When to get help

Call emergency services — 999 in the UK, 112 or 999 in Ireland and the EU, 911 in the US and Canada, 000 in Australia, 111 in New Zealand — if your baby:

is finding it hard to breathe: grunting noises, the tummy sucking in under the ribcage, breathing very fast, or shallow breathing;
has pauses in their breathing;
has lips, tongue, face or skin that turn blue or grey — on brown or black skin this may be easier to see on the palms or soles;
is unable to swallow fluids or saliva;
is having a seizure;
is floppy, will not wake, or is not responding as usual.

Ask for an urgent appointment or call an advice line — NHS 111 in the UK, phoning rather than using the website for a child under 5; GP out-of-hours in Ireland; your paediatrician in the US or Canada; healthdirect on 1800 022 222 in Australia; Healthline on 0800 611 116 in New Zealand — if your baby is under 6 months and has symptoms of whooping cough, has a cough that is very bad or getting worse quickly, feels very unwell, has a high temperature at the age thresholds (38°C / 100.4°F under three months, 39°C / 102.2°F from three to six months), is feeding much less than usual, or if you are worried.

See a GP non-urgently if the cough has lasted more than three weeks.

When a cough is just a cough

The NHS gives a usable rule for children: if your child is feeding, drinking, eating and breathing normally and there is no wheezing, a cough is not usually anything to worry about. It adds the reason — although it is upsetting to hear, coughing helps clear phlegm from the chest and mucus from the back of the throat. Children often cough with a cold because mucus trickles down the back of the throat.

A cough will usually clear up on its own within three to four weeks. That is longer than most people expect, and a cough that is slowly improving at week two is following the normal course.

Listening for the ones that are not

The character of the cough and the breathing around it are what matter.

Barking, like a seal

With a hoarse cry and a high-pitched rasping sound on breathing in, this suggests croup. The NHS advises contacting a GP or NHS 111 for any suspected croup, because treatment can shorten it.

Wheezing or crackling, with fast breathing and poor feeding

In a baby under two this suggests bronchiolitis. The NHS notes symptoms are usually worst between days three and five and the cough usually settles in about three weeks.

Bouts of coughing, worse at night, sometimes with vomiting

This is the pattern of whooping cough. The NHS describes coughing bouts lasting a few minutes that are worse at night, possibly with a whoop — a gasp for breath between coughs — and notes that young babies under three months and some adults may not whoop at all. A baby may have difficulty breathing after a bout and may turn blue or grey, and may bring up thick mucus that causes vomiting. The cough can last several weeks or months. A high temperature is uncommon.

The CDC says babies younger than one year are at greatest risk of getting whooping cough and of severe complications from it. The NHS lists dehydration, breathing difficulties, pneumonia and seizures as increased risks in babies under six months, and says hospital treatment is usually needed for a baby under six months with whooping cough. This is why any suspicion of it in a young baby is an urgent call rather than a routine one.

A cough that is worse at night or brought on by activity

The NHS suggests this could be a sign of asthma and warrants a GP appointment, though asthma is rarely diagnosed in the first year.

What not to give a baby

No honey under one year. The NHS's hot lemon and honey remedy is explicitly not suitable for babies under 1, and its children's cough advice offers it only from age 1.
No over-the-counter cough and cold remedies under 6 years, including decongestants, unless a GP or pharmacist advises it. That is the NHS position, and it covers babies completely.
No aspirin under 16.
Do not expect antibiotics. The NHS says antibiotics are not normally prescribed for coughs, and will only be given where there is a bacterial infection or a risk of complications.

What actually helps

Rest, fluids, and small frequent feeds. Keeping your baby upright while awake makes breathing easier. Do not smoke around them. Beyond that there is not much, and the NHS is candid that even the remedies it lists for older children have limited evidence behind them.

Prevention worth having

Whooping cough is the one cough on this list with a real preventive route. The NHS notes the vaccine is given as part of the 6-in-1 at 8, 12 and 16 weeks and 18 months, and as part of the 4-in-1 pre-school booster. It also recommends the vaccine in pregnancy, usually around 20 weeks, to help protect a baby in the first few weeks of life before their own doses take effect.

Timeliness matters more than usual here, because the gap being covered is exactly the age at which whooping cough is most dangerous.

Staying off nursery

For an ordinary cough, keep your baby at home if they have a high temperature or are not well enough for normal activities. For whooping cough the rule is specific: stay off until 48 hours after starting antibiotics, or three weeks after the cough started if antibiotics were not given.

Coughs in Babies