• coronavirus
• asthma