Wheezing and coughing in a 5-month-old baby

A clinician should listen to your baby's chest and assess breathing, hydration, temperature and oxygen level. Seek emergency help now if your baby is struggling for breath, has blue or grey lips, has pauses in breathing, is unusually difficult to wake, or cannot feed because of breathlessness.

A wheeze is a high-pitched sound, often heard when breathing out. A blocked nose can also create noisy breathing, so a recording made when the sound occurs may help the clinician distinguish it.

Bronchiolitis commonly presents in babies with cough, rapid breathing, feeding difficulty and wheezing or crackling sounds. Other infections or irritation of the airways can produce similar symptoms. The pattern cannot be diagnosed reliably from sound alone, and asthma is not confirmed from a single wheezing illness in a young baby.

Keep your baby upright while awake and offer smaller, more frequent breast or bottle feeds. Saline nose drops followed by gentle suction before feeds may help if nasal blockage is interfering with feeding. Keep the environment free of smoke, incense, vaping aerosols and strong fragrances.

Do not give over-the-counter cough or cold medicines, honey, or someone else's inhaler. Nebuliser treatment is useful only for selected causes and should be given when a clinician recommends it. Place your baby flat on their back on a firm sleep surface for every sleep; do not prop up the cot mattress.

Call emergency services for severe effort with each breath, grunting, marked pulling-in under the ribs, blue or grey colour around the lips, breathing pauses, a seizure, or reduced responsiveness. These signs are urgent regardless of the suspected cause.

Arrange same-day assessment if breathing is faster or noisier than usual, feeds are much smaller, nappies are noticeably drier, vomiting prevents fluids staying down, fever develops, or the cough and wheeze are worsening. Babies can tire during respiratory illness, so reassess rather than waiting if their behaviour changes.

Ask whether the noise comes from the nose, throat or lower airways; whether feeding and hydration are adequate; which changes should trigger emergency care; and when your baby should be checked again. Also mention premature birth, previous breathing problems, sick contacts, fever, choking episodes and any smoke exposure.