Sick or Serious? Decoding Your Baby’s Coughs

Coughing is a normal reflex that clears the throat and airway of mucus, saliva, and other irritants. In children, it’s usually a sign of a viral upper respiratory infection. “Coughing is the body’s way of ridding itself of foreign irritants,” says David L. Hill, M.D., a pediatrician in Boone, North Carolina, and author of Dad to Dad: Parenting Like a Pro.

 In simplest terms, a cough is the body’s way of protecting itself by clearing out the airways. It’s a normal response to things like postnasal drip, phlegm, and food stuck in the throat.

 There are two kinds of coughs:

  1. Dry Coughs
  2. Wet Coughs

Dry coughs occur when your baby has a cold or allergies. The dry cough helps clear out postnasal drip or irritation from a sore throat.

Wet coughs occur when a respiratory illness accompanies a bacterial infection. A wet cough causes mucus to form in your baby’s airways. Mucus contains white blood cells to help fight germs.

Baby's Coughs

Keep Track of Your Baby’s Coughs:

One of the best memories when being a parent is playing I Spy with your kid. Instead of finding a spotted something-or-other, you’re trying to figure out what’s causing the baby’s cough.

Coughing is a protective reflex we have that helps clear the throat and lungs of irritants like dust, smoke, or germs. But it could be an early sign of illness. If your baby is coughing, don’t panic—just listen closely and act accordingly.

Children younger than 4 months don’t cough a lot, so it can be severe if they do. Suppose a newborn is coughing terribly in the winter, for example. In that case, it could be a respiratory syncytial virus (RSV), a dangerous viral infection for infants.

However, if your baby is older than 1 year old, a cough is much more likely to just be a cold. So how can you tell? To help you differentiate between a wait-and-see cough and one that demands immediate medical attention, all you have to do is stay calm, listen carefully to the baby’s cough, and follow the directions below.


  1. Common Cold or Viral Flu 


Nature of Cough: Dry Cough


Runny nose

Sore throat

Dry cough

However, based on how severe the cold is, there is a possibility that your baby could have rattling mucus and a slight fever, especially during the night.


The best thing as a parent you can do for your little one is probably something you’re already doing: Helping them get lots of fluids, plenty of rest, and as much comfort as possible when he’s feeling miserable.


The AAP recommends that babies with colds suck on a pacifier dipped in honey (just be sure your child is at least 1 year old before you give them honey). If you prefer, prop the baby up on pillows and let them have some breast milk or formula.

You can also help clear mucus from your baby’s nose with saline nose drops. A cool-mist humidifier will keep the baby’s airways nice and moist.

  1. COVID-19 

Compared to adults, babies are not severely affected by the COVID-19 virus. However, there may be asymptomatic cases and instances where babies develop a wide range of symptoms of COVID-19, such as cough, upon direct exposure to the virus. These usually occur during 2-14 days of exposure.

Nature of Cough: Dry and continuous. Some babies may also have a wet cough.


Runny nose

Mild to moderate fever

Shortness of breath

Decreased feeding

Behavioral changes




It is extremely rare, but there can be instances where babies experience severe symptoms of COVID-19. 



If you think your little one may possibly be having COVID-19, don’t panic! Call your health care provider, and they will arrange the testing. If they do test positive, isolate them along with their primary caregiver from the rest of the family. Seek immediate medical help for alarming symptoms, such as:


-breathing or feeding difficulties

-blue-ish lips


-an inability to wake


  1. Baby Croup

Baby Croup is a condition that is caused by a viral infection that irritates your baby’s upper airways (commonly the trachea) and causes them to swell. This can cause difficulties in breathing.

Nature of Cough: Similar to a bark. Babies will also gasp for air.


The most common symptom of a croup-induced cough is hearing your baby coughing continuously at night with a noise similar to a barking wheeze accompanied by difficulty in breathing, hence the name ‘croup.’ The barking noise, which resembles a seal, appears at the point of inhalation and not during exhalation. A slight fever can also occur.

It is more common among children under the age of 5 and begins as a normal cold before developing into croup. This is not a severe condition. It usually clears up after 3-4 days from the first time you notice your baby coughing during sleep. If it doesn’t subside after four nights, contact your doctor.


First, try to get your baby to calm down—the more they panic, the more they’ll struggle to breathe. Hold your child and talk to them in a soothing voice.

Once they’ve calmed down, consider one of the following techniques:


  • Run your shower and close the bathroom door. Then let your child breathe in the steamy air. If you don’t have a shower, try boiling some water and pouring it into a bowl for your child to breathe in.
  • If it’s a mild evening, then take them outside; the damp air will be effective in making it easier for them to breathe.
  • Have your baby breathe the air from a cool-mist humidifier.

  1. Bronchiolitis

Bronchiolitis is a respiratory infection affecting children under the age of 3, especially those younger than 6 months. The vast majority of these cases result from the respiratory syncytial virus (RSV), which is generally one of the most frequent reasons kids visit the emergency room. For children above the age of 3, the condition usually occurs as a common cold. But for toddlers and infants younger than that, bronchiolitis can be potentially life-threatening if left untreated.

 Nature of Cough: Wheezing cough


Common symptoms include a cold, running nose, and wheezing. However, this can be easily confused with asthma. However, bronchiolitis can be distinguished from asthma because it occurs mainly during autumn and winter and would also induce a slight fever and loss of appetite.


If your baby has bronchiolitis, you can treat it at home once her breathing is under control. Babies need plenty of fluids, rest, and a cool-mist humidifier to help them breathe easier. You should be monitoring your baby’s respiratory rate. If it gets higher than 50 breaths per minute, then your child is in respiratory distress. In this case, call 000 immediately.

  1. Whooping Cough (Pertussis)

This is a life-threatening bacterial infection that affects unvaccinated babies. (DTaP Vaccine)

Nature of Cough: A loud and consistent ‘whoop’ sound


Discolored Face

Bulging Eyes

Coughing Spasms

Tongue Sticking Out



Prevention is better than cure. Therefore, make sure that your baby is immunized via three doses of the DTaP vaccination.


If you believe that your baby is suffering from whooping cough, call 000 immediately. By the time coughing fits develop, then the child must be hospitalized immediately so they can receive oxygen during the coughing spells. Your baby and every member of your household will be prescribed the antibiotic erythromycin to prevent the spread of the highly contagious disease. When your child comes through the initial attack, pertussis should run its course. This can take many months of isolation.


  1. Asthma 


Nature of Cough: Wheezing cough


Retractions due to respiratory distress

Cold symptoms

Runny eyes

Itching (especially the eyes)


Whatever your baby’s case, it’s always best to call your doctor when you hear your infant wheezing. Commonly, despite arriving at a definite diagnosis of asthma, doctors often use asthma medication to treat most bouts of wheezing.

Your doctor might prescribe a liquid form of albuterol to open the airways, or a nebulizer may be used if the attacks are very severe. If your child has an itchy, runny nose and has difficulty breathing, call your pediatrician immediately. As it is with bronchiolitis, you should observe your child’s respiratory rate. If it gets too high, which is 50 breaths per minute or more—your child is definitely in respiratory distress. Call 000!

  1. Pneumonia


Nature of Cough: Wet and phlegmy cough



Extreme fatigue

Breathing difficulties

Phlegm expelled in shades of green and yellow



The first step is to call your doctor, especially if your baby has a fever.

Once your doctor identifies whether the pneumonia is bacterial or viral, they can make a diagnosis and treatment plan.

Bacteria cause most cases of pneumonia, and bacterial pneumonia is usually more dangerous than viral pneumonia. Viral pneumonia can cause serious complications in some babies. Still, it is less of a concern in a healthy baby than bacterial pneumonia would be.

The most common source of bacterial pneumonia is what is called Streptococcus pneumoniae (also known as “strep”). The pneumococcal vaccine can help prevent this kind of bacterial pneumonia.



  1. Expelling Foreign Objects


Since babies always stick things in their mouths, persistent cough is a common culprit.

Nature of Cough: Small, persistent cough, gasping for air.


Persistent cough and sometimes wheezing

Pneumonia due to swallowing food the wrong way (peanuts most commonly)


If the baby’s airway is blocked completely, they will:

Turn pale or blue

Make no sound at all

Appear very distressed



First thing’s first: If you see that your baby’s airway is totally blocked, turn them over immediately and deliver five back blows between the shoulder blades. If you’re unable to remove the foreign object, call 000.


If the object is only partially lodged, tilt Baby’s head down and give them a few gentle pats on the back, so they’ll try to cough it up. If you think your baby is suffering from a partially lodged object, and they don’t appear able to cough it up, get them a chest x-ray. If a bit of food is found stuck, the doctor will refer you to a specialist who can perform a bronchoscopy. During the procedure, the child will be put under general anesthesia, and a tiny fiber-optic tube with tweezers at the end will go down the airway to pick out the foreign body.