Coughing is a defensive reaction that clears irritants, germs, and foreign particles from the airways. Dry cough in babies refers to coughing without mucus production, whereas wet cough refers to cleaning phlegm (mucus) from the airways. Dry cough in infants may often indicate viral infections.
If your infant has a dry cough and other symptoms, or if the baby is younger than three months old, you should seek medical attention (1). Read on to learn about the causes, remedies, treatments, and prevention for dry cough in infants.
What Is Dry Cough?
A cough without airway accretion is referred to as dry cough. Baby cough can be classified depending on the cause, duration, and other characteristics. The following features may help you distinguish dry cough from wet or moist cough in babies.
- A dry cough is a nonproductive cough without phlegm (mucus).
- Dry cough may cause a sudden cough with loud or empty noise.
- Your baby may have an upper or lower respiratory tract infection with a dry cough.
- Dry cough may worsen in a warm room and may get better on cold air exposure.
- Dry cough may become a wet cough if there are secondary bacterial infections.
Note: Babies may not be able to cough up (expectorate) sputum, so coughing may not be productive even though they have airway secretions. In these situations, you may notice low and heavy cough sounds, which are called wet cough, chest cough, or moist cough.
It is recommended to seek a pediatrician’s help to determine the type of cough since it is difficult to distinguish between the types of coughs. It often requires examination with a stethoscope to identify the presence of airway secretions (2).
Is Dry Cough Dangerous For Babies?
Not all dry coughs are dangerous in babies older than three months. Its seriousness depends on the cause, duration, and severity of the cough.
- Cough can be caused by a common cold or due to some irritants and often resolves without any treatment (3).
- A post-viral dry cough or viral-induced cough for a shorter duration can be normal. However, you may consult a pediatrician if it lasts longer than a week or ten days.
- Chronic coughs that last more than four weeks can be concerning and may require a clinical examination to identify the underlying cause (4) (5).
Even if the cough is not due to severe respiratory system issues, excessive coughing may deteriorate your baby’s health.
Symptoms Associated With Dry Cough
The cough itself is a symptom and not a disease. You may notice other symptoms along with cough, depending on the underlying cause. The following symptoms and signs may be seen with coughing in babies.
- Frequent vomiting or spitting up
- Excessive crying
- Lack of appetite
- Runny or stuffy nose
Cough syrups, cough drops, and other over-the-counter cold and cough medicines are not recommended for babies (6). You may seek medical care for the diagnosis and treatment of all types of cough in babies.
Causes Of Dry Cough In Babies
A cough without the production of mucus can occur due to various reasons. It can often be seen at the end of a viral respiratory illness or during exposure to airway irritants.
The following conditions can be the major causes of dry cough in babies.
- Viral respiratory infections: Common cold, flu, croup, acute bronchitis, and viral pneumonia may cause dry cough in babies. Sometimes babies can have wet coughs during this illness, and dry cough may develop towards the end of the infection. Post-viral cough (post-infectious cough or lingering cough) can occur after a viral disease due to airway hyper responsiveness (7).
- Environmental irritants: Smoke, odors from chemicals, and hot and dry climate, may cause coughing from throat dryness and airway irritation (8).
- Gastroesophageal reflux or acid reflux: Regurgitation of gastric contents to the esophagus could stimulate the cough reflex. Regurgitation of food to the back of the throat can cause dry cough in babies due to irritation. Re flux-related cough is common in the day time. Sometimes this may aspirate into airways and lead to aspiration pneumonia, often associated with dry cough (9).
- Allergies, sinusitis, and asthma: These may cause dry cough due to postnasal drip or airway irritation. Asthma coughs can be dry and often come with wheezing in babies. Sinus infection may also cause a productive cough with mucus in many babies (5) (10).
- Pertussis or whooping cough: This is a bacterial infection caused by the Bordetella pertussis bacteria. Pertussis causes violent, uncontrollable multiple coughs, and babies may have a “whoosh” sound while inhaling after a coughing fit (11). This type of severe coughing attacks requires emergency care.
Although viral illnesses are a significant cause of dry cough in babies, rarely bacterial respiratory infections may cause dry cough. You may consult a pediatrician for identifying the exact cause and treatment of dry cough in babes.
Diagnostic Tests For Cough In Babies
Pediatricians may establish a diagnosis with physical examination and symptoms in most cases. Hearing the cough could help the doctor determine whether it is dry or moist. The subsequent investigations can be done to confirm the diagnosis of the underlying cause (12).
- Chest X-ray: This may help identify and rule out causes of cough, such as pneumonia or any birth defects.
- Sputum culture: Analysis of mucus samples may help identify causative organisms and recommend specific treatments.
- Bronchoscopy: This is the visualization of the airway using a flexible tube with a camera at one end. It may help determine the presence of any foreign bodies in the airways or any birth defects that lead to cough in babies.
- Blood tests: This helps identify the presence of inflammatory markers.
- GI endoscopy and esophageal pH monitoring: It is used to identify acid reflux from the stomach to the esophagus.
Pediatricians may refer the baby to an allergy specialist, gastroenterologist, or infection specialist, depending on the infant’s signs and symptoms that require specific attention.
Treatment Of Dry Cough In Babies
Dry cough is treated depending on the underlying cause. The following treatment may be prescribed for dry cough in babies (7).
- Ibuprofen (Advil, Motrin) and acetaminophen (Tylenol) are prescribed for fever and body aches.
- Whooping cough requires immediate hospitalization and a course of antibiotic treatment.
- Post viral cough may not require specific treatment if other symptoms are not seen and if your baby’s health status is good. However, you may consult a pediatrician if it lasts longer.
- Babies with recurrent allergies may be referred to allergy specialists for specific treatment.
- Cough due to asthma requires long-term asthma control with medications. Exacerbations of asthma symptoms are managed with specific medications for quick relief.
Caution:Over-the-counter (OTC) cough and cold medications are not recommended for babies, and you may avoid giving OTC fever medicine, such as aspirin, since it may cause Reye syndrome. Do not self-medicate with any cough or cold medicine no matter how severe the dry cough.
Prevention Of Dry Cough In Babies
The following factors may help prevent cough and cold in babies (13).
- Follow good hand hygiene practices in the family.
- Asthmatic and allergic cough can be prevented by avoiding triggers.
- Avoid giving small toys and food, such as nuts, to babies since it can be inhaled or swallowed.
- Avoid exposure to triggering factors such as smoke, perfumes, etc.
- Vaccinate the baby as per schedule.
Annual influenza vaccine and DTwP or DTaP vaccine for pertussis and other diseases could help prevent cough in babies.
Tips To Provide Relief From Dry Cough
Your baby’s pediatrician may recommend the following tips for cough relief after the examination (14):
- Use a cold-mist humidifier in the child’s room to ease breathing. It may help keep the airways moist and reduce postnasal drip, coughing, and congestion.
- If the weather is not too cold, then you may open windows to allow fresh airflow in the room. This may help your baby breathe easier.
- Maintain adequate hydration with breastfeeding, clear fluids, soups, etc., appropriate for the baby’s age.
- Ensure the baby gets proper rest and good sleep for early recovery.
Home Remedies For Dry Cough
Dry cough that is not severe and with no other symptoms can be treated with home remedies. The following remedies may help to ease cough and make your baby breathe easier (14):
- Breastfeeding: Exclusively breastfed babies should be fed frequently to avoid dehydration due to viral illness. In addition to providing adequate nutrition, breast milk contains immune factors that can help your baby fight.
- Adequate hydration: Giving lots of water can help maintain hydration in weaning babies. You may also try cool popsicles if your baby refuses to drink water.
- Saline drops: This may help relieve a blocked nose. You may add a few drops of saline to the baby’s nose and tilt their head backward. Saline can be prepared at home by adding half a teaspoon of salt to 240 ml (eight ounces or one cup) of purified or bottled water. You can also consult a doctor for recommending ready made saline.
- Nasal suction: You may use a bulb syringe to remove (suck) extra mucus from your baby’s nose. This can be useful if your baby has a runny nose.
- Honey for babies older than one year: You may give half or one teaspoon of honey before bed since it may help to reduce nighttime coughing.
Caution: Honey should not be given to babies younger than one year since it may cause infant botulism that can be fatal.
It is best to consult a pediatrician before trying any home remedies. You should also stay alert towards any other signs and symptoms that emerge along with dry cough.
Over-the-counter cough syrups and cold medications should not be used without consulting a doctor. You may seek medical care if your baby’s cough lasts longer than a week or causes breathing trouble.
2. Deirdre Donnelly and Mark L Everard; ‘Dry’ and ‘wet’ cough: how reliable is parental reporting?; The United States National Library of Medicine
3. Cough In Children; The American Academy of Allergy, Asthma & Immunology
4. Ajay S. Kasi and Rory J. Kamerman-Kretzmer,Cough; The American Academy of Pediatrics
5. 8 Causes of chronic cough in kids; Rush University Medical Center
6. Common Over-the-Counter Medications; Healthychildren; The American Academy of Pediatrics
7. Cough; Raisingchildren; The Government of Australia
8. Air Pollution and Respiratory Health among Children with Asthmatic or Cough Symptoms; The American Journal of Respiratory and Critical Care Medicine
9. Anna Rybaket al.,Gastro-Esophageal Reflux in Children; The United States National Library of Medicine
10. Akio Niimi; Cough and Asthma; The United States National Library of Medicine
11. Pertussis (Whooping Cough); The Centers for Disease Control and Prevention
12. Diagnosing Chronic Cough; Hassenfeld Children’s Hospital at NYU Langone
13. Common Cold; The Centers for Disease Control and Prevention
14. Cough; Seattle Children’s Hospital
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