Why Do Babies Have Dry Coughs At Night?

It's 3am and you jolt awake to the sounds of your baby's hoarse coughing over the monitor. Sitting up in bed, you hear her little throat making hacking, barking sounds as she tries to clear it. You hurry to her crib where you find her red-faced and irritated, coughing hard between whimpers. Scooping her up, you gently pat and rub her back as she continues coughing, her little body tense with effort. Feeling anxious and concerned, you pace the nursery while cradling her close, wishing you could make this nagging nighttime cough go away.

As a parent, hearing your baby's dry, hacking coughs ringing through the night can be worrying. You feel helpless every time she wakes up coughing, coughing, coughing. But take comfort, this common nighttime cough is usually nothing serious. In this article, we'll discuss the reasons for babies' nocturnal coughs, and provide tips to help your child (and you!) sleep more soundly. So take a deep breath, cuddle your coughing cutie close, and read on to learn why babies often get those dry, barking coughs at night.

How dry coughs differ from other types of coughs?

A dry cough, as the name suggests, is one that does not produce phlegm or mucus. It often sounds harsh and hoarse, even barking. With a dry cough, the back of the throat is irritated, triggering a cough reflex, but there is no actual fluid in the lungs or bronchial tubes to expel. Dry coughs can be caused by environmental irritants like smoke or dust, post-nasal drip, throat infections, or even acid reflux.

In contrast, a wet cough, also called a productive cough, does bring up phlegm or sputum. It sounds loose and gurgly as mucus from the lungs is coughed up. Wet coughs are often part of chest colds and lung infections like bronchitis where extra fluid and mucus accumulates in the chest.

There are also tickly coughs which are lightly hacking from irritation, and croupy coughs which have a distinctive seal-like bark caused by irritation around the voice box.

While coughs can vary, parents should watch for any worsening, such as difficulty breathing, high fever, or changes in mucus. It's always best to contact your pediatrician if your baby's cough persists or you have any concerns.

Why do babies have dry coughs at night?

Babies can experience dry coughs at night for various reasons, both when they are unwell and when they are not. Let's discuss these scenarios in detail.

When Babies Are Sick:

Respiratory infections: One of the most common reasons for a baby to have a dry cough at night is a respiratory infection, such as a cold, flu, or bronchitis. These infections can lead to irritation and inflammation in the airways, resulting in coughing, which may be more noticeable at night due to the baby lying down.

Postnasal drip: When a baby has a cold or allergies, excess mucus can drip down the back of their throat, leading to a dry and persistent cough. This can be particularly bothersome at night as the mucus accumulates when the baby is lying flat.

Asthma or wheezing: Some babies may have underlying conditions like asthma or wheezing, which can cause nighttime coughing. Asthma-related coughs can be triggered by allergens or irritants in the bedroom, making them more prominent at night.

When Babies Are Not Sick:

Dry air: Dry indoor air can lead to dry throat and coughing in babies. During the winter months when indoor heating systems are active, the air can become dry, irritating the baby's throat and causing coughing, especially at night.

Teething: Teething can also lead to nighttime coughing. As a baby's teeth emerge, the increased saliva production can cause a cough-like response when they swallow the excess saliva.

Reflux: Gastroesophageal reflux (GER) or gastroesophageal reflux disease (GERD) can cause stomach contents to flow back into the baby's esophagus. This can lead to irritation and coughing, which may be more noticeable when lying down.

Environmental irritants: Babies may be sensitive to environmental irritants in their sleep environment, such as dust, pollen, or pet dander, which can trigger nighttime coughing.

In both scenarios, it's crucial to consider the baby's overall health, symptoms, and any accompanying signs of illness. If the cough persists, is severe, or is accompanied by other concerning symptoms (such as difficulty breathing or high fever), it's advisable to consult a pediatrician for a proper evaluation and guidance. In many cases, simple measures like using a humidifier, keeping the room at an optimal temperature, and maintaining a clean sleep environment can help alleviate nighttime coughing.

Differences between a cough from illness versus a non-illness cough 

Illness cough characteristics:

Often accompanied by other cold/flu symptoms like fever, runny nose, sneezing. This suggests an underlying infection may be present.

The cough sound may be wet, deep or barky. This type of cough quality is more consistent with infection/inflammation in the lungs or airways.

Discomfort is shown through fussiness, irritability, and the baby seeming more tired/listless than usual. The cough is interfering with their regular activity levels and comfort.

As the illness progresses over days, the cough frequency and severity tends to increase rather than remaining isolated incidents.

Non-illness cough traits:

No associated cold/flu symptoms of systemic infection.

The cough sounds dry and hacking rather than stuffed/wet.

Normal behavior in between - still playing, eating, sleeping regularly without obvious disturbance.

May only occur at specific times rather than constant. For example, only at night or when laid flat due to reflux/drainage.

Episodes tend to be singular bouts that stop for a period rather than continuous.

Triggers align with conditions like reflux or postnasal drip as per family history.

Developmental immaturity of lungs is age-appropriate.

How long does a dry cough last in babies?

The duration of a dry cough in babies can vary, but here are some general guidelines:

Viral cough (from a cold): Most coughs associated with a viral infection like a cold will typically last 2-3 weeks. A cough that persists for more than 3 weeks after the other symptoms have cleared could indicate a secondary infection.

Post-viral cough: In some cases, especially in younger babies, the cough may linger for 4 weeks or longer even after the initial viral symptoms are gone. This is generally nothing to worry about.

Cough due to reflux: Reflux-related coughs in babies often last until around 1 year of age when baby's gastroesophageal sphincter matures. However, individual coughing spells from reflux may clear up within a few weeks.

Cough due to asthma: A chronic, recurrent cough lasting more than 4 weeks could point to asthma in older babies. Consult the pediatrician.

Persistent bacterial infection: If accompanied by fever or other symptoms, a cough lasting over 3 weeks requires medical evaluation to rule out complications.

In general, an occasional dry cough under 4 weeks is usually normal if baby is otherwise healthy. Seek medical advice if coughing is severe, disruptive to feeding/sleeping, or persists without improvement longer than expected. The duration alone may not be concerning.

How can I help my baby's dry cough at night?

Here are some things you can try to help relieve your baby's dry cough at night:

Humidifier - Use a cool mist humidifier in baby's room to add moisture to the air which can ease coughing.

Saline drops/spray - Add 1-2 drops of saline in each nostril before bed to loosen mucus and encourage drainage rather than coughing.

Elevate the head of the crib mattress - Raise one end by 3-5 inches so milk/secretions are less likely to drain down the throat when sleeping.

Clear nasal passages before sleep - Use a saline bulb syringe or gentle suction before bedtime to clear the nose if stuffy.

Limit exposures - Avoid secondhand smoke, strong scents, dust etc. that could irritate airways before sleep.

Small feed before bed - A warm milk feed can soothe coughing especially in younger babies by coating the throat.

Call doctor - For persistent or severe cough at night despite home remedies, contact your pediatrician to rule out any underlying issues. Medicine may be advised in some cases.

Stay on schedule - Maintain regular sleep/wake cycles even if coughing as sleep disruptions can exacerbate coughing.

Comfort baby - Gentle back rubbing or using a humidifier sound machine can distract baby from coughing at bedtime for a good night's rest.

Conclusion

As promised in the introduction, let's explore the common reasons behind babies' dry nighttime coughs. Often it's due to their immature airways being more easily irritated when laying flat. Reflux is another frequent trigger as lying down causes gastric contents to reach the throat more. Post nasal drip from allergies or colds can also provoke coughing. Developmentally, babies' cough reflex is stronger at night as their lungs and throat adjust.

Hopefully this provides some reassurance that your baby's dry coughs are likely normal. With gentle care and home remedies like saline and positioning, you can support their comfort until the cause resolves naturally. And you'll get through this challenging phase with the same love and patience that serve you both so well. While worrying is understandable, take comfort knowing these nocturnal coughs are mostly harmless. Now go cuddle that sweet cougher, breathe deep, and look forward to more restful nights ahead. With understanding and time, this too shall pass.