Thursday, January 3, 2013

How to Deal with Your Infant’s Cold

If you're wondering what medications you can give an infant for a cold, it's wise to err on the side of nothing and rely on home care to make your child more comfortable. According to the Consumer Healthcare Products Association, or CHPA, drugstore cold and cough medications can pose a danger to infants and children. Adverse reactions to over-the-counter cold medications are more common in infants under the age of 2.

A baby with just nasal congestion probably does not have a cold. A short time ago, they were floating in water (amniotic fluid) and hanging upside down. If they had a stuffy nose, no one would know…it was filled with fluid anyway. When a child is born, they emerge into a dry world; a world that can dry out those mucous membranes. There new world is also filled with germs.

Babies do get colds (sometime). Since mothers can certainly get colds, so their babies can get colds, too. I have a theory that the cuter the baby, the more likely they are to get cuddled and kissed, thus getting more colds from admiring siblings, friends and relatives. Mothers like it when I tell them that their child has a cold because they are too cute. Of course, funny-looking babies (and I see a lot of those) get colds, too. I don't openly identify those FLKs (funny-looking kids) to their parents, mostly since the parents may be FLAs!

New parents are sticklers for hygiene. They wash their hands and everything that touches the baby. A pacifier drops on the floor and it is treated like toxic waste, and a new, sterilized one is popped in their mouths. If they also have a snotty-nosed, two-year old at home anxious to hold their new little brother or sister, there is a hygiene dilemma. You can wash their hands, change their clothing, but there is really no way to adequately sanitize a two-year old.

What cold medicines can I give the baby? The easy answer – none. Not only have cold medicines been found to be ineffective, they have the potential to make things worse. Over-dosages of potent decongestants, antihistamines, and cough medications were common, so the new recommendation is to withhold giving any medications to a child under the age of six YEARS. Of course, cold symptoms can be treated with non-medicines.
A stuffy, congested nose can be miserable. Parents can liquefy this mucous (medical term for snot) by saline nasal sprays or drops, maintaining adequate hydration, and by using a cool mist humidifier. 

Babies cannot blow their own noses. They can exert a powerful sneeze, and blow snot all over the place, but it takes years of practice to get a kid to properly blow their noses. This is where the infamous nasal aspirator – the bulb syringe – the much-feared nose sucker – comes in. The kids typically hate it, but it is very helpful to clean out snotty noses.

My technique: Loosen the snot first, if it is not already very wet. Instill a drop or two of saline in each side of the nose and let it marinate for a minute or so. Then, quickly close off one nostril with your finger, while aspirating the open side with a fully-compressed bulb syringe. Avoid touching the sensitive nasal septum if you can. Repeat on the opposite nostril. Babies are primarily-nose breathers, so do this rapidly. Finally, put another drop of saline in each nostril and leave it there. They will sniff it back and loosen the mucous you were not able to aspirate. If you do this routinely before nursing or feeding the baby a bottle, they will start to associate getting their nose sucked out with getting something to eat. They will also nurse better with a snot-free nose.

The color of snot, even if fluorescent green or canary yellow, is not medically-relevant in most cases, but parents often feel that colored snot is a definitive sign of a bacterial infection needing antibiotics. It is (s)not. There may be bacteria in the snot, but green snot does not mean the child has a sinus infection or pneumonia. In kids, the sinuses are anatomically small and much less-likely to become infected than adult sinuses, but it can happen, so having the child properly examined if green mucous persists more than 7-10 days is appropriate.

Cool mist or warm steam? Either one is fine, as long as you are careful. A cool mist humidifier does not need to be in close proximity to be effective – blown in their little faces to the point that moss is growing on their north sides. Humidifier can also grow mold, so they need to be inspected and cleaned often. Steam vaporizers can burn curious little hands or feet sticking out of crib slats, so extra, extra caution should be exercised, so kids do not pull boiling water on themselves. And, just use water. Mentholated additives or aromatic oils may smell good to caring grandmothers, but they are not particularly helpful. They can even be harmful for babies with some respiratory complications reported.

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