When your baby coughs, the sound may alarm you, but don't fret too much. Coughing is his body's important defense against respiratory illness. Coughing helps him expel irritants and mucus from his airways, but since coughs come in different forms, they DO provide clues about what's going on with your little one.

There are circumstances when you should call your pediatrician or when a trip to the E.R. is in order. For instance, babies younger than 4 months old don't cough much, but if they do, pay close attention as it could be an indication of something serious going on.

Two Types of Coughs — Dry and Wet

Your little one is hacking, but it's not producing anything.

"Dry coughs are commonly caused by infectious diseases like a cold or flu," says Joseph Gigante, M.D., professor of pediatrics at Vanderbilt University School of Medicine.  "Irritants like allergy triggers, smoke or pollution can also lead to dry coughs which are typically non-productive (no phlegm or mucus)," he adds.

Meanwhile, wet coughs may be more alarming to parents. 

"Wet coughs are typically productive," Gigante says. "They are caused by conditions that cause increased mucus, phlegm and fluid in the airways and lungs. Conditions that can cause a wet cough include cold, flu, pneumonia or asthma," he adds.

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"Coughs due to cold and flu tend to last one to two weeks, and a post-viral cough can last up to eight weeks." — Joseph Gigante, M.D.

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Gigante says the kinds of coughs that warrant a trip to the E.R. are those related to breathing issues. A child struggling for breath (when the ribs are pulled in with each attempt to breathe) is a red flag. Also, if breathing becomes noisy (wheezing or croup) and the lips or face turn blue, parents should not hesitate to act. 

Treatment

When your pediatrician sees your child, he will determine if the baby's cough is viral or bacterial. This is the indicator for whether your child will receive a round of antibiotics.

"Viral infections do not respond to antibiotics, so antibiotics are not indicated for these types of infections," Gigante says. "Coughs due to cold and flu tend to last one to two weeks, and a post-viral cough can last up to eight weeks," he adds.

Should a bacterial infection be present, such as pneumonia, it will be treated with a 10-day course of antibiotics, Gigante says.

While there are no cures for coughs in infants, there are supportive treatments you can implement to ease your little one's discomfort.

"Keep nasal passages as clear as possible with normal saline drops and a bulb suction syringe," Gigante says.

Also, a cool-mist humidifier placed in your infant's sleeping environment can be helpful, and it's important to keep your baby well hydrated. 

NOTE: The American Academy of Pediatrics (AAP) says parents should not give over-the-counter cough/cold medicines to children younger than 6 years. 

TYPES OF BABY COUGHS

ASTHMA
Sound: Wheezing
Unless there's a family history of asthma and allergies or Baby has had bouts of eczema, asthma isn't common in children younger than 2. Without a definitive asthma diagnosis, a baby's wheezing due to a tightening of airways is called reactive airway disease. True asthma symptoms will result in Baby suffering from retractions, a sucking in and out of the chest and diaphragm. If your baby does have asthma, before the onset of wheezing, you'll most likely notice cold symptoms and itchy, runny eyes.

TREATMENT: Anytime Baby is wheezing, call your pediatrician immediately. Whether or not it's asthma, most doctors will prescribe an asthma medication to treat wheezing. If an asthma attack is severe, albuterol by way of a nebulizer with an infant mask will be administered. Always keep track of your child's respiratory rate. If it reaches 50 or more breaths per minute, your child is in respiratory distress and you need to dial 911.

 

BRONCHIOLITIS
Sound: Wheezing
When bronchiolitis occurs, it follows a basic cold with a runny nose and cough. Most cases of bronchiolitis in babies 12 months and younger are the result of respiratory syncytial virus (RSV). RSV in infants can be life threatening, and Gigante says children younger than 2 years are at an increased risk of this lower respiratory tract infection. The wheezing cough of bronchiolitis sounds similar to asthma, but with bronchiolitis, Baby may also have a slight fever and loss of appetite.

TREATMENT: Give Baby plenty of fluids and lots of rest. Use a cool-mist humidifier. Be sure to keep a check on Baby's respiratory rate. If it gets too high (50 breaths per minute or more), he's in respiratory distress and you need to call 911.

 

COLD OR FLU
Sound: Dry hacking
Coughs associated with a cold are usually dry, but may come with a rattling sound if the cold is severe and Baby has mucus in his lungs.

TREATMENT: The AAP says don't give cough or cold medicines to children younger than 6 because they don't work and can have fatal side effects. Use natural methods like honey (for babies older than 1 year), saline drops and a cool-mist humidifier.

 

CROUP
Sound: A seal-like bark
A viral infection is usually the croup culprit. If your child has it, the sound is unmistakable — it sounds as if he's barking, and you'll hear it on the inhale.

TREATMENT: Make use of a cool-mist humidifier, and have your child breathe in the mist. You can also run a hot shower with the door closed, and sit in the steam with your Baby to ease his breathing. Croup usually clears up in four days; if it doesn't, call your pediatrician.

 

FOREIGN OBJECT
Sound: Gasping
If Baby suddenly starts gasping or coughing while eating or playing with a small toy, look in his mouth. If there's a foreign object, he's apt to cough it out on his own. If Baby's airway is blocked, he'll exhibit distress; make no sound; turning pale or blue.

TREATMENT: Turn Baby over immediately and deliver five back blows between his shoulder blades. If you can't dislodge the object, call 911. If the object is partially lodged, help Baby cough it up by tilting his head down and giving him a few gentle pats on the back.

 

PERTUSSIS
Sound: Loud, rapid whooping
Also known as whooping cough, pertussis has resurfaced in recent years with frequent coughing spasms, face discoloration, tongue sticking out and bulging eyes.

TREATMENT: Prevention is of paramount importance, so make sure Baby is up to date on his immunizations. If you suspect your baby is suffering from pertussis, call 911 pronto. If it is whooping cough, Baby will be admitted to a hospital for oxygen. Baby and every member of the household will be given an antibiotic to prevent the highly contagious disease from spreading.

 

PNEUMONIA
Sound: Wet and phlegm-like
Pneumonia can be either bacterial or viral stemming from a variety of causes, including the common cold. A baby with pneumonia will have noticeable fatigue, and his cough will be productive.

TREATMENT: You must see your child's pediatrician to treat pneumonia, as the treatment differs depending on whether it's viral or bacterial. Bacterial pneumonia will be treated with antibiotics, and you'll typically notice substantial improvement after the second dose. You can't treat viral pneumonia with antibiotics. For your child's home recovery, use a cool-mist humidifier during the night. Sit with baby for 10 - 15 minutes in a steam-filled bathroom, then cup your hand to firmly strike your child's back and chest for a few minutes. This will help loosen phlegm, causing a productive cough that will help to clear Baby's lungs. Administer children's versions of acetaminophen or ibuprofen to lower fever and alleviate pain, per your pediatrician's instructions.