Infants (babies under 1 year old) should not take cough medicine or syrup unless a healthcare provider instructs it. The following nonmedication interventions are safer alternatives.
- Plenty of fluids
- Bulb suction
- Saline drops
- Humidifier
- Steam
- Acetaminophen (for fever and discomfort)
This article reviews the risks of giving an infant cough medicine, safe treatment alternatives, what to do when an infant’s cough is not improving, and at what age kids can take adult cough medicines.
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Stay Calm and Be Aware of Serious Symptoms
Having a sick child can be nerve-racking. But it’s important to stay calm, take an active role in your child’s health, and watch for serious symptoms that may require medical attention.
Risks of Infant Cough “Medicine”
Most cough medicines are unsafe for infants due to safety concerns such as overdose, convulsions (involuntary muscle spasms), and heart problems.
Manufacturers label child cough and cold products as unsuitable for children under age 4. However, 2- through 4-year-olds usually can take certain types of cough medicine under the recommendation of a healthcare provider.
Safe Infant Cough Medicine and Treatment
The following are nonmedication treatments that can ease an infant’s cough.
Fluids
Give your little one plenty of fluids to avoid dehydration. Fewer wet diapers and dark urine show they are not getting enough fluids. Fluids thin the mucus, keeping it from getting thicker and clogging the airways.
Fluid choices depend on their age and breastfeeding status. They include:
- Breast milk or formula
- Water
- Pedialyte
- Broth
- Gelatin
Your healthcare provider may suggest thinning the formula with Pedialyte if it worsens the baby’s cough. Try avoiding cow’s milk in older children while they have a cough because it can increase congestion.
Bottle-Feeding Safety Precautions
Always hold babies slightly upright, at an angle, when bottle-feeding. Do not prop their bottle unless they can independently remove it from their mouth.
Bulb Suction and Saline Drops
Using a bulb syringe, parents can use saline drops before suctioning mucus from the nose or throat. Saline thins the mucus and soothes the lining of the nose. Clearing the airways makes breathing, eating, and drinking easier.
Humidifier
Using a cool mist humidifier in the baby’s room hydrates the nasal passageways, decreases swelling, and thins mucus. Clean the humidifier regularly to prevent the growth of bacteria and mold.
Steam
Run a hot shower with the bathroom door closed, so you and your little one can sit in the steamy bathroom (not the shower). Breathing in steam widens and soothes the airways, which loosens congestion and helps oxygen get deeper into the lungs.
Reduce Allergens or Irritants
Some allergens or irritants can cause or worsen a cough, including:
- Smoke
- Dust mites
- Mold
- Pets
- Cockroaches
Tips to Reduce Allergens
The following tips reduce allergens and irritants:
- Avoid smoking (even if you smoke outside, smoke lingers on clothing and can irritate a child’s airway).
- Use an air purifier.
- Vacuum twice a week using a high-efficiency (HEPA) filter.
- Use an anti-allergic filter in central air or heat systems.
- Keep pets out of sleeping areas.
- Wash linens in warm or hot water
- Dry linens thoroughly (warm or hot air in the clothes dryer helps avoid mites).
- Use an anti-allergic mattress covers.
- Scrub bathrooms and basements to cut down on mold potential.
- Occasionally pull curtains back to prevent mold on windowsills.
- Keep humidity at or below 50% in your home.
Acetaminophen
You can give Tylenol, Feverall, Tempra, Actamin, and Panadol (acetaminophen) to infants 12 weeks or older. It helps reduce fever and discomfort.
For infants less than 12 weeks old, consult a healthcare provider. The provider will want to determine the underlying cause of a fever before recommending acetaminophen.
The American Academy of Pediatrics (AAP) recommends giving the following doses of acetaminophen, based on a concentration of 160 milligrams (mg) in every 5 milliliters (mL) of medicine, every four to six hours.
- 0–3 months (6–11 pounds): 1.25 mL
- 4–11 months (12–17 pounds): 2.5 mL
- 12–23 months (18–23 pounds): 3.75 mL
Follow dosing instructions carefully, and do not give more than four doses of acetaminophen in 24 hours.
Do Not Give Honey to Infants
You may be tempted to give your baby honey to relieve their cough. However, infants under 12 months should not have honey due to the risk of infant botulism (a dangerous toxin).
Infant Cough Not Getting Better With Medicine
Most infant coughs resolve in two to three days, but some (like those from pertussis) can last for weeks. A lingering cough (lasting more than a few days) can indicate an underlying condition requiring medical treatment.
The following signs and symptoms require immediate medical attention.
- Lethargy (listless, not responding to their environment)
- Not eating or drinking
- Dehydration (not peeing or having a bowel movement as often or at all)
- High fever (over 100.4 degrees F (38 degrees C) for infants less than two months or 102 degrees F (39 degrees C) for children of any age)
- Difficulty breathing (persistent wheezing, fast breathing, ribs showing with breaths, or nostril widening with inhalation)
- Trouble swallowing
- A high-pitched sound when they try to breathe in or out
- A cough in any newborn (within the first two weeks)
- Worsening symptoms
- Blue-tinged skin or lips
In addition, if you feel your child should see a healthcare provider, follow your instincts.
Causes of Infant Coughs
Infant coughs can be caused by the following:
When Are Children Old Enough for Adult Cough Medicine?
Giving adult medicine can be unsafe for young children for the following reasons:
- The ingredients may be harmful to kids.
- The medicine can cause an overdose in a small child.
- The medicine may not be effective.
- The medicine may only temporarily relieve an underlying problem that needs further medical care.
Children are typically old enough for adult cough medicine when they reach adolescence, around age 12. However, it is essential to consult with a healthcare professional first, even for teenagers.
Some medications may be safe for younger children under the supervision of a healthcare provider.
Summary
Cough medicines are not safe for infants. Healthcare providers recommend using nonmedication interventions such as drinking fluids, suction, saline drops, and humidifiers. A cold is the most common reason for an infant’s cough. Other underlying causes include allergies, asthma, RSV, the flu, croup, pertussis, and COVID-19.
Most coughs are minor and resolve within a couple of days. See a healthcare provider if it lingers longer or if they have other symptoms like fever, difficulty breathing, lethargy, and dehydration.
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