My Baby Is Coughing and Sneezing but No Fever

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As a parent, few things are harder to hear than the sound of your little one hacking away with a bad cough. To make matters worse, it's tough to treat cold and flu symptoms like coughing in babies, since many over-the-counter medications are off-limits for young children.

In fact, the American Academy of Pediatrics (AAP) advises against using over-the-counter cough and cold medicines for children under 4 years old due to the risk of dangerous side effects.

Thankfully, there are still things you can do to make your baby feel better. Here's everything you need to know about baby coughs—from why they happen to how you can help.

Why Your Baby Might Be Coughing

When something irritates our lungs or throat, we cough in response. Some common reasons your baby might be coughing include:

• Illness. Everything from respiratory viruses like a cold, flu, or croup to bacterial infections such as bronchitis and pneumonia can trigger coughing in babies. This is usually due to an increase in mucus in the throat or lungs, or sometimes because of inflamed or irritated bronchial tissue.
• Allergies. Most children don't develop seasonal allergies until at least two years of age, but your baby could be allergic to something else in their environment. Pet dander, dust, mold, and other household allergens are typical culprits.
• Reflux. Babies are prone to gastroesophageal reflux disease (GERD), which can cause coughing and gagging as stomach acid irritates the throat.
• Whooping cough. Also known as pertussis, more commonly known as whooping cough, is a serious bacterial illness that can affect babies as well as adults. Adults and children coming in contact with your baby should be up to date with their Tdap or DTap vaccines. Meanwhile, your baby should receive their first pertussis vaccine at 2 months of age.
• Asthma. If your baby tends to cough while trying to fall asleep at night their cough could be due to asthma.

In most cases, you don't need to rush to the doctor when your baby starts coughing. In fact, it may be better to wait so you can gain a better understanding of what could be causing your baby's cough.

Is your baby's cough chronic, or does it only happen when they're sleeping? Does it last for a few days, come with a runny nose or congestion, and then disappear? Does it only happen at Grandma's house? Understanding the context is an important diagnostic tool for your child's pediatrician and it may help to collect some "data" before calling a doctor.

That said, there are times when you should definitely not wait to call your doctor or seek emergency care for a child's cough, like if your baby is under 3 months of age or when the cough is accompanied by high fever or signs of breathing difficulty.

Signs of Breathing Difficulty

To monitor your child's breathing, take their shirt off and observe them while they are as comfortable as possible like watching TV or playing on a tablet. Here's what you should look for.

• Count how many times your child breathes in 60 seconds.
• Determine if your baby is working harder to breathe than usual. Take their shirt off and while they are calm and see if their skin is pulling in at any of these places when they breathe in: right above the collar bone, at the neck right between the collar bones, between the ribs, and on the belly right below the ribs.
• Observe your child's nostrils to see if they are flaring, which also is a sign your child is working harder to breathe.
• Look to see if they can't nurse or take a bottle like usual and instead frequently pause to stop and catch their breath.

If you observe these signs in your child, call your pediatrician and share the details of what you're noticing. And if you feel your child is in immediate danger, don't hesitate to call 9-1-1.

How to Decode Different Coughs

Most coughs are not a sign that something is seriously wrong with your baby, but since there are several different kinds of coughs you may hear, it helps to know some of the more common types.

• Dry cough. Often due to asthma or allergies, a dry cough is usually persistent but not productive (meaning it doesn't bring up any mucus).
• Wet cough. These coughs often sound bad, but are usually the result of mucus breaking apart in the chest, a necessary part of recovering from illnesses involving lots of congestion.
• Whooping cough. If your baby coughs excessively to the point that they cannot take a bottle or nurse or they make a "whooping" sound as they inhale afterward, it could be a sign of pertussis. This bacterial infection is particularly dangerous for younger babies who haven't yet been vaccinated against it, but any young child with a whooping cough should be seen by a doctor ASAP.
• Barking cough. Does your child's cough sound like a seal is barking? This is a common symptom of croup, a viral illness that typically goes away on its own but may require medical care in severe cases. Both warm steam and cold, crisp air can alleviate some of the symptoms of croup.
• Wheezing cough. You may notice a wheezing cough in a child with asthma, allergies, GERD, or bronchitis.
• Nighttime cough. Common viral illnesses that produce mucus—and post-nasal drip—are a typical cause for coughs that only strike during the night, but asthma and GERD coughs may also become more prominent then, too.

Regardless of how your child's cough sounds or what you think might be causing it, you should never ignore signs of distressed breathing. Even if you're 99% sure your baby "just" has a cold, these warning signs should prompt you to call the doctor right away. If your baby has discoloration of the skin or lips you need to call 911, as they need immediate care.

What You Can Do

Unfortunately, the vast majority of common medications for coughs are not considered safe to give your baby. These include cough syrups, decongestants, lozenges, and expectorants. Instead, try one of these at-home remedies.

• Offer liquids. If your baby is very young, this will be limited to breastmilk or formula, but babies older than 6 months can be given water, broth, popsicles, or even fruit with a high water content, like watermelon. Coughs often become persistent when the throat is dry, so hydration can help.
• Change your baby's position. Whether your baby is coughing from mucus or acid reflux, lying down can make it worse. During the day, allow your baby to spend more time upright by placing them in a bouncy seat, high chair, or with you in a baby carrier if mucus is the issue. But, do not let your baby sleep in a bouncy seat, carrier, or swing and do not elevate the mattress in your baby's crib. If acid reflux is the issue, you could try wearing your baby.

Never place soft materials such as a wedge inside the crib or under a mattress of a baby under 18 months of age, as this poses a suffocation risk.

• Use supplemental treatments. Flush your baby's nasal passages gently with saline to clear away irritants and, if your baby is old enough, give a small spoonful of honey to coat their throat. Due to the botulism bacteria, however, never give honey to a baby under one year of age. Remember, many products marketed as "all-natural" are not actually safe for babies and most pediatricians recommend steering clear of herbal or alternative medications.
• Use steam. Placing a cool-mist humidifier in your baby's room while they sleep—or sitting with them in a steamy bathroom—can quiet a persistent cough by moistening the airways and soothing irritation.

If Your Baby Is Still Coughing

You've tried several strategies to lessen your baby's coughing but nothing has worked, it's important to first focus on what you think might be the reason for the cough because you may just need to give it more time to work its way out of their system.

For example, if your baby had a cold that triggered the cough, it could linger for quite a while after the illness resolves—sometimes two or three weeks! If an illness-induced cough lasts longer than that, you should contact your doctor; they may provide your child with an albuterol inhaler with a mask and spacer or check for a secondary infection like pneumonia.

If you don't know the source, a cough lasting more than 10 days should be evaluated by your child's pediatrician. Coughing that happens without any obvious illness could point to asthma, allergies, or GI issues, all of which would require treatment by a physician.

When to See a Doctor

There are several signs that a cough warrants medical treatment. Your child may need a chest x-ray, an antibiotic, an inhaler, or even just a thorough examination to rule out other issues.

Call your doctor if your baby:

• Coughs for more than 10 to 14 days
• Has a fever for more than three days (Babies under 2 months need to be seen immediately for any fever over 100.4)
• Coughs after any kind of physical activity
• Is coughing frequently during the night
• Coughs persistently after eating
• Appears dehydrated
• Displays noisy breathing like rattling, whistling, or wheezing
• Has a cough and is under 3 months of age (Newborns should always be evaluated at the first sign of illness.)

Sometimes, a cough becomes severe (or is a symptom of a severe illness or condition). If you observe any of the following signs in your child, you should seek emergency care right away:

• Skin retractions (skin pulling in) at the neck and chest area with breathing
• Labored breathing
• A cough that sounds like barking or "whooping"
• Dizziness, excessive sleepiness, refusal to eat or drink, or trouble crying
• Difficulty swallowing
• Coughing up blood
• Pale or blue skin or lips

A Word From Verywell

The vast majority of baby coughs are caused by viral illness and will resolve on their own, so chances are you don't need to worry (or run to the doctor). If you're concerned about the sound of your baby's cough or it has gone on for more than 10 to 14 days, contact your doctor. And, of course, any signs of distress that appear along with a cough merit emergency care in any circumstance.

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My Baby Is Coughing and Sneezing but No Fever

Source: https://www.verywellfamily.com/what-to-do-if-your-baby-is-coughing-4846489

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