This post is also available in: Svenska
The first time your baby gets a cold, you probably have so many questions. What should I do? Are they going to be clear of this? Is it the RS-virus? As a pediatrician, I am not nearly as interested in whether your child has RS-virus or not.
I am more interested in two things:
- Can/is your baby eating & drinking?
- Is your baby having difficulty breathing?
It’s quite obvious, as human beings, we need to be able to eat, drink and breathe without difficulties. Even if your child has a stuffy nose and they look like a mess, as long as they meet the above requirements, they are on track to getting better. With very simple care, healthy infants can cope with colds just fine.
Can your baby eat & breathe?
Babies with the common cold, who have difficulties breathing, and cannot eat, are often admitted to the children’s emergency room. If your baby cannot eat and you do not know what to do, seek medical care.
Note! Often it doesn’t take much to help your baby and most times, not always, treatment can be done at home.
In fact, both breathing problems and feeding problems are often due to something as trite as nasal congestion. When you go into the children’s emergency room, the first thing that happens (after a long wait, of course) is that the nurse makes a “nasal toilet” aka, they begin nasal irrigation. In the vast majority of cases, the nasal irrigation is enough to clear their nasal passages leading to a somewhat satisfied baby who can both eat and breathe again. Many families can go home without even seeing a doctor.
That is, ¨when you finish reading this post, there is a good chance that you will not have to go to the children’s emergency room with your baby! Whoo!
Why is nasal congestion so disabling in babies?
- Babies’ noses are tight. We’ve all tried to pick out that golden nugget every now and then. We ALL know the struggle. Their nostrils are teeny tiny! That’s why it easily clogs with snot, mucus and worse still when the mucous membranes swells during periods of the cold caused by both RS-virus and other viruses.
- Babies, up to about 6 months of age, can only breathe through their nose, and not through their mouth.
- Babies can and must breathe while eating (whether breastfed or bottle fed). If their nose is clogged, they will release their chest or bottle and stop eating & drinking.
It’s amazingly fascinating that last point. Babies can drink and breathe at the same time! The consequence, however, is that a congested baby can neither breathe nor eat.
Clearing a baby’s nose
There are nasal irrigation devices available to purchase at pharmacies. They work well! At a children’s health service, the opposite is usually done. Instead of sucking out the snot, you flush it down their throat. Sterile physiological saline solution is most commonly used for nasal irrigation, but salt water spray works well.
Babies’ nasal cavity are quite large (even if they are narrow). Therefore, it is not enough to drip breast milk or saline into the nose. You need to rinse the nose thoroughly. Most often, it takes 1- 2 mL per nostril. A plastic syringe without the tip (available at pharmacies) is excellent for this purpose . Hold the baby’s head with your left hand (if you are right-handed) and flush straight into, not upwards, their nose with your other hand. The baby will snort and cough and swallow and discharge a lot of dissolved snot. It can seem scary, but it’s not dangerous. Continue until it looks like the nasal cavity is clean.
It’s important to know that the nasal septum is pain-sensitive, but not the nasal wing. This means that you should avoid the nasal septum (the inner wall of the nose, against the other nostril), while you press the syringe or spray bottle against the nasal wing (the outer part of the skin around the nostril) without it hurting.
When does my baby need go to the pediatric emergency department with a cold?
If a sick baby still struggles to breathe and eat after nasal irrigation, it is time to go to the nearest children’s emergency room. Bring some sandwiches for yourself and a book, as there may be a long wait. And be careful about hand hygiene there, because there are a lot of children with nasty diseases, gastroenteritis to mention one…
When does my baby go to the medical center with a cold?
If your baby can breathe and eat, but is extra whiny and may have a little fever, then they may have otitis (an ear infection). In infants, it is always treated with antibiotics. Give acetaminophen for pain relief and try to position your baby slightly upright when they are sleeping, perhaps in a baby carrier. Then go to the medical center the morning after to check if they have an ear infection.
If your baby is under three months of age and has a fever (above ~101F or 38.5C), then go to your nearest medical center. In the past, it has been recommended that pediatricians should check up on these babies, at least in Stockholm. But now it has been decided that a general practitioner should also assess young babies with fever.