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Winter Cold Survival Guide

Your antibodies help protect your baby for up to six months after birth, but little ones can still catch colds. Here's what you need to know.

  • Your baby may be hit hard. Until her immune system is more fully developed and she's been exposed to different viruses, her symptoms may be more severe than those in older kids, says Josh Petrikin, MD, a pediatrician at the Mayo Clinic, in Rochester, Minnesota.
  • His tummy can act up. Don't be surprised if your baby vomits or has diarrhea. Excess mucus production can irritate his stomach and make his stools looser.
  • She may not have a runny nose. Because an infant's nasal passages are so small, even a little inflammation can cause mucus to become trapped in the back of her nose.
  • Breathing gets harder. Congestion can restrict your baby's tiny airways, making it more difficult for him to breathe. This is especially true if his cold symptoms are caused by the respiratory syncytial virus (RSV). Like a cold, RSV can bring on fever, a cough, and stuffiness, but after a couple of days, the cough gets worse and breathing sounds rapid and distressed, explains Gail Demmler, MD, professor of pediatrics at Baylor College of Medicine, in Houston. RSV can lead to bronchiolitis -- infection and inflammation of the lower airways. In severe cases, your child may even need to be hospitalized.
  • Your doctor needs to know. You should definitely phone him if your baby is under 3 months of age and has a rectal temperature of 100.4 degrees or higher, or is between 3 and 6 months and has a reading of 102 degrees or higher. Also call if your little one has problems breathing (watch for wheezing, flared nostrils, or a sucking in of the chest), if she has a fever that lasts longer than 12 hours or other symptoms that last longer than a week, if she spikes a fever a few days into the cold, if she is feeding poorly, or if her behavior is unusual and you're worried.

If your child's coughing, sneezing, and congestion haven't improved after a week to 10 days, she may have something more serious.

Pneumonia

This infection takes hold when a cold virus settles deep in the lungs. Suspect pneumonia if your child develops a new fever after being sick for about a week; if his cough becomes worse; if he complains of chest pain, wheezes, or has any trouble breathing; or if he just seems fussier and not himself. Pneumonia can strike at any age, but babies and kids with lung disorders like asthma are at greater risk for serious complications.

Croup

In babies and toddlers, the cold virus can also cause this inflammation of the larynx and trachea. A day or two into your child's cold -- usually just a few hours after you've put him down for the night -- you'll hear what sounds like a seal barking in his bedroom. He may gasp for breath, wheeze, and cry hoarsely between coughs. What to do right away: Turn on a hot shower and sit together in the steamy bathroom, or take your child outside and let him inhale cold air, suggests Neil Schachter, MD, author of The Good Doctor's Guide to Colds & Flu. If your child is still struggling to breathe after 10 to 20 minutes, call the doctor.

Ear Infection

If your child has been sniffling for a few days and then suddenly develops a fever and can't sleep at night, think ear infection. "Colds cause general inflammation of the respiratory tract," explains Dr. Petrikin. "That can close off the eustachian tubes, which help drain fluid in the middle ears. When fluid backs up, bacteria can flourish." Ear infections may be treated with acetaminophen as well as antibiotics. Fortunately, as children grow, so do their eustachian tubes; ear infections peak between 6 months and 2 years, but then taper off.

Sinus Infection

Bacterial infections can also develop in the sinuses when fluid gets trapped there. "Sinus infections usually don't occur until kids are 2 years old and the sinuses are better formed," says Dr. Demmler. Symptoms to watch for: fever, congestion, a cough that lasts longer than 10 to 14 days without any improvement, bad breath, swollen eyelids, or a headache. Your pediatrician may recommend acetaminophen, decongestants, saline drops or spray, and antibiotics.

  1. DO limit your child's exposure to sick people. Reschedule a playdate if you know there's a sibling home sick. If you have to be around people who are ill, teach your child to keep her hands away from her eyes and nose -- entryways for cold germs.
  2. DON'T teach him to sneeze or cough into his hand. Unless he washes his hands pronto, he'll contaminate anything he touches. If he can't grab a tissue in time, he should
    sneeze into his upper arm or elbow.
  3. DO toss tissues promptly. They can harbor plenty of nasty germs.
  4. DON'T overlook toothbrushes. They're a great place for viruses to multiply. "In many bathrooms, they're all touching one another, passing germs back and forth," says Ellen Schumann, MD, a pediatrician at the Marshfield Clinic, in Weston, Wisconsin. "I change my sons' toothbrushes about once a month. If one child has been sick, I'll toss his toothbrush as soon as he's feeling better."
  5. DO use your dishwasher's sanitizing cycle, if it has one. "The sanitizing cycle keeps the water hotter for longer and disinfects dishes better," says Dr. Schumann.
  6. DON'T rely on supplements. There's been a lot of buzz
    about using zinc, vitamin C, and echinacea to treat colds, but there's no good evidence that any of these supplements are very effective.
  7. DO keep hands clean. Hand-washing is the number-one germ buster. Lather up your child's hands and rub them together for 20 seconds (sing "Happy Birthday" twice); then rinse with warm water.

Try these gentle ways to soothe your child's symptoms.

Stuffy nose

  • For a baby, squirt saline drops into each nostril, wait a minute, and then suck the secretions out with a bulb syringe (especially before feedings). You can start teaching your toddler how to blow out through his nose, but you'll need to hold the tissue for him.
  • Use a cool-mist humidifier in your child's bedroom (place it within 10 feet of her head) to loosen congestion.
  • Elevate your child's head at night. For a baby, put a pillow under one end of the crib mattress. Give older kids an extra pillow.
  • Increase fluids. For a baby, offer more formula or breast milk. For older kids, give them anything liquid, such as ice pops or Jell-O.
  • Get your child into the cold air. Let her play outside, or take her for a walk in the stroller. Cold temperatures help mucus drain.
  • Talk to your doctor about using a nasal decongestant if your child's stuffiness is severe -- especially if he's up during the night -- but never give one without asking because it can
    thicken mucus and make it harder to clear, says Dr. Schumann.

Cough and Sore Throat

  • To soothe airways, use a cool-mist humidifier, or steam up the bathroom with a hot shower.
  • Talk to your doctor before giving cough medicine. Most provide minimal relief in young kids and may have troublesome side effects.
  • Give acetaminophen or ibuprofen if your child has throat pain.
  • Let toddlers and older kids suck on lollipops. Don't give cough drops to a child until he's 4, because they're a choking hazard.
  • Offer cold fluids or frozen treats to numb the throat.
  • Have your preschooler or school-age child gargle with warm saltwater.