My Baby Coughs & Seems to Choke on Saliva During Sleep

When you notice your baby coughing and choking during sleep, you might wonder what could be wrong. There are a few different possible reasons, but it can be difficult to diagnose the cause at home. You should report any nighttime coughing and choking to your child's pediatrician so that you can get a correct diagnosis and start treatment if necessary 1.

Potential Causes

One potential cause of coughing and choking in babies is sleep apnea, which occurs when swelling in the tonsils blocks the airway and causes saliva to pool there. Another reason for nighttime coughing and choking in babies is infant reflux 1. Infant reflux develops when the esophageal sphincter, the ring-shaped muscle between the esophagus and stomach, isn't strong enough to keep the contents of the stomach contained, allowing them to come back up into the throat. Asthma, allergies and colds can all lead to coughing and choking at night, as well.


Before your baby's doctor can recommend treatment, she will need to figure out the actual cause of the sleep disturbances. The doctor might want to directly observe your child sleeping, so you might need to spend the night in a pediatric hospital. Another option is to videotape your child when he experiences nighttime coughing and choking, so your doctor can observe him without needing to keep him hospitalized overnight 1. The doctor might want to examine the esophagus for damage using a flexible tube with a camera or might do tests to monitor the amount of stomach acid.

Possible Solutions

Depending on the specific cause and the severity of the coughing and choking your baby experiences, his pediatrician might recommend any of a wide range of solutions. Sleep problems caused by swollen tonsils could require tonsil removal. If there is an underlying illness or allergy, treating that problem could solve the sleep issues. In some cases, the sleep position can make a difference, so the doctor might advise raising the head of the crib by about 30 degrees or suggest that your child be put to sleep on his side.


Don't try to solve sleep coughing and choking issues yourself, because in some cases, you could make the problem worse or introduce new issues 1. While laying your baby to sleep on his tummy might seem like a good idea to let his throat drain better, it can increase the risk of Sudden Infant Death Syndrome, or SIDS. You should also not give your baby medications intended for adults or older children, including acid reflux medication or decongestants, since these can be dangerous for a young baby.