Truth: Your baby will get sick this winter. Still, there's plenty you can do to keep those doctor visits to a minimum and comfort baby when she has a cold.

By Rebecca Felsenthal Stewart, Mary Ann LoFrumento, MD
June 11, 2015
Sick baby
Credit: Alexey Losevich/ Shutterstock

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.

Understanding Colds

The dreaded first cold hits just as your baby adopts a routine sleeping and feeding schedule. There's no avoiding it. Although babies are born with some of their mothers' immunity to illness -- which is enhanced by breastfeeding -- they're not completely protected against the ever-changing collection of viruses that cause upper respiratory infections. This means that most healthy babies will get six to eight colds before their first birthday. On a positive note, they will help your child begin to build up immunity of his own.

For many new parents, the real concern is deciding if their baby has just a cold -- or something more serious. Take a deep breath and face this challenge. You'll see it's easy to figure out once you know the signs.

The Life Cycle of a Cold

The common cold comes on slowly and lasts about nine days. I find it helpful to break the cycle down into three days coming, three days here, and three days going.

Three Days Coming: During the first three days, when your child is contagious, she may seem fussier than usual, have a slight decrease in appetite, and even have a fever. If she is less than 3 months old and her rectal temperature is above 100.4 degrees F., call your pediatrician's office right away for advice and instructions. (Some good news: Once your child is a preschooler, a cold causes only a slight increase in temperature.) On the second or third day, you'll spot a runny nose, signaling that your child's immune system is fighting back. During this stage, the mucus is clear and thin, and runs constantly. I know it's difficult, but try not to be on tissue patrol; multiple attempts to get your kid to blow will bother her more than the runny nose.

Three Days Here: During the middle phase of a cold, the fever has usually gone away, and your baby might be less fussy and eating better. The mucus will thicken a bit and may turn light yellow. Your child will now have the classic "stuffy and runny nose." This is also when he could develop a cough; when a baby lies on his back, mucus drips down the nasal passages to the back of the throat and sets off a cough response to keep the fluid out of the lungs. Inevitably, your child will have a hard time sleeping.

Three Days Going: Like a houseguest who stays too long, colds can linger. In the final three days, the mucus thickens even more and becomes crusty. Your baby will act normal in most ways, eating well and resuming activity.

How to Prevent a Cold in Babies

"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. After those first two months, here are more ways to prevent your baby from getting a cold.

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. Another tip: 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.

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.

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.

Is There a Magic Cure?

The simple truth: There is no quick fix for a cold or the flu. Antibiotics aren't effective against viruses, and antiviral drugs for some influenza strains aren't approved for babies. Plus, a growing body of research suggests that decongestants and combination decongestant-antihistamine products are not very effective in children, who can also experience side effects, such as jitteriness or difficulty sleeping.

Most pediatricians don't recommend these medications for babies, and many are now advising parents to use them minimally for all kids. Nonprescription cough suppressants and expectorants have also been shown to have little effect on coughs linked to colds in kids, and experts advise against their use in children under age 14.

Figuring Out the Flu

Now that you know what the typical cold looks like, let's talk about the flu. It usually peaks from November through March, often for a few weeks at a time. Children can be contagious a day before symptoms start and for as long as they show them, which can be for up to two weeks.

When Do You Need to Call Your Doctor?

  • If your baby is listless, not reacting to you, has poor color, or if you just feel something isn't right.
  • If the cough is worsening or your child is having difficulty breathing.
  • If your baby is crying much more than usual, patting or pulling on the ear, or refusing nursing or drinking from a bottle.
  • If you suspect your infant has the flu, especially if he or she has a high fever and cough which persists for more than three days. NOTE: Any infant under 3 months with a fever (rectal temperature of 100.8 or greater) must be seen.
  • If your older child has a high fever for more than five days, a worsening cough (with or without chest pain), a headache for more than five days, or a headache that is getting worse or is accompanied by a stiff neck.