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Here’s Why Your Baby May Be Coughing At Night

And what you can do to help.

Although you never want to see your child sick, there’s something about them being ill at night that takes on a whole other level of intensity. Maybe it’s the lack of sleep, stress from caring for your kid all day, or a bit of both, but cold symptoms just seem to be magnified at night. During the daytime, if your child is constantly clearing their throat, it somehow seems more manageable than your baby coughing in their sleep at night, right? If your baby is coughing well into the wee hours of the morning, here’s how to handle it, when to worry, and when a trip to the pediatrician would be prudent.

What does a baby coughing at night mean?

You’ve finally gotten your baby to bed, only for them to be awakened by continuous coughing. It’s frustrating for sure, but there’s a reason why your child might be coughing more when the sun goes down. “Parents often notice that when a baby has a cold, the cough becomes worse at night,” Dr. Natalie Thoni, a board-certified pediatrician at Orlando Health Arnold Palmer Hospital for Children, tells Romper. “When a baby is asleep on their back, the sinuses are draining and causing irritation in the upper airways, leading to a cough.” Another cause of a cough at night in young children, according to Thoni, is croup, though the telltale croup cough has a very specific sound. A common respiratory illness of the trachea, larynx, and bronchi, croup can lead to stridor (a noisy or high-pitched breathing sound) or a barking cough which can make your kid sound like a seal, per a PubMed study. And, you guessed it, croup is worse at night.

What does it mean if Baby only coughs at night?

There can be a few reasons why your baby only coughs at night. But, if you’ve noticed this trend, you should speak to your child’s pediatrician to uncover the cause of the cough — and allay your concerns. “If the cough only occurs at night, then reflux may be a more likely cause,” Dr. Denise Scott, M.D., a board-certified pediatrician explains. But if your child has been sniffling or sneezing, too, then there’s a good chance that they could have a cold or other illness. “If an infant has not been vaccinated, then pertussis or whooping cough is something to be concerned about as are RSV (Respiratory Syncytial Virus) and Covid.” Even a reaction to an animal in the house or to second-hand smoke could be the culprit, Scott says.

Whether it’s due to illness or exposure to some other irritant, the reason why your kid is coughing at night is probably because of the way your baby is positioned. “When an infant lies down, any nasal drainage will run down the back of the throat and can stimulate a cough,” she says.

How can you help Baby to sleep at night if they’re coughing?

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As they say, an ounce of prevention is worth a pound of cure. But how do you know how to cure coughing when you don’t understand what’s causing it? “If this is a new symptom and it is occurring in association with other symptoms such as nasal congestion, fever, runny nose/mucus production, then doing what you can to clear out the nares before the baby lays down can be helpful. This would include using nasal saline and a suction,” Dr. Krupa Bhojani Playforth, a board-certified pediatrician explains. “If the cause is reflux, then avoiding overfeeding and keeping the baby upright for 20-30 minutes after a feed can be helpful.”

If you’re looking for some home remedies that might quell the coughing, a humidifier can help, as can keeping your child hydrated with plenty of fluids. For newborn babies, that means offering lots of breast milk or formula. “If your child is older than 1 year, you can also try giving a teaspoon of honey before bed to help with nighttime coughing,” advises Thoni. But back away from the over-the-counter meds, especially if you’re not sure why your child is coughing. “Unfortunately, there is no cough medicine for infants and children and no over-the-counter cough medicine should be used in children without talking to your doctor first.”

When congestion is keeping your kid awake, you can try to help them safely decongest their petite air passageways. “Use saline drops and suction the nose well prior to bedtime, because if an infant can breathe out of their nose, that helps to lessen the cough,” advises Scott. “Also, putting something under the head of the mattress, such as a folded towel or blanket, to slightly elevate the head of the bead (about 30 degrees), can be helpful for both drainage symptoms and reflux.”

When should you go to the doctor?

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There comes a point when a cough could require immediate medical attention. “You should have your baby evaluated by a doctor if the cough is leading to any trouble breathing,” advises Thoni. “A baby having trouble breathing will often be breathing faster than normal and may be pulling in their ribs or using their neck muscles to help them breath.” If your normally rosy-cheeked cherub starts to show blue discoloration around the lips or face, you should take them to the emergency room right away.

Other symptoms that can warrant a trip to the pediatrician include a refusal to feed, or extreme irritability, according to Scott. “Anything that makes you as the parent uncomfortable or worried are reasons to have your baby seen by a doctor,” she says.

“Many parents worry that they are bothering the pediatrician, but many of us understand how worrisome it can be to have your child coughing,” adds Playforth. “Coughing is uncomfortable, and it can interfere with sleep, feeding and breathing, but we would much rather discuss what is going on with a worried parent than not. Trust your gut!”

Study referenced:

Sizar, O., Carr, B. (2021) Croup, PubMed, https://pubmed.ncbi.nlm.nih.gov/28613724/

Experts:

Dr. Natalie Thoni, M.D., a board-certified pediatrician at Orlando Health Arnold Palmer Hospital for Children

Dr. Denise Scott, M.D., a board-certified pediatrician

Dr. Krupa Bhojani Playforth, M.D., a board-certified pediatrician