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A cough that occurs only in the morning in a five-month-old baby can have several potential causes, many of which are relatively harmless. However, it's important to monitor the situation to determine if further medical evaluation is necessary.

### Possible Causes of Morning Cough in Babies

1. **Post-Nasal Drip:** Overnight, mucus can accumulate in the back of the throat, especially if your baby has a mild cold or allergies. This can cause a cough in the morning as the baby clears the throat.

2. **Dry Air:** If the air in your baby's room is dry, especially in winter or if you use heating, it can cause dryness in the throat and airways, leading to a morning cough.

3. **Gastroesophageal Reflux (GERD):** Babies with mild reflux may cough in the morning if stomach contents have come up into the esophagus while lying down. This type of cough is usually mild and occurs more when the baby is lying flat.

4. **Environmental Irritants:** Dust, pet dander, or other irritants in the baby’s sleep environment can trigger a cough. Morning coughs might happen as the baby wakes up and starts to breathe more deeply.

5. **Mild Respiratory Infection:** A lingering cough in the morning could be a sign of a mild cold or respiratory infection. If this is the case, you might notice other symptoms such as a runny nose, mild fever, or sneezing.

### What You Can Do

- **Maintain Humidity:** Use a cool-mist humidifier in your baby's room to help keep the air moist, especially during dry months or if the air in your home is particularly dry.

- **Ensure Proper Sleeping Position:** Make sure your baby is sleeping with the head slightly elevated. This can help if reflux is the cause of the cough. However, avoid using pillows under the baby’s head, as this can be unsafe. Instead, you can elevate the head of the crib slightly.

- **Monitor for Other Symptoms:** Keep an eye on any additional symptoms such as fever, difficulty breathing, wheezing, or persistent cough throughout the day. If any of these occur, it may indicate a more serious condition.

- **Check the Environment:** Ensure there are no strong scents, smoke, dust, or other potential irritants in your baby’s sleep environment.

### When to Consult a Doctor

- If the cough persists for more than a week or worsens.
- If your baby shows signs of difficulty breathing, wheezing, or has a persistent fever.
- If there are any signs of a more serious infection, such as a high fever, lethargy, or refusal to eat.
- If you suspect reflux is causing discomfort or is associated with frequent spitting up.

A morning cough can often be benign, but it's always best to err on the side of caution and consult your pediatrician if you have any concerns about your baby’s health or if the cough seems to persist or worsen over time.