Chesty coughs in babies: causes and symptoms?

The chesty cough, also known as a productive cough, is a natural mechanism triggered by the body to clear mucus accumulated in the respiratory tract. It usually occurs following irritation of the respiratory tract and serves to eliminate secretions. When a virus or bacteria infects the respiratory tract, the immune system responds by increasing mucus production to trap and eliminate pathogens. However, in infants, the natural drainage of secretions is less effective than in adults due to the immaturity of their respiratory system. Coughing then becomes the primary mechanism for clearing mucus.

Chesty cough vs. dry cough: what’s the difference?

The dry cough usually occurs in fits when the airways are irritated. It does not involve the expulsion of mucus and is therefore considered non-productive. 

Unlike a dry cough, a chesty cough usually results in the expulsion of mucus through the mouth and nose. It typically occurs when a baby has a cold or is suffering from an upper respiratory tract infection such as bronchitis or bronchiolitis. 

Although a chesty cough is a beneficial reflex that allows the body to effectively clear excess mucus, it can be quite alarming for parents. If your baby has a chesty cough, it’s important to consult your pediatrician if the symptoms persist.

There are several possible causes for your baby’s productive cough. Here are the most common causes in infants:

Respiratory Tract Infection: Infections affecting the respiratory system, such as the common cold, bronchitis, or bronchiolitis, are common causes of a productive cough in babies. These conditions lead to increased mucus production, which the body tries to clear through coughing.

Gastroesophageal reflux (GERD): GERD can irritate the respiratory tract in some babies. This can lead to a persistent cough accompanied by phlegm.

Good to know: In cases of GERD, a chesty cough is more pronounced after meals or when the baby is lying down.

Respiratory allergies: Increased sensitivity to certain environmental allergens, such as mould or dust mites, can cause a cough in young children. In such cases, the cough is often accompanied by a runny nose and frequent sneezing.

Note: Respiratory allergies are relatively rare in newborns. However, don’t hesitate to ask your pediatrician for advice if there is a family history of allergies.

Teething: When the first teeth come in, saliva production increases in young children. This can lead to a chesty cough, especially if the toddler has trouble swallowing their saliva.

Did you know?

Teething can be accompanied by upper respiratory infections due to inflammation caused by the pressure of the teeth on the gums. It is therefore common for a baby to have a runny nose or a productive cough when teething.

In infants, a chesty cough is usually accompanied by various symptoms. Here are the most common signs to watch for when your baby has a productive cough:

• Stuffy nose: Your baby may have trouble breathing through their nose and have a significant runny nose

• Difficulty breathing: You notice that your baby is struggling to breathe and making wheezing sounds, especially at night when lying down

• Mild fever: a low-grade fever may occur, especially if the chesty cough is caused by an infection or teething

• Loss of appetite: The baby refuses to drink or eat due to respiratory discomfort

• Regurgitation: if the baby has a significant excess of mucus, regurgitation or vomiting may occur following a coughing fit

• Fatigue: A productive cough can disrupt the baby’s sleep and require a lot of energy, which can lead to daytime fatigue and irritability

• Frequent crying: Coughing can be distressing for your baby and lead to behavioural changes, such as increased crying and a desire for closeness (being held, cuddled, etc.)

For young children, it is essential to contact a healthcare professional if symptoms persist. If in doubt, do not hesitate to contact your pediatrician.

A few good habits can help you prevent a productive cough from developing in your baby. Here are our tips to help prevent your baby from developing a cough:

1. Dress your baby according to the temperature: Make sure your baby is dressed warmly enough during the cold season and avoid exposing them to the cold for too long. Indoors, be careful not to overdress your baby; sudden temperature changes can weaken their respiratory system.

2. Clean your baby’s nose: Don’t forget to clean your baby’s nose daily using saline solution. This helps clear the nasal passages, remove accumulated impurities, and prevent mucus buildup. 

3. Emphasise handwashing: As soon as possible, teach your little one to wash their hands with warm water and soap to prevent the spread of viruses. If your baby is too young to wash their hands, keep small cleaning wipes on hand to use as needed. 

4. Stay away from irritants: Certain substances such as cigarette smoke, household cleaning products, perfumes, etc., can irritate your baby’s airways and cause coughing. Whenever possible, limit your baby’s exposure to ENT irritants.

5. Avoid contact with sick people: Minimise contact with sick family members and limit outings to crowded places with your baby as much as possible during seasonal flu outbreaks. 

6. Ventilate your baby’s room: Every day, be sure to open the windows in your baby’s room wide for at least 10 to 15 minutes to let in fresh air and oxygen. This simple habit helps reduce the presence of allergens and limit the concentration of indoor pollutants. 

7. Monitor your baby’s diet: Depending on your baby’s age, make sure their food is carefully selected, rich in vitamins and minerals, and tailored to their needs. A healthy diet is the foundation of a strong immune system.

A nighttime cough can make your baby’s nights difficult, disrupting their sleep and, consequently, their overall well-being. As a parent, it’s important to take steps to improve their comfort and promote restful sleep. Here are some tips to help soothe your baby and ease their nighttime cough:

Raise the head of their mattress

One of the first steps to take is to slightly elevate the head of the mattress. To do this, you can slide a small pillow or a folded towel under the mattress to create a slight incline. This position helps reduce symptoms associated with gastroesophageal reflux, a common cause of nighttime coughing, while helping clear airways congested with mucus.

Warning: Raising your baby’s head can be done safely as long as you place a small pillow under the mattress to create a slight incline (10–15°). Never place a pillow directly under your baby’s head to avoid the risk of suffocation. Also, make sure the crib complies with safety standards, with no pillows or objects in the sleeping area.

Humidify the air in the room

Dry air is often responsible for irritating the respiratory tract, thereby worsening the cough. Maintaining proper humidity levels in the baby’s room is essential to prevent this problem. Use a humidifier suitable for children’s rooms and regularly monitor the room’s humidity levels with a hygrometer. For children aged 0 to 2 years, the optimal humidity levels range from 40% to 60%. Proper humidity helps thin mucus, making it easier for your baby to breathe.

Keep your baby well-hydrated

If your baby is old enough to drink water, offer small sips before bedtime. This can soothe a sore throat and help them feel more comfortable throughout the night. If you’re breastfeeding your baby, feel free to nurse them throughout the night to help soothe their cough.

Create a soothing environment

Soft lighting and gentle white noise (such as the sound of waves or rain) can help soothe your baby. This promotes peaceful sleep and helps them fall back asleep more quickly if they wake up at night due to a chesty cough.

If the cough persists despite the advice provided, we recommend contacting your pediatrician. They can perform a thorough diagnosis and refer you to an ENT specialist if necessary. An allergy test or even a chest X-ray may be prescribed in some cases to determine the underlying cause of your baby’s cough.

If you choose to use natural remedies, be sure to consult your healthcare provider. Some natural remedies known to soothe a chesty cough are not suitable for use in young children.

If your baby has a chesty cough, sitting or being held upright can help them feel better. If you enjoy using a baby sling or carrier, feel free to keep your baby close to you as much as possible to help them clear their mucus more easily. Most babies sleep well when being carried. For naps, a walk in the fresh air—making sure to cover your baby well with a hat—can be an excellent way to enjoy some fresh air while ensuring they get the rest they need for a speedy recovery.

Marine is a naturopath specialising in children’s well-being and a parenting coach. With 10 years’ experience supporting families, she now channels her passion into serving her community by sharing natural and caring advice.