Of all the milestones your baby will encounter in her first year, few will be as heartbreaking as her first cold. She might pant during feedings, snort herself awake during a nap, or look at you, bewildered, as if to say, "What is happening to me?"
You'll want to do anything you can to make her feel better. While over-the-counter meds aren't an option at this age—they're neither safe nor effective, experts say—that doesn't mean you can't make your baby more comfortable when she's feeling under the weather.
For the first six months, babies tend to breathe through their nose, so congestion can hit them hard, says Mike Patrick, M.D., assistant professor of pediatrics at Nationwide Children's Hospital in Columbus, Ohio. The standard blue-bulb syringe can be too big for the tiniest nostrils, so try the smaller green version that's marketed as an ear syringe. After inserting it into your baby's nostril, tilt the tip down slightly so it's more perpendicular to his face, and gently push it in as far as it can go.
"You'll be surprised how much mucus you can get out," says Dr. Patrick. For more power, use saltwater nose drops or spray to loosen the congestion. You can buy some at the drugstore, or make your own every day by mixing a quarter teaspoon of salt in 8 ounces of water, boiling it for ten minutes, and then cooling it to room temperature.
Just like adults, babies sometimes don't feel like eating when they're sick, but you should still encourage your little one to nurse or take a bottle as often as possible, says Charla Tabet, an infant-development specialist at La Rabida Children's Hospital in Chicago. If she won't drink milk, consult with your doctor to make sure she doesn't become dehydrated—and ask if it's okay to offer her an electrolyte solution, such as Pedialyte AdvancedCare. (Available in ready-to-drink flavors like grape, strawberry, and mixed fruit; $6.29, CVS.)
Feeding your baby in an upright position can also help ease congestion and prevent mucus from running down her throat while she's trying to drink.
"Babies don't have the muscle strength to cough effectively, so it can be tough for them to clear phlegm," says Stan Spinner, M.D., chief medical officer of Texas Children's Pediatrics in Houston. One way to help: Take your baby into the bathroom and turn on the shower to make the air hot and steamy. "It will get his nose running, loosen the mucus in his throat, and make his coughs more productive," says Dr. Spinner.
Try doing it before bed, since mucus tends to drain into his throat and chest while he's lying down. A humidifier set up in the baby's bedroom can also help ease congestion, Dr. Spinner says. Be sure to keep it out of your baby's reach, and fill it with fresh water every day so it doesn't get moldy.
READ MORE: How to Decode Your Baby's Cough
Your baby needs more sleep when she's sick, but all those annoying symptoms can make a decent snooze difficult. A comforting bedtime routine—such as playing music or taking a bath together—can go a long way toward encouraging her to nod off too.
A cool mist humidifier in your baby's room during nap time and at night can help with the cough by moistening the dry winter air, says Rhya Strifling, M.D., a mom and pediatrician at the University of Kentucky College of Medicine. Also, be sure not to have the heat turned up too high, which can worsen Baby's congestion. Instead, she says to keep your home at a comfortable 70-72 degrees in the winter months.
Most over-the-counter cough and cold medicines (aside from acetaminophen and ibuprofen) are not recommended for children under the age of 6 according to the AAP. "Usually antibiotics are not needed, unless the congestion develops into an ear infection or pneumonia," says Dr. Strifling. "If your baby has fever for more than three or four days, or you feel like his symptoms are getting worse rather than better, than it might be time to visit your pediatrician.” Also, don’t use honey for a cough in babies under 1 because of the risk of botulism.
Although it may seem like your little one’s congestion would benefit from sleeping on an incline, Dr. Strifling says it’s not a good idea. “There isn't really a safe way to prop up infants for sleep,” she says. The American Academy of Pediatrics’ new sleep recommendations also advise against letting your baby sleep in the car seat, so put him down on his back in his crib or bassinet to sleep. Because sick babies might need smaller, more frequent feeds, be prepared to get up more often during the night.
According to the Centers for Disease Control (CDC), 80 percent of all infectious diseases are transmitted through the hands. "It's crucial that anyone handling the baby keeps their hands clean," says Dr. William Sears, Associate Clinical Professor of Pediatrics at the University of California, Irvine, School of Medicine. "And also remember to clean children's hands with baby wipes -- especially once they start putting everything in their mouths." Also be sure your baby's hands are completely dry to ensure the alcohol from the wipe is not ingested.
If your baby seems to be getting worse, it may be time to contact your pediatrician. For infants up to 3 months, any fever over 100.4°F is a "call your doctor right away" scenario, says William Varley, M.D., community pediatrician with Children's Hospital of Pittsburgh. For older babies, look out for a fever that lasts more than three days or that develops a few days after the onset of cold symptoms. Other signs to watch for include wheezing or rapid, strained breathing, which may indicate a virus or pneumonia. If your baby develops coughing fits, it may be whooping cough. Don't hesitate to reach out to your doctor with concerns.
READ MORE: Surviving Baby's First Cold & Flu Season