It is common for parents to feel concerned when their newborn coughs. While a cough in a newborn can sometimes signal a more serious issue, it is often a normal physiological response. Understanding the distinctions between typical and concerning coughs helps parents respond appropriately to their baby’s health.
Normal Reasons Newborns Cough
Newborns frequently cough for various benign reasons, as their tiny bodies are still adapting to the world outside the womb. Coughing is a natural reflex designed to protect the airways by clearing them of irritants or excess secretions.
One common reason for a newborn’s cough is to clear their airways of milk, saliva, or small amounts of mucus. During feeding, some milk might go down the “wrong pipe,” triggering a cough to expel it. The developing respiratory system of a newborn is also sensitive, making even minor irritants like dust or lint in the air enough to provoke a cough.
Small amounts of spit-up or reflux are another frequent cause of coughing in infants. When stomach contents irritate the throat or airways, a cough reflex is activated to clear the area. Newborns have smaller airways compared to older children and adults, meaning that even a minor obstruction or irritation can lead to a more noticeable cough.
Signs a Newborn’s Cough is Concerning
While many newborn coughs are harmless, certain signs indicate a more serious underlying condition. These include a fever, particularly if the baby is under 12 weeks old with a temperature of 100.4°F (38°C) or higher. Lethargy, such as unusual sleepiness or difficulty waking, and poor feeding, like refusing multiple feedings or taking less than half the normal amount, are also concerning indicators.
Difficulty breathing is a red flag, often presenting as rapid breathing, nasal flaring (nostrils widening with each breath), or retractions (skin pulling in between ribs or at the neck with each inhale). A bluish tint around the lips or fingernails (cyanosis) signals insufficient oxygen and requires immediate medical attention. Changes in the cough’s sound can also indicate a problem. A barking cough suggests croup, while a high-pitched whistling sound during breathing (wheezing) may indicate bronchiolitis or asthma. A persistent, wet, or phlegmy cough, especially with a high fever, might point to infections like bronchiolitis, pneumonia, or whooping cough.
Coughing fits or prolonged, uncontrollable coughing spells, particularly those that end with a “whooping” sound or cause the baby to turn blue, indicate conditions like pertussis. Coughing accompanied by frequent or forceful vomiting, beyond typical spit-up, is also a cause for concern. Any combination of these symptoms warrants prompt evaluation by a healthcare professional.
When to Contact Your Pediatrician
Knowing when to seek medical advice for a newborn’s cough can be challenging. If a newborn exhibits severe difficulty breathing, such as struggling for each breath, barely able to cry, or if their lips or face turn bluish, immediate emergency medical attention is necessary. These signs suggest a lack of oxygen and require immediate intervention. Unresponsiveness or loss of consciousness also necessitates calling emergency services immediately.
For less severe but still concerning symptoms, a prompt visit to the pediatrician is appropriate. This includes a high fever in a baby under 3 months old, a persistent cough accompanied by other symptoms like lethargy or significantly reduced feeding, or severe nasal congestion that impedes breathing or feeding. If the cough lasts more than two or three weeks, or if mild symptoms persist and worsen, contact the pediatrician for an evaluation.
Parents should always feel comfortable contacting their doctor if they are worried about their newborn’s cough, even if the symptoms appear mild or turn out to be nothing serious. Pediatricians understand parental concerns and can provide guidance, determining whether an office visit, emergency care, or home management is the most appropriate course of action. Seeking timely professional advice ensures the baby receives proper care and provides peace of mind for the parents.
Managing Mild Newborn Coughs at Home
For mild newborn coughs that do not present concerning symptoms, several home management strategies can help alleviate discomfort. Keeping a newborn’s airways clear can be achieved by using saline nasal drops to loosen mucus, followed by a nasal aspirator or bulb syringe to gently remove it. This is particularly helpful before feedings and sleep to ensure easier breathing.
Using a cool-mist humidifier in the baby’s room can add moisture to the air, which helps soothe irritated airways and thin mucus, making it easier to cough up. It is important to clean the humidifier daily to prevent the growth of mold or bacteria. Ensuring adequate hydration through frequent feedings, whether breastfeeding or formula-feeding, helps keep secretions thin and prevents dehydration.
Elevating the baby’s head slightly during sleep can sometimes reduce coughing caused by postnasal drip or reflux. This can be done by placing a small towel or wedge under the mattress at the head of the crib, creating a gentle incline, but never directly under the baby’s head due to suffocation risks. Avoiding irritants in the environment, such as tobacco smoke, strong perfumes, or harsh cleaning products, can also help prevent coughs. Parents should never use over-the-counter cough and cold medicines for infants, as they are not recommended. Honey should also be avoided in infants under one year of age due to the risk of infant botulism.