Everything You Need To Know About Your Infant’s Cough

Your mind can race to plenty of places when you hear your baby start to cough. And don’t forget your heart when the coughing happens while they’re eating because turning baby over, head lower than body, and smacking their back is now a maternal instinct. But there are many reasons why an infant coughs, and learning about them will help you know when it’s totally normal or time to take them to the pediatrician.

Coughs are common in babies and easily passed from those that are closest them, including parents or older school-age siblings in the house. If your baby has shared child care, coughs are pretty routine. “Coughs can be frustrating for parents,” says Dr. Olumuyiwa Akerele, D.O., pediatrician and new father. “If the infant is in day care, that would probably be a big source besides the parents.”

Any hint of a baby’s discomfort can be alarming to parents, and I’ve been there too. You want nothing more than to fix it all and help them feel better. So I called a couple of experts to offer insight and reassurance about the causes and treatments for baby coughs, and the signs to watch for before raising your level of concern.

Why is my newborn baby coughing?

Babies, just like older children and adults, cough to clear their airways. Different factors can cause your baby to develop a cough, but “viral illnesses are the Number 1 reason for an infant having a cough,” Akerele says. If your baby has a viral illness, like the common cold, mucus builds up in the nasal cavities and lungs and coughing is the body's reflex to get rid of it. In addition to a cough, they may have a runny nose and some throat irritation as well.

Environmental factors like heavy pollen, dust, and smoke can also contribute to an infant's coughing because they can irritate the nose and throat, but they don’t typically produce a lingering coughing reaction. Other causes can be more serious, like if your baby has developed pneumonia or has an upper respiratory infection such as whooping cough, says Akerele.

What are the symptoms of whooping cough?

Whooping cough is a serious illness for babies that is unfortunately common. It’s a respiratory disease caused by a bacterium called Bordetella pertussis and is very contagious. Many of the more severe cases are among babies under 1 year old, with half of them needing hospitalization. “Children under 2 months are at highest risk,” says pediatrician Dr. Anastasia Gentles, M.D.

The early symptoms are very similar to those of a common cold, making it hard for parents to anticipate the seriousness of it at first. More serious symptoms of whooping cough appear after one to two weeks, which include:

• harsh cough
• shortness of breath
• a distinctive whooping sound at the end of the coughing
• apnea, which is a pause in breathing

Generally, the most telling whooping cough symptom is the whooping sound as the sufferer catches their breath, but infants do not often make that sound. Instead, “infants can stop breathing,” Gentles says.

Getting the DTaP and Tdap vaccines, which offer protection against diphtheria, tetanus as well as pertussis (aka whooping cough), is the most effective way to prevent whooping cough, advises Gentles. “The other children and adults in the house are the way that they [babies] catch it,” so she recommends the close relatives get vaccinated, too. The Centers for Disease Control and Prevention (CDC) also backs the safety and effectiveness of the vaccine for pregnant women.

What are the symptoms of pneumonia?

One of the more serious reasons your baby may have a progressing cough can be that they’ve developed pneumonia. It’s caused by a viral, bacterial, or even fungal infection that fills the lung’s air sacs with fluid. Your baby with pneumonia would have a cough — usually one that produces mucus — chest pain, fever, and fatigue, and will be working much harder to breathe, taking short, quick breaths.

If you notice any of these symptoms, call a doctor, especially if your baby is under age 2.

What are cough remedies for a newborn?

A cough can be very uncomfortable for your baby, but, “there’s no real-good remedy in terms of medicines,” Akerele says. Over-the-counter cough medicines aren’t deemed safe for children under age 6.

Parents have to focus on just comforting their babies. “Most of the time, it’s supportive care — suctioning up the nose, making sure they’re adequately hydrated, and getting the boogies out,” says Akerele.

In the case of a more serious diagnosis, like whooping cough or pneumonia, a pediatrician may prescribe antibiotics. This treatment is more effective when your baby starts the meds early into their illness.

When to worry about Baby’s cough and contact a healthcare provider

Since cough medications are not advised or ineffective for babies, coughs may persist for weeks. Usually that is not a cause for alarm. So when should you worry about your baby’s cough? If they are showing the following signs, per Akerele:

• difficulty feeding
• difficulty or increased effort to breathe
• breathing faster than normal
• lethargy
• mild fever

If there are no other symptoms accompanying your baby’s cough, and your baby otherwise seems fine, just continue to monitor them at home and give them lots of love. Of course, if you have any concerns or questions, contact your provider.

Experts interviewed:

Dr. Olumuyiwa Akerele, D.O., pediatrician at Naval Hospital in Jacksonville, FL

Dr. Anastasia Gentles, M.D., pediatrician and medical director at Pediatrix Urgent Care of Houston