How to Take Care of an Infant With a Cold
Caring for an infant, especially a newborn, is quite intimidating. We are concerned about how they are breathing, their eating, their sleeping, how they are dressed, and their overall comfort. They seem so fragile. We carefully support their head, and we religiously place them on their backs to sleep. Just when we think we are almost comfortable with this little human being, they catch a COLD!
This article tells you what to do when your infant has a cold and suggests ways to help your baby be more comfortable.
Make sure to read when to call your doctor. Trust your instincts—if you feel your baby is not right, or the illness appears to be more than just a cold—call your doctor or bring your baby to urgent care during off-hours.
Taking care of a runny or stuffy nose
Caring for a newborn with a stuffy nose can be terrifying! Babies do not know how to blow their nose and do not understand that crying is just making their symptoms worse. As parents, we do not have the option of using any cold medication for our baby. Here is the direct, and rather gross, instructions on how to clear your baby's nose:
- Clear mucus- using a soft tissue, wet papertowel or wet washcloth may be used to gently squeeze the nostrils and wipe away the mucus. A bulb syringe may be used (see instructions below) if mucus seems to be "endless."
- mucus with the consistency of rubber- although gross and uncomfortable, this type of mucus is easiest to remove. Sometimes just gently pulling down as you wipe the baby's nose clears the mucus from the inside. You may be able to actually pull the mucus out. If not, a bulb syringe may be used after the mucus is moistened with saline drops.
- dry mucus- this may be the most uncomfortable for the baby and the most difficult to remove without irritating the baby's nose. Speak to your doctor first but saline drops or spray especially made for newborns/infants may need to be used first. You should allow the saline to sit in the nose 1-2 minutes. You could use a wet washcloth or wet soft papertowel and this may help loosen the mucus. If this doesn't work, a bulb syringe may be used only once the mucus is wet and is not sticking to the baby's nose. Irritating the baby's nose may worsen symptoms.
Do not use wipes to clean your baby's nose! Wipes burn especially if the nose is becoming raw. Boogie Wipes; however can be used but a wet washcloth is probably better.
How to use a bulb syringe
Parents are often given a bulb syringe in the hospital just after delivery because baby's typically are congested. Mucus from a cold is harder to deal with but it is the same concept. All bulb syringes are not equal. Some are almost impossible to squeeze. The easiest to use are very soft and are typically available in the color blue. See some of the suggestions listed on the right. Just in case you did not master the use of the bulb syringe in the first few days of life, I am giving you instructions:
- Make sure you are using the bulb syringe on a hydrated nose. Saline drops may be used a few minutes prior to using the bulb.
- Ensure you are using a clean bulb. This can be cleaned using warm soapy water and rinsed well. Squeeze the bulb so that all the air is pushed out and allow the bulb to suck in the soapy water. Swirl the bulb around and rinse.
- Before inserting the bulb in the baby's nose, squeeze out all excess air. Place the bulb in the baby's nostril.
- The bulb works best if you point it towards the sides of the nostril. Although it may feel like pointing the bulb straight up the nostril will work best, this may not be true.
- Slowly allow the bulb to fill with air and attempt to allow the bulb to suck in mucus. You may need to repeat this a few times. Be careful not to cause irritation.
- Have a tissue ready to collect the mucus from the bulb. Before trying again, make sure the bulb is cleared into the tissue.
- If the mucus is rather thick, the bulb may help you bring down the mucus enough to attempt to pull it out gently with a tissue or wet soft paper towel.
- Ensure you clean the bulb well after each use.
Using a Humidifier of Vaporizer at night
You should discuss this with your doctor. Some doctors want you to use a vaporizer (heats water) because it keeps the baby's room warm and is less likely to bread germs since it is heating the water. Some doctors want you to use a cool mist humidifier because it reduces inflammation which could help the baby breath easier. Your specific symptoms should be discussed before choosing one.
You need to follow your products instructions. Many have specific cleaning instructions (the use of soapy water versus vinegar) and warnings (which parts not to submerge in water, where to use the humidifier, which materials may be damaged, etc.). My suggestion is to buy a relatively cheap one that is easy to clean-- you can always buy another one. My first one was large, expensive and hard to clean and I broke it within 2 months.
Taking care of a fever
It is important to keep in mind that an increased body temperature is a natural immune system response towards infection. Pediatricians will often tell you to only treat a fever (typically with acetaminophen infant liquid drops used specific to your Pediatricians instructions and dosage) only if the fever is causing discomfort within the infant or if the fever is considered high.
Although you will hear the rectal temperature is the most accurate, this is also the hardest temperature to take. Ask your doctor how they would prefer you take your infant's temperature. Most pediatricians will ask you which method you took the temperature and will ask for the result. They add degrees based on their own knowledge. I have found the forehead scanning thermometers the most accurate and convenient. The low beeping noise actually kept my baby distracted for the 2 seconds it took to get a reading. It is important to follow directions and take 3-4 readings. The highest reading is the most accurate. You may obtain many different readings because you may take your finger off the button too early or too late. I had a habit of lifting it off of my baby's head as I read it for instance which gave me a low reading and I had to retry. I also tried the thermometers that could read 3 or 4 ways as well as a pacifier thermometer for an oral temperature. Pacifier thermometers only work if your baby wants to use a pacifier which may not be the case with a stuffy nose!
I am also adding my favorite product I could not live out whenever my son was prescribed antibiotics- the medication dispenser mini bottle. He did not like the taste of the medicine and I could not use the syringe very well on him. I was able to get the medicine down by using this mini bottle either with the medicine alone or mixed with breast milk or formula (medication will normally tell you what it can and cannot be mixed with).
Dressing your child appropriately: Overdressing your baby can trap in heat raising a temperature yet underdressing your baby can give them a chill. Try to make your baby as comfortable as possible. Dress him or her in light cotton layers. Cotton breathes and allows the release of heat and exchange of air. Your baby's needs will change. When he or she is sweaty, take off a layer, maybe use a damp washcloth on his or her forehead. When he or she seems cold, put back on layers. Remember how you feel with a fever- at times you are very hot while other times you feel like you have the chills. I tend to dress my baby in thin cotton two piece pajamas with a thin cotton sleepsac. I take off the sleepsac at times and found the two piece pajamas do not trap as much heat as one-piece of footsie pajamas but still cover the baby.
When to call your doctor
Taking care of an infant can be nerve-wrecking. Most parents are torn between calling the pediatrist at every change in their infant to attempting not to call and handle the situation themselves. You should ask your pediatrician when you should call the office. Here is a list of guidelines most doctors would recommend you follow when you have a sick infant. Keep in mind, if your baby has pre-existing conditions or a history of medical issues, your doctor may want you to call sooner rather than later.
Fever: In general, you should call your pediatrician if your infant under three months of age has a rectal temperature at or above 100.4 F., if your infant aged 3-6 months has a temperature above 101 F., or if an infant above 6 months has a temperature above 103 F.
Vomiting: In general, you should call your pediatrician if your infant has symptoms of dehydration (urinating less often, dry mouth, weight loss, etc.), is vomiting dark green bile (bilious vomiting is a sign of an intestinal obstruction), has projectile vomiting (pyloric stenosis), or if he has a severe headache or abdominal pain (you would only know this if your child was older and able to tell you).
Coughing: You should see the doctor if your child's cough or cold symptoms continue to worsen after 3-5 days, if they aren't improving in 10-14 days, or if he has another specific complaint, such as ear pain, a constant cough, chest pain, wheezing, or trouble breathing.
Trouble Breathing: If your infant is having trouble breathing you should call your pediatrician but, how can you tell? You can usually recognize that your child is having trouble breathing if he is breathing fast and hard, if you can see his ribs moving in and out (retractions), or if it seems like he can't catch his breath.
Dehydration: The first sign of dehydration is that your child will urinate less frequently (your child should be urinating every six to eight hours). Other symptoms of dehydration can include a dry mouth, not having tears when crying, sunken eyes, and decreased activity or increased irritability.
Irritability: If your child is fussy and crying, but is easily calmed if you just hold him, then that is less concerning than a child who is not consolable and continues to cry. Call your pediatrician if your child is inconsolable and not acting like himself.
Lethargy: There is confusion with this word! It is more than just being tired and less active. If you are unable to wake your child despite attempts to arouse your child with touch, loud noise, etc., then you should seek medical attention right away. It is less concerning if he is awake and alert and is just not as active as usual.
Rashes: In general, you should call your doctor if your child has a rash and a fever, especially if the rash is purple and doesn't blanch or fade briefly when you press on it, or an itchy rash that isn't relieved with home remedies.