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Surviving Baby's First Cold and Flu Season

Mother pushing baby stroller

My son, Noah, was born during the harshest of Januarys, between two blizzards. I suffered a mild case of cabin fever, but at least it was easy to keep him in for those first couple of months -- away from all the unwelcome germs I just knew were lurking outside my door. I was right to be concerned: Infants don't have the antibodies to fight off most colds and gastrointestinal infections -- making them more likely not only to get sick but to stay that way longer.

"In the first year, babies come down with about six to 12 infections, most lasting seven to ten days," says Mary Anne Jackson, M.D., a pediatric expert at Children's Mercy Hospital and Clinics, in Kansas City, Missouri. "That's up to 120 days of the year they may be sick."

During those first few months, a rectal temperature higher than 100.4 degrees F means an automatic call to the doctor. And if your baby is under 1 month, she may need to be readmitted to the hospital. "For that reason, we'd love to keep newborns from becoming sick," says Theoklis Zaoutis, M.D., associate chief of the division of infectious diseases at The Children's Hospital of Philadelphia. Unfortunately that's just not realistic.

So what's a mom to do? A lot! Put these germ-fighting habits into play and you could help your sweetie dodge an illness this winter or at least make those sick days more bearable for both of you.

Treat the first two months differently.

"Until your baby has his first round of shots at 2 months, you should be extra cautious," says Mary Ian McAteer, M.D., a pediatrician in Indianapolis. It's best for newborns to avoid crowds, so leave him at home.

Keep Baby close.

When you do venture out, stay six feet from anyone who's coughing or sneezing, and wear your cutie in a carrier. Strangers are less likely to touch your babe's hands and face when she's attached to you. If she's in a stroller, keep the canopy down, and cover it with a light blanket.

 
Mind the company your family keeps.

Ask guests who have been sick to hold off on visiting until they no longer have symptoms and are fever-free for at least 24 hours (without using a fever reducer). Allow little kids to look at the baby but not to touch him.

Suds up.

"A lot of germs are carried on your hands," Dr. Zaoutis says. Scrub for at least 20 seconds -- "Happy Birthday," twice -- every time you come in from a public place, use the bathroom, eat, or change a diaper. Stool is full of bacteria, and if it makes its way to your infant's mouth, it can cause diarrhea and vomiting.

Keep nursing.

Serious colds and ear and throat infections are reduced by 63 percent in infants who breastfeed exclusively for six months, studies show. Babies who nurse are also much less likely to come down with respiratory tract infections and stomach bugs.

Slather on the sanitizer.

Stash alcohol-based hand sanitizer in your bag and next to the changing table, and keep some out for guests. It's convenient and just as effective as hand-washing, unless your hands are visibly soiled, Dr. Jackson says.

Disinfect surfaces.

Germs can live for hours on things like shopping carts, so keep a package of sanitizing wipes in your diaper bag.

Take precautions at the pediatrician's office.

The waiting room is filled with germs -- even if there are separate sick and well rooms, Dr. Jackson says. Request the first or last slot of the day, when you're less likely to be met with a crowd of coughing kids. Or ask to sit in an exam room with Baby, rather than in the waiting area.

Don't delay or skip any of your baby's vaccines.

"Following the vaccine schedule is the best way to prevent illnesses like the measles, meningitis, and chicken pox," Dr. McAteer says. "Because we don't see these illnesses frequently, parents think we don't need these vaccines, but no -- that's the proof that they're doing their job." If you wonder whether it's safe to give so many shots so close together, the answer is yes, according to a study from the Institute of Medicine.

 
Get your shots too.

In particular, moms and moms-to-be need the flu and pertussis (whooping cough) vaccines. Getting the flu shot when you're pregnant passes antibodies on to your fetus that should last her for about six months, Dr. Jackson says. (Babies don't get the flu vaccine until they're 6 months old.) Flu can be deadly in newborns, making any side effects you may experience from the jab (low-grade fever, nausea) minor in comparison. The Centers for Disease Control and Prevention recommends that expectant moms also get vaccinated against whooping cough between 27 and 36 weeks so they don't pass the disease to their unvaccinated newborn. Everyone in your baby's circle needs immunized.

Boost your immunity.

It's hard to get enough sleep when you have a newborn who's up every two hours, but do what you can to get shut-eye, even if that means napping during the day. Make sure you eat well too. Keeping your body humming will help you fight off illnesses that could get passed to your little one.

We asked pediatricians for the quick and dirty on the season's offenders that strike babies most.

The Common Cold

What it looks like: Watch for the usual signs: a runny nose, congestion, cough, and fever. Your babe may also have difficulty sleeping and eating. (It's hard for an infant to nurse or take a bottle when his nose is stuffed up.)

When to call the M.D.: If he's a newborn, right away. "In a baby under 6 months, each cold could be serious," says Mary Ian McAteer, M.D., a pediatrician in Indianapolis. Your doctor will want to check and see if he's struggling to eat, breathe, or sleep.

How it's treated: Gently clear his nasal passages using saline drops and a bulb syringe, and run a humidifier in his room to keep the air moist. But never elevate the head of his crib mattress or let him sleep sitting up in a car seat -- both are unsafe, Dr. McAteer says.

Respiratory Syncytial Virus (RSV)

What it looks like: In adults and older babies, RSV looks like a common cold. But if it infects a newborn's lungs, your baby may develop bronchiolitis or pneumonia. Keep an eye out for wheezing, trouble breathing (her chest will pull in when she tries to get air), and a high fever.

When to call the M.D.: Pick up the phone anytime your infant is coughing or wheezing. If her breathing seems especially labored, get her to a doctor immediately, says Mary Anne Jackson, M.D., a pediatrician in Kansas City, Missouri.

How it's treated: Because RSV is particularly dangerous for preemies and babies with congenital heart or lung problems, your M.D. may recommend a monthly shot that could help reduce the severity of RSV. If she does get sick, soothe with saline drops, a bulb syringe, and a humidifier. Ask before using a fever reducer.

Croup

What it looks like: Croup is easily distinguished by its barking, seal-like cough. The sound usually gets worse at night, and it may scare you.

When to call the M.D.: Anytime your baby is making odd noises, you should call your pediatrician's hotline. Croup is so obvious that doctors can often diagnose it by listening to it over the phone, Dr. Jackson says.

How it's treated: You'll be told to sit in a steamy bathroom or take Baby for a walk in the cool outdoors. If the coughing hasn't subsided in 15 to 20 minutes, or if you can see her ribs pulling in, head to the doc's office or the ER. She may need medication to open her airways.

Influenza

What it looks like: Your tot may have a cough, a runny nose, and vomiting. One of the biggest indicators? Fever. Babies with flu run higher temps than those with a cold, and are less likely to play and eat through it. The good news: Getting your family vaccinated can prevent flu.

When to call the M.D.: Don't take flu-like symptoms lightly: More than 20,000 U.S. children under 5 are hospitalized each year with flu complications, and tots under 2 are especially vulnerable. Call your pediatrician: She can test for influenza simply by swabbing Baby's nostrils.

How it's treated: If the flu test comes back positive, your doctor may prescribe an antiviral medication, such as Tamiflu. Ask her about using a fever reducer too. Feed Baby as frequently as you can, even if it's small amounts at a time, to get him the nutrition he needs.

Whooping Cough (Pertussis)

What it looks like: Whooping cough starts off like a cold, but after a week or two, your baby may develop a severe hack, followed by a whooping sound. Pertussis can be preventable with the vaccine.

When to call the M.D.: Babies with pertussis often become so lethargic that they can't eat -- even before the cough sets in. Call your doctor at the first sign of trouble. About half of infants under a year will need to be hospitalized.

How it's treated: An antibiotic called azithromycin is used to treat the infection. Your baby will need to stay in the hospital if she has a severe cough with vomiting or labored breathing, or if she actually stops taking air in for short periods.

Is It A Stomach Bug?

If your baby has diarrhea and vomiting, he may have the highly contagious norovirus, the top cause of "stomach flu." He should recover within a few days. In the meantime, keep him hydrated by nursing or bottle-feeding him small portions frequently. Call the doctor if he seems to be in pain or is too tired to drink; if you spot blood; or if he shows any signs of dehydration, such as a sunken soft spot on the top of his head, splotchy skin, or dry diapers.

How to Give Your Baby Medication
How to Give Your Baby Medication

Originally published in the January 2014 issue of American Baby magazine.

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