Common cold in babies

Overview

A common cold is a viral infection of your baby's nose and throat. Nasal congestion and a runny nose are the main signs of a cold.

Babies are especially likely to get the common cold, in part because they're often around older children. Also, they have not yet developed immunity to many common infections. Within the first year of life, most babies have six to eight colds. They may have even more if they're in child care centers.

Treatment for the common cold in babies involves easing their symptoms, such as by providing fluids, keeping the air moist and helping them keep their nasal passages open. Very young infants must see a doctor at the first sign of the common cold to make sure croup, pneumonia or other more serious illnesses aren't present.

Symptoms

The first signs of the common cold in a baby are often:

• A congested or runny nose
• Nasal discharge that may be clear at first but might thicken and turn yellow or green

Other signs and symptoms of a common cold in a baby may include:

• Fever
• Sneezing
• Coughing
• Decreased appetite
• Irritability
• Difficulty sleeping
• Trouble nursing or taking a bottle due to nasal congestion

When to see a doctor

Your baby's immune system will need time to mature. If your baby has a cold with no complications, it should resolve within 10 to 14 days. Most colds are simply a nuisance. But it's important to take your baby's signs and symptoms seriously. If symptoms don't improve or if they worsen, it's time to talk to your doctor.

If your baby is younger than 3 months of age, call the doctor early in the illness. In newborns, it's especially important to make sure that a more serious illness isn't present, especially if your baby has a fever.

If your baby is 3 months old or older, call the doctor if your baby:

• Isn't wetting as many diapers as usual
• Has a temperature higher than 100.4 F (38 C)
• Seems to have ear pain or is unusually irritable
• Has red eyes or develops yellow or greenish eye discharge
• Has trouble breathing or wheezing
• Has a persistent cough
• Has thick, green nasal discharge for several days
• Has other signs or symptoms that worry you, such as an unusual or alarming cry or not waking up to eat

Seek medical help immediately if your baby:

• Refuses to nurse or accept fluids
• Coughs hard enough to cause vomiting or changes in skin color
• Coughs up blood-tinged mucus
• Has difficulty breathing or is bluish around the lips
• Has unusually low energy or sleepiness

Causes

The common cold is an infection of the nose and throat (upper respiratory tract infection) that can be caused by one of more than 200 viruses. Rhinoviruses are the most common.

A cold virus enters your baby's body through his or her mouth, eyes or nose.

Once infected by a virus, your baby generally becomes immune to that virus. But because so many viruses cause colds, your baby may have several colds a year and many throughout his or her lifetime. Also, some viruses don't produce lasting immunity.

Your baby can be infected with a virus by:

• Air. When someone who is sick coughs, sneezes or talks, he or she might directly spread the virus to your baby.
• Direct contact. Someone with a cold who touches your baby's hand can spread the cold virus to your baby, who can become infected after touching his or her eyes, nose or mouth.
• Contaminated surfaces. Some viruses live on surfaces for two hours or longer. Your baby may catch a virus by touching a contaminated surface, such as a toy.

Risk factors

A few factors put babies at higher risk of a common cold.

• Immature immune systems. Babies are, by nature, at risk of common colds because they haven't yet been exposed to or developed resistance to most of the viruses that cause them.
• Exposure to other children. Spending time with other children, who don't always wash their hands or cover their coughs and sneezes, can increase your baby's risk of catching a cold. Exposure to anyone with a cold can increase the risk of getting a cold.
• Time of year. Colds are more common from fall to late spring, but your baby can get a cold at any time.

Complications

These conditions can occur along with a common cold:

• Acute ear infection (otitis media). This is the most common complication of the common cold. Ear infections occur when bacteria or viruses enter the space behind the eardrum.
• Wheezing. A cold can trigger wheezing, even if your child doesn't have asthma. If your child does have asthma, a cold can make it worse.
• Acute sinusitis. A common cold that doesn't resolve may lead to an infection within the sinuses (sinusitis).
• Other infections. A common cold can lead to other infections, including pneumonia, bronchiolitis and croup. Such infections need to be treated by a doctor.

Prevention

There's no vaccine for the common cold. The best defense against the common cold is commonsense precautions and frequent hand-washing.

• Keep your baby away from anyone who's sick. If you have a newborn, don't allow visits from anyone who's sick. If possible, avoid public transportation and public gatherings with your newborn.
• Wash your hands before feeding or touching your baby. Wash your hands thoroughly and often with soap and water for at least 20 seconds. If soap and water aren't available, use an alcohol-based hand sanitizer that contains at least 60% alcohol. Teach your older children the importance of hand-washing. Avoid touching your eyes, nose or mouth with unwashed hands.
• Clean your baby's toys and pacifiers often. Clean frequently touched surfaces. This is especially important if someone in your family or your baby's playmate has a cold.
• Teach everyone in the household to cough or sneeze into a tissue. Throw away used tissues right away and then wash your hands thoroughly. If you can't reach a tissue in time, cough or sneeze into your elbow. Then wash your hands.
• Review your child care center's policies. Look for a child care setting with good hygiene practices and clear policies about keeping sick children at home.

Simple preventive measures can help keep the common cold at bay.

Diagnosis

If your baby is younger than 3 months of age, call his or her doctor early in the illness. In newborns, it's especially important to make sure that a more serious illness isn't present, especially if your baby has a fever.

In general, you don't need to see the doctor if your older baby has a common cold. If you have questions or if your baby's symptoms worsen or don't go away, it might be time to see the doctor.

Your baby's doctor can generally diagnose a common cold by your baby's signs and symptoms. If your doctor suspects your baby has a bacterial infection or other condition, he or she may order a chest X-ray or other tests to exclude other causes of your baby's symptoms.

Treatment

There's no cure for the common cold. Most cases of the common cold get better without treatment, usually within a week to 10 days, but a cough may linger for a week or more. Antibiotics don't work against cold viruses.

Try to make your baby more comfortable with measures such as making sure he or she drinks enough fluids, suctioning nasal mucus and keeping the air moist.

Over-the-counter (OTC) medications generally should be avoided in babies.

Fever-reducing medications

You can use OTC fever-reducing medications if a fever is making your child uncomfortable. However, these medications don't kill the cold virus. Fever is a part of your child's natural response to the virus, so it may help to allow your child to have a low-grade fever.

For treatment of fever or pain in children, consider giving your child infants' or children's over-the-counter fever and pain medications such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin, others). These are safer alternatives to aspirin.

For children younger than 3 months old, don't give acetaminophen until your baby has been seen by a doctor. Don't give ibuprofen to a child younger than 6 months old or to children who are vomiting constantly or are dehydrated. Use these medications for the shortest time. If you give your child a pain reliever, follow the dosing guidelines carefully. Call your doctor if you have questions about the right dosage for your baby.

Children and teenagers recovering from chickenpox or flu-like symptoms should never take aspirin. This is because aspirin has been linked to Reye's syndrome, a rare but potentially life-threatening condition, in such children.

Cough and cold medications

Cough and cold medications aren't safe for infants and young children. OTC cough and cold medicines don't treat the underlying cause of a child's cold and won't make it go away sooner — and they can be dangerous to your baby. Cough and cold medications have potentially serious side effects, including fatal overdoses in children younger than 2 years old.

Don't use over-the-counter medicines, except for fever reducers and pain relievers, to treat coughs and colds in children younger than 6 years old. Also consider avoiding use of these medicines for children younger than 12 years old.

Self care

Most often, you can treat an older baby's cold at home. To make your baby as comfortable as possible, try some of these suggestions:

• Offer plenty of fluids. Liquids are important to avoid dehydration. Formula or breast milk is the best choice. Encourage your baby to take in the usual amount of fluids. Extra fluids aren't necessary. If you're breastfeeding your baby, keep it up. Breast milk offers extra protection from cold-causing germs.

• Suction your baby's nose. Keep your baby's nasal passages clear with a rubber-bulb syringe. Squeeze the bulb syringe to expel the air. Then insert the tip of the bulb about 1/4 to 1/2 inch (about 6 to 12 millimeters) into your baby's nostril, pointing toward the back and side of the nose.

  Release the bulb, holding it in place while it suctions the mucus from your baby's nose. Remove the syringe from your baby's nostril and empty the contents onto a tissue by squeezing the bulb rapidly while holding the tip down. Repeat as often as needed for each nostril. Clean the bulb syringe with soap and water.

• Try nasal saline drops. Your baby's doctor may recommend saline nasal drops to moisten nasal passages and loosen thick nasal mucus. Look for these OTC drops in your local pharmacy. Apply saline nasal drops, wait for a short period, and then use a suction bulb to draw mucus out of each nostril.
• Moisten the air. Running a cool-water humidifier in your baby's room can ease nasal congestion. Change the water daily and follow the manufacturer's instructions for cleaning the unit.

Preparing for your appointment

If you need to see your baby's pediatrician or family doctor, here's some information to help you get ready for your baby's appointment.

What you can do

Make a list of:

• Symptoms you've noticed in your baby, including any that may seem unrelated to the reason for which you scheduled the appointment.
• Key personal information, such as whether your baby goes to child care or has otherwise been exposed to someone with a common cold. Include how many colds your baby has had, how long they lasted and whether your baby is exposed to secondhand smoke. It might help to make a note on your calendar the day you realize your baby has a cold.
• All medications, vitamins or supplements your baby is taking, including dosages.
• Questions to ask your doctor.

For a common cold, some questions to ask the doctor include:

• What is likely causing my baby's symptoms?
• Are there other possible causes?
• What tests are needed?
• What's the best course of action?
• My baby has other health conditions. How can I best manage them together?
• Are there restrictions we need to follow?
• Are there over-the-counter medications that aren't safe for my child at this age?

Don't hesitate to ask other questions you have.

What to expect from your doctor

Your baby's doctor is likely to ask you questions, including:

• When did your baby's symptoms begin?
• Have they been continuous or occasional?
• How severe are they?
• What, if anything, seems to improve them?
• What, if anything, appears to worsen them?
• Has the nasal congestion caused your baby to eat or drink less?
• Is your baby having as many wet diapers as usual?
• Has there been a fever? If so, how high?
• Are your child's vaccinations up to date?
• Has your child taken antibiotics recently?

Your doctor will ask additional questions based on your responses and your baby's symptoms and needs. Preparing and anticipating questions will help you make the most of your time with the doctor.