Can a 4 month old get a cough and congestion from teething?

No: There have been some reports of an association between teething and low-grade fevers. If there is any association with runny nose and coughing, I am not aware of it. Certainly it wouldn't be associated with severe coughing.

No: Sometimes teething associated with a low grad fever, excessive salivation (drueling) but coughing ang congestion are not from teething.

Maybe: I can be hard to determine the exact cause of an infants symptoms... It might be related to teething or it might be a cold. Please monitor your child closely and give palliative care: 1. Cold compresses 2. Children's tylenol (acetaminophen) per the label's directions. 3. Maintain hydration. 4. Call your pediatrician if the fever increases or persists for more than 3 days.