What to Expect the First Year (120 page)

Duration.
The common cold usually lasts 7 to 10 days (day 3 is usually the worst). A residual dry nighttime cough, which may not appear until the end of the cold, may linger longer.

Treatment.
There is no known cure for the common cold, but symptoms can be treated, as necessary, with:

• Saline nose drops to soften dried mucus that may be clogging your baby's nostrils. Suctioning of mucus with a nasal aspirator (see
illustration
) may be necessary to help baby breathe through the nose.

For a baby who's having trouble breathing through a stuffy nose, saline drops to soften the mucus and aspiration to suction it out will bring welcome relief.

• Moist air to help clear nasal passages. Run a cool-mist humidifier (which is safer than a warm-mist humidifier, but do keep it clean) in baby's bedroom at night.

• Moisturizing ointment, spread lightly on the rims of the nostrils and under the nose to help prevent chapping and soreness.

• Elevation of the head of the crib (by placing pillows
under
the mattress) to make breathing easier.

• Acetaminophen (for babies over 2 months) or ibuprofen (for babies over 6 months) for fever reduction if needed (it usually isn't with a cold). Check with your doctor for guidelines.

• Plenty of fluids, particularly warm ones (chicken broth, once the ingredients have been introduced, really is effective—and it can be served strained and slightly warm in a sippy cup), and a nutritious diet. If baby isn't taking solids yet, be sure to keep up breastfeeding or formula bottles. For babies on solids, try to offer vitamin C–rich foods each day. Frequent small meals may be more appealing than three squares.

Prevention.
The number one way to prevent a cold is to wash your baby's hands regularly. Can't get to a sink? Hand-sanitizing gels or wipes will do in a pinch, though they're not as effective as soap and water in washing away those germs. Keep your baby away from anyone with a cold, when possible. Use a disinfectant solution to clean surfaces that may be contaminated with cold germs, and follow other tips for preventing the spread of illness (
click here
). Breastfeeding can reduce susceptibility to colds, but not entirely. Remember that there's no way to entirely protect your little one from cold viruses. The average child has 6 to 8 colds a year, and that's not usually a concern as long as growth and development are normal.

When to call the doctor.
Usually, there's no need to contact the doctor for a simple cold, but if it's your baby's first cold or if baby is under 3 months, a call to the pediatrician is a good idea, if only to put your mind at ease.

Also call if your baby shows any of the following:

• Extreme lethargy

• Refusal to eat or drink

• Difficulty sleeping, is very restless during the night, or has pain that causes night waking (will be difficult to detect in a small baby)

• Foul-smelling, greenish or yellowish nasal discharge from nose or from coughing

• Wheezing

• Breathing significantly more rapidly than usual

• A cough that's getting worse or continues during the day after other symptoms are gone

• Swollen glands in the neck

• Pulling on ears day or night

• Running a fever over 102°F or has a low-grade fever for more than 4 days

• Symptoms last longer than 10 days

If your baby seems to have a continuous cold, a chronically runny nose, or very long-lasting or frequent colds (especially when accompanied by under-eye circles), talk to the doctor about the possibility that allergies might be responsible (though it's rare for this to be the case in babies).

Symptoms.
Also known as acute otitis media, an ear infection is when the middle ear (between the outer part of the ear and the innermost part of the ear) gets plugged with fluid and becomes infected and inflamed. When examined by the doctor (you won't be able to see this from the outside), the eardrum appears pink early in the illness, then red and bulging. Symptoms include:

• Pain, often worse at night because lying down changes pressure in the ear. Your baby may complain, or tug, rub, or clutch at an affected ear—crying when sucking on breast or bottle may indicate ear pain that has radiated to the jaw

• Fever

• Fatigue

• Crankiness and irritability

If the infection persists or worsens, the eardrum could perforate (develop a small hole, which usually heals in less than a week). If this happens, pus, often tinged with blood, may spill into (and be seen in) the ear canal. The perforation will relieve the pressure and thus the pain, but treatment of the infection will help prevent further damage—so it's crucial that you tell the doctor if you suspect a rupture (crust in and around the ear is a telltale sign).

Often, even after treatment, fluid remains in the middle ear, a condition called otitis media with effusion. Symptoms include mild hearing loss (your baby may fail to respond consistently to sounds, such as your voice). While typically temporary (usually lasting about 4 to 6 weeks), the hearing loss can become permanent if the condition continues untreated for many months, especially if there are also frequent bouts of infection.

Cause.
Ear infections are often secondary infections brought on by a cold or other upper-respiratory infection (or, rarely in babies, allergies), which causes the lining of the Eustachian tube (the tube that connects the middle ear to the nose and the back of the throat) to swell, become congested, and accumulate fluid. The fluid becomes a breeding ground for infection-causing germs. Behind the inflamed eardrum, the buildup of pus and mucus produced by the body in an attempt to respond to the infection causes the pain of earache. Young children are more likely than older children and adults to get ear infections because their Eustachian tubes are short (allowing germs to travel up them more quickly and making it easy for them to become blocked) and horizontal rather than slanted (making drainage poor), and because they get more colds and other respiratory illnesses in general than older kids and adults do.

Duration.
Although pain, fever, and other symptoms usually diminish or disappear shortly after treatment is begun, it can take 10 days or more of treatment with antibiotics to resolve an acute ear infection. Fluid may remain in the middle ear for much longer.

Treatment.
If you suspect an ear infection, call the doctor so that you can get your child's ears checked. If there's infection, the doctor will probably prescribe a course of antibiotics for your infant (the wait-and-see approach is usually reserved for children over age 2 or 3). You might be asked to come back into the office for a recheck, but this is usually not needed—especially if baby seems to be feeling better.

Your doctor will likely recommend acetaminophen (for babies over 2 months) or ibuprofen (for babies over 6 months) for pain and fever relief. Heat (applied with a heating pad set on low, warm compresses, or a covered hot-water bottle filled with warm water) or cold (applied with an ice pack wrapped in a wet washcloth) can also be used to relieve pain. Elevating your little one's head (with pillows
under
the crib mattress) during sleep may also be helpful.

Prevention.
Here's what you can do to minimize your child's risk:

• Breastfeed for at least 6 months, preferably the entire first year, or longer.

• Reduce exposure to germs as much as possible, since even common colds can lead to ear infections. That means steering clear of sick kids and washing your hands and your child's hands frequently.

• Stay up-to-date on your child's immunizations. The pneumococcal vaccine, which is given to prevent serious infections such as pneumonia and meningitis, may also reduce the risk of ear infections. Since ear infections are a common complication of flu, make sure your baby receives a yearly flu vaccine after age 6 months.

• Be sure to feed baby in a more upright feeding position, especially when he or she has a respiratory infection.

• Limit pacifier use to sleep time only.

• Wean off the bottle at 12 months.

• Prevent exposure to secondhand smoke, which makes children more vulnerable to ear infections.

When to call the doctor.
Call during regular office hours if you suspect an ear infection (it's not an emergency). Call again if your child isn't feeling better after 3 days (with or without antibiotics) or if the infection seems to get better and then returns (it could be a sign of a chronic ear infection). Call, too, if you notice any hearing loss.

Symptoms.
The flu (short for “influenza”) is a contagious viral infection that usually rears its very infectious head between the months of October and April (aka flu season). Its symptoms include:

• Fever

• Dry cough

• Sore throat (your baby may reject food and drink, or seem in pain when swallowing)

• Runny or stuffy nose

• Muscle aches and pains

• Headache

• Extreme fatigue, lethargy

• Chills

• Loss of appetite