Cough (0-12 Months)

When To Call

Call 911 Now

• Severe trouble breathing (struggling for each breath, can barely cry)
• Passed out or stopped breathing
• Lips or face are bluish when not coughing
• You think your child has a life-threatening emergency

Go to ER Now

• Choked on a small object that could be caught in the throat
• Ribs are pulling in with each breath (called retractions)
• Not alert when awake ("out of it")

Call Doctor or Seek Care Now

• Trouble breathing, but not severe
• Nonstop coughing spells
• Lips or face have turned bluish during coughing
• Harsh sound with breathing in (called stridor)
• Wheezing (high-pitched purring or whistling sound when breathing out)
• Breathing is much faster than normal
• Dehydration suspected. No urine in more than 8 hours, dark urine, very dry mouth and no tears.
• Milk taken is less than half of normal amount
• Weak immune system. Examples are sickle cell disease, HIV, cancer, organ transplant, taking oral steroids.
• High-risk child (such as cystic fibrosis or other chronic lung disease)
• Fever in baby less than 12 weeks old. Caution: do NOT give your baby any fever medicine before being seen.
• Fever higher than 104° F (40° C)
• Your child looks or acts very sick
• You think your child needs to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

• Age less than 6 months old
• Earache or ear drainage
• Fever lasts more than 3 days
• Fever returns after being gone for more than 24 hours
• You think your child needs to be seen, but the problem is not urgent

Contact Doctor During Office Hours

• Coughing causes vomiting 3 or more times
• Runny nose lasts more than 14 days
• Cough lasts more than 3 weeks
• You have other questions or concerns

Self Care at Home

• Cough with no other problems

Care Advice

What You Should Know About Coughs:

• Most coughs are a normal part of a cold.
• Coughing helps protect the lungs from pneumonia.
• A cough can be a good thing. We don't want to fully turn off your child's ability to cough.
• Here is some care advice that should help.

Homemade Cough Medicine:

• Goal: decrease the irritation or tickle in the throat that causes a dry cough.
• Age 6 months to 1 year: give warm clear fluids to treat the cough. Examples are apple juice and lemonade. Amount: Use a dose of 1-2 teaspoons (5-10 mL). Give 4 times per day when coughing.
• Caution: do not use honey until 1 year old.

Drugstore Medicines for Cough:

• Cough Medicines. Don't give any drugstore cold or cough medicines to young children. They are not approved by the FDA under 6 years. Reasons: not safe and can cause serious side effects. Also, they are not helpful. Reason: they can't remove the tickle in the throat. They also can't remove dried mucus from the nose. Nasal saline works best.
• No Antibiotics. Antibiotics are not helpful for coughs. Antibiotics may be used if your child gets an ear or sinus infection.

Coughing Fits or Spells - Warm Mist and Fluids:

• Breathe warm mist, such as with shower running in a closed bathroom.
• Give warm clear fluids to drink. Examples are apple juice and lemonade.
• Age less than 6 months. Only give breast milk or formula.
• Age 6 - 12 months of age. Give 1-2 teaspoons (5-10 mL) each time. Limit to 4 times per day.
• Reason: both relax the airway and loosen up any phlegm.

Vomiting from Hard Coughing:

• For vomiting that occurs with hard coughing, give smaller amounts per feeding.
• Also, feed more often.
• Reason: vomiting from coughing is more common with a full stomach.

Humidifier:

• If the air in your home is dry, use a humidifier. Reason: dry air makes coughs worse.

Fever Medicine:

• For fevers above 102° F (39° C), give an acetaminophen product (such as Tylenol).
• Another choice is an ibuprofen product (such as Advil). Caution: avoid ibuprofen until 6 months or older.
• Note: fevers less than 102° F (39° C) are important for fighting infections.
• For all fevers: keep your child well hydrated.

Avoid Tobacco Smoke:

• Tobacco smoke makes coughs much worse.

Return to Child Care:

• Your child can go back to child care after the fever is gone.
• For practical purposes, the spread of coughs and colds cannot be prevented.

What to Expect:

• Viral coughs last for 2 to 3 weeks.

Call Your Doctor If:

• Trouble breathing occurs
• Wheezing occurs
• Cough lasts more than 3 weeks
• You think your child needs to be seen
• Your child becomes worse

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