Cough and cold in babies and children

Avoiding colds is impossible, because they spread easily and seem to be wherever children are. Nor is it desirable to try, because every cold a baby gets helps them build up their immune system. Of course, that doesn’t make colds any less of a hassle. An infant with a cold might be having a pretty rough time, because babies under six months mainly breathe through their noses. That means it can be hard for a sniffly little one to breathe and to get enough fluids and nourishment.

What are colds? How are they transmitted?

Colds are caused by a virus and almost always involve mucus and sneezing – often paired with a stuffy nose, fever and cough. A cold can also bring a headache and sore throat, but of course, it’s hard to know if a baby has these symptoms, since they can’t express themselves verbally. Colds are usually transmitted during the first few days and they’re spread through droplets when someone sneezes or coughs nearby. But they can also be caught in other ways, for example via toys, or if the baby holds hands with a friend who has a cold, and then puts their hands in their mouth or rubs their eyes.

A cold often lasts between one to two weeks. Some infections are caused by the RS virus, which is more severe and can last up to a month. Colds can also lead to complications, such as eye or ear infections. Despite what it sounds like, colds actually have nothing to do with being cold – but people used to think they did, which is likely where the cold got its name.

After an infection, the immune system remembers the virus and you are protected from reinfection by the same one. That might sound promising, but unfortunately there are quite a lot of cold viruses out there – and as a result, it might feel like you’re home caring for a sick child more than you’re at work during those earliest years as the parent of a young child. But it gets better! The older your baby gets, the more colds they will have had, and then they won’t get sick as often.

How to help a baby with a cold

Most colds can be managed at home, as long as your baby seems cheerful enough, is taking in fluids and is in good condition otherwise. There is also quite a lot you can do at home to help a little one who is having a tough time with a cold. Nose drops can be a miracle cure for a baby who is finding it hard to eat and sleep due to a stuffy nose, but they should not be used on babies under one year old.

If your infant has a stuffy nose and is having a hard time sleeping, try elevating their head by walking with them in a carrier or placing them in a bouncer on the floor. Before the baby eats, it is important to thoroughly clear their nose with a saline solution or saltwater spray for better breathing while eating. It will not usually help to just use a few drops – you need to properly irrigate their nose. Try a pipette, spray, or plastic syringe, which are all available at drugstores.

How to clear mucus from a baby’s nose:

1. Have the baby in a semi-reclining position and carefully hold their head with one hand.
2. Hold the pipette/syringe or spray carefully against the outer side of the nostril, where the baby is less sensitive.
3. Press straight in (not straight up), or spray inside the nose. The baby might find this uncomfortable and may fuss as a result, but it isn’t dangerous.
4. Repeat a few times, until the mucus has either come out or has been swallowed.
5. See if the baby can take in fluids by breastfeeding or bottle-feeding.

You can also try a nasal aspirator, which is available at drugstores. Using a nasal aspirator isn’t very fun for the baby or for the parents, but it can be effective. Remember to break up thick mucus with saline solution first, to help it come out easier. If your baby has a fever, read more here about what to keep in mind.

If your baby is under three months old and has severe sniffles, you should always contact your paediatrician for an assessment. This is also true – regardless of age – if you can’t get the baby to drink or if they are having trouble breathing.

Cough in babies and children

Coughing is how the body tries to get rid of matter in the airways. So it is good and important for the body to be able to defend itself, and it’s a sign that the cough reflex works as it should. Cough can last between one to three weeks per cold. Usually, the baby will mainly cough at night, because swelling of the mucous membranes in the airways increases when you lie down.

To help little ones cough less, you can try having them sleep in a bouncer on the floor for a moment – but only if an adult is nearby and can watch over the baby. If the baby is older, you can try elevating their head, for example with a few books under the legs of the bed or mattress, when it is time to sleep.

More tips for coughing kids:

• Give the baby extra fluids, which loosens phlegm – juice usually goes down well.
• Avoid cough suppressants, because they counteract their purpose: the phlegm needs to come up. Plus, there isn’t actually any scientific evidence that they help.
• If your household has more than one parent, sleep in shifts so that you both have the chance to rest. Sick babies often sleep poorly, which usually means long nights for parents.
• Cold outdoor air might be soothing for some kinds of cough, such as croup. You can learn more about croup further down in this article.

How can I tell if my child is having trouble breathing?

One good tip is to observe your child’s breathing when they’re healthy and bare-chested. This will show you what it should look like. A healthy person breathes calmly and effortlessly. A baby who is having trouble breathing may have to fight harder and usually takes shorter and quicker breaths. The baby might also have so-called retractions, which means the skin between the ribs (and above the belly) pulls in with each breath. This isn’t easy for the untrained eye to see, but if you have a sense of how your baby breathes when healthy, you can often notice if something looks unusual..

It’s also good to know that coughing and the sniffles are not all that can produce quicker breaths – this is also a common warning sign with fever. Trouble breathing should be taken very seriously and you should immediately seek emergency medical care.

Asthma caused by a cold can result in lots of coughing in babies and children

Most little ones cough for a while after a cold, but if it seems like the cough never wants to get better and lasts through the night, it could be asthma caused by a cold. A productive cough is common and the baby may breathe more heavily, but sometimes this shows up with less common symptoms, such as fatigue and low energy. Seek care from a paediatrician for an exam. If the baby is having trouble breathing, you need to immediately seek emergency care.

The baby will often grow out of asthma caused by colds by age three or four. But while they have it, the baby will almost always need to be treated with an asthma spray (bronchodilator and anti-inflammatory), which the baby breathes in from an inhaler.

A hoarse, barking cough in babies could be false croup

Some babies get so-called false croup alongside a regular cold. The mucous membranes just below the vocal cords become swollen and the baby develops a hoarse, barking cough that is painful. Swelling increases when lying down, which is why the baby often wakes up with a cough and breathing difficulties after a few hours of sleep. In most cases, croup is not dangerous, but it can be very uncomfortable the first time, for both the baby and the parents.

The most important thing you can do is to stay calm so that you can comfort your baby, because the issue can get worse if they cry and get upset. Sit with the baby in an upright position, which reduces swelling. You can also try sitting near an open window to let in cool, fresh air – but wrap up baby in a blanket so they don’t get cold. If that works, the baby will often fall asleep in your arms and after a while, you can put them back down. A croup cough can be very painful in the throat, so a dose of pain-relieving paracetamol can help the baby relax. If you can’t get the cough under control and the baby is still having trouble breathing, then seek emergency medical attention.

A baby who has had croup once is likely to get it again with the next cold. If you know your baby gets croup easily, and if they are over a year old, you can try giving them nose drops at bedtime when a cold seems to be on the way.

Cough attacks can be whooping cough

All babies over three months are offered a whooping cough vaccine. As a result, it is a very rare disease, but it does still occur from time to time. Whooping cough often starts as a common cold, but transitions into coughing fits that can be so intense that the baby nearly loses their breath or vomits. When the baby finally takes in air, you hear a wheezing or whistling sound called a “whoop”. If you have a baby under six months who you think has been exposed to whooping cough, you should contact your paediatrician immediately, because antibiotics may be necessary – even for preventive purposes, if someone in the family is sick.

Lingering symptoms might be allergies

If the baby is sniffling and has itchy or runny eyes/nose, it could be an allergy. Dust mite allergies are most apparent in the morning, and pollen allergies are most apparent in pollen season. Contact your paediatrician if you think your baby might have an allergy so that they can investigate.

And don’t forget – you can always call for advice about a cold, cough or any other sickness.

Please note that all information above is based on Swedish recommendations.