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Welcome back to First Breaths to First Steps by Bev Garrison. I’m your host today and we’re going to talk about, does my baby have a cold? I think this is probably one of the most common questions I received when working in private practice, pediatrics. It’s very likely for newborn babies and or younger babies to catch colds versus older kids and adults.
In the first year, you can have up to seven to 12 episodes of viral illness or colds upper respiratory wise. And so I think today my biggest purpose in my podcast is to identify just a little introductory facts about colds, what symptoms that you may see, how we’re at risk for catching colds, simple treatments -things that we can do, things that maybe we don’t want to do as well, and then signs when you want to go in and get further evaluation by your primary care provider.
Babies, just like adults, are born with some immunity, but it’s definitely not a mature immune system. This may be what puts them at risk of picking up colds. There’s hundreds of viruses that can cause colds that are out there. We get some passive immunity if moms are nursing and they’re also born with some immunity from mom. But they definitely can be susceptible at certain times of the year, usually in winter, cold and flu season and or if they’re around a lot of other children.
So let’s talk about some of the symptoms that are present in most common colds. Nasal congestion, fussy/kind of irritable behavior, sometimes with, or without a fever. Sometimes parents have a big question about what is a fever. Most of the time primary care providers or pediatricians will define a fever at a 100.4 Fahrenheit or greater. So that’s generally the rule of thumb that I tell most people to look out for. Another symptom that we tend to see is running nose; lots of clear drainage, cough, decreased appetite, or even just difficulty feeding or nursing secondary to congestion. Sometimes difficulty sleeping sometimes scratchy throat, or they can have a harsh quality to their voice.
So, how do we get colds? Easy, right. Everyone is sick certain times a year, but think of three major things: AIR. So if you’re around someone who is sick, they’re coughing or sneezing. Droplets are spewed out into the air and so it’s easy for newborns or babies to breathe that in and have colds set up.
The second way that babies can get colds or viruses is with DIRECT CONTACT. Again, if someone who is ill is holding your baby, handling your baby, they can directly spread those germs to your baby and usual entry is at the nose, the mouth or the eyes. Sometimes too babies can also come in contact with CONTAMINATED SURFACES. Maybe sharing toys and then germs are on toys and babies are putting that in their mouth or whatnot; so that’s another way to spread germs and, or pick up colds.
Risk factors for sure, for babies, as far as what puts them at a more likelihood to get colds: their immune system. Definitely born with one, but they’re a little bit immature. If they’re around other children and most of the time, certain time of year. Although it is kind of a popular belief that we only get sick in the winter or cold and flu season. You can definitely have summertime colds.
When are signs that you would want to take your baby in? Most of the time, if babies are less than two months of age, it’s probably recommended that if they had any combination of the symptoms above that they’re looked at. Especially if symptoms are going on for a couple of days. Because let’s face it they’re at the age where they can’t necessarily tell you “I feel bad or this hurts” and all you’re going on is I’m seeing this fever and maybe some congestion.
Another good reason to go in would be if you’re not seeing as much urine output from your child or they’re not drinking enough. Definitely not drinking enough plays a huge role because even in adults, we tell you to drink lots of fluids and make sure that you’re well hydrated. Another reason to go in would be if you see red eyes or eyes with any sort of discharge, stuff coming out of them. We talked about earlier, just about fever, but if symptoms are noted in someone who’s less than two months of age, I would say a 100.5, if three to six months, you could maybe go a little bit higher if you saw a fever greater than 101. Fever lasting longer than four days is another good reason to go in. And definitely, if you see rash, you have vomiting and diarrhea, a croupy type cough () which tends to be a very harsh, dry cough) a cry that sounds odd, trouble breathing, pulling in between ribs, thick mucus, rubbing his ears, or you think that maybe your baby is dehydrated. Those would all be great reasons to take your child in. And at the end of the day if you’re worried it’s best to get those questions answered and addressed so that you have the best things to do for your baby.
So let’s talk about treatment. Things that you can do for sure is increase fluids. Either the formula that they’re drinking, breast milk or you can offer Pedialyte . Pedialyte or any electrolyte type solution will help to hydrate them. Sometimes babies aren’t keen at taking milk when they’re congested and so being able to offer them something else is nice to have at your fingertips. A lot of these electrolyte solutions will come dry and they will give you instructions on how to add it to your own water so that you can have it around easily and not be worried that it’s going to expire too quickly. It is a good thing to remember that once you open electrolyte solution it’s only good for a certain amount of time. So make sure that you read on the instructions. Some of them, you can only have open for 24 to 48 hours and then it’s no longer good. But in kids, less than a year of age, we usually recommend offering some type of electrolyte rather than just water.
The next thing that you can try, which is. I think one of the best solutions ever is using nasal saline and suction. Nasal saline will come in a small bottle. That if you hold the bottle upside down, it will drip out – one drop at a time. If you hold it up right, then it sprays and kind of aerosolizes for adult use.
So for infants or smaller babies, what I would do is turn it upside I do one to two drops each nostril. If you’re seeing a lot of congestion, then it’s okay to suck it out. If you’re not seeing a lot of fluid prior to even putting the saline in there, you could just put an extra drop in and allow it to rinse back. Sometimes you’ll see the baby’s kind of gag and sputter a little bit because it’s running down the back of their throat, but it helps to keep that nasal passage nice and clear.
There are lots of different ways to suction out. Probably the most familiar is using a bulb suction. These are usually given to you at the time of delivery and you go home with it from the hospital. But a bulb section looks exactly like that -a little ball, it’s rubber and then it comes to a point. What you’d want to do is put the saline in the nose. Press in on the bulb before you insert it in the nostril about halfway. And then gently put it in one nostril at a time and release that depressed part of the bulb and it should suck out any fluid congestion and or extra saline that you have there. There’s also another type of nasal suction; what’s called a nose Frieda. It has a mushroom type tip that you put just gently against the nostril. It doesn’t necessarily go in and you also suck out with a tube at the other end to your mouth. Don’t worry, there’s a filter, so you’re not actually sucking that congestion into your mouth, but it does provide that negative pressure to get that saline and snot out of their head for lack of better description. A lot of parents find that that is easier. The one thing to remember about suction is that if you’re not seeing a lot of drainage coming from either nostril you may not want to be sucking out. Sometimes placing either the bulb syringe or the nose Freida suction type product in the nose without a lot of things to take out can cause more swelling and sometimes make babies more stuffy than they were to begin with. So if you don’t see a lot of fluid, I would just put an extra drop of saline to help rinse that nasal passage way and keep them clear.
The last thing that I think is a really good thing to do when babies have colds is run a humidifier in the nursery. It’s good background, white noise can kind of help take the place of even a noise machine and help them to sleep. But will also change that ambien humidity in the nursery or where the baby is sleeping. Which can make it a little bit easier for them to breathe.
Steam is also kind of a way of changing humidity, but can be helpful. What I recommend to parents is if any adult is getting into the shower, wrap your baby in a hand towel or a hooded towel and hand them to the adult that’s in there. That steam of the shower, we’ll just have that congestion start coming out of their nose. You won’t even have to suck it out. It’ll just run out and you could just wipe with a soft wet baby washcloth. And clear that congestion. Steam is really nice to do first thing in the morning when babies wake up and they’re super congested and before they go to bed, just so that you’re clearing them out as much as possible. Making them more comfortable to be able to lay down and tolerate sleeping.
Some of the complications that can happen from cold, especially cold that lasts a while and they’re not going away is kids can have your infections. So fluid stays in that kind of upper airway up in your head. And the ear drainage is not maybe as efficient as it should be. And so once that material stays there then they develop ear infections.
Another complication that could happen – wheezing or difficulty breathing. So you always want to make sure that you’re listening to the cough and looking at kind of the effort at which your child is using to breathe. Just to make sure you don’t feel like they’re working too hard. So if you’re seeing what we call retractions, pulling in at the ribs, like there having little gills, like fish, trying to breathe. nose is flaring or color around their lips or gums does not look good. Those are all good signs that that’s too much effort to breathe and you should be seeing your primary care provider.
Another thing that you can have a complication from upper respiratory infection would be secondary infections, including pneumonia. So pneumonia is a bacterial infection, usually in the lower part of our lungs, that kind o collects from fluid that isn’t moving out. Again, kids will usually have fever with that as well as increased effort in breathing. Sometimes parents will describe that they seem like they’re breathing faster, even though the fever is down. Or you may also see that they’re just not drinking very well, seem a little bit more tired or worn out.
What are some things that you don’t want to do as far as treatment and how can we maybe prevent some colds? Things that you don’t want to do is treat viruses with antibiotics. They don’t work. Those two types of infections are very different and so antibiotics don’t address cold viruses. Another thing to think about in small infants is that over the counter cold medicines are not made for babies. We want to make sure that it is not impacting their respiratory effort or their ability to breathe so it’s always a really good idea in anyone who’s less than the age of two, that you’re consulting a physician or health care provider to help you choose whether or not a cold medicine is appropriate. We also don’t use aspirin in kids. It is linked with a illness called Reyes syndrome when aspirin is given and children are ill.
Another thing that I usually don’t recommend it vapor rub -things that you put on topically. It’s been around for a really long time, but I do find that sometimes those topical applications can cause irritation at the skin.
So how can we prevent colds? Probably one of the best ways is washing our hands frequently. Especially anytime you’re getting ready to hold your baby, feed your baby, bathe your baby. It’s just good for you to start off on that nice clean platform. I would avoid anyone who is ill – that’s probably the golden rule, right there is to really assess if people you’re going to be around or ill, then I’d probably decrease the exposure of your infant to them.
Definitely if others in your house or not feeling well, or maybe they have colds. You want to coach them on frequent hand washing as I stated above. But also coughing or sneezing. Into a tissue or their elbow. This way, you’re helping to decrease that aerosoled droplet that may get other people sick.
So in summary, pretty common for our newborns and babies to get colds. It’s probably not related to anything that you’re doing in particular that puts them at risk, but you do want to make sure that you’re familiar with symptoms that may be indicative of a cold. Including nasal congestion or runny nose, being more fussy and irritable, fever, cough or any sort of difficulty in breathing, decreased appetite or difficulty feeding and nursing and or difficulty sleeping.
Things that you want to think about as far as how to prevent is making sure that you’re really just not around others who are not feeling well and washing hands and encouraging everyone who comes in contact with your baby to also follow these good hygiene practices.
Lastly treatment. Don’t forget good old saline and suction is probably your best bet. Easy to do and can really make them a little bit more comfortable to sleep and rest . Definitely increasing fluids, making sure that they’re hydrated as well as running a humidifier. So i hope these tips and tricks on colds in babies has been helpful and until next time be well!