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Baby’s First Cold

Strategies for Prevention and Treatment

Tis the season – not only for the holidays, but for congestion, runny nose, cough, and fevers. Preventive measures and a few simple products in your medicine cabinet will make what could be your little one’s first cold and flu season more comfortable.

First, parents and caregivers: It’s not too late to get your flu shot. This is especially important for homes with newborns. Since infants cannot get their first flu shot until they are six months old, all household contacts should have one to protect the newborn from exposure. Even breastfeeding moms should have a flu shot. All household contacts also need the “Tdap” or tetanus-pertussis vaccine. Pertussis, more commonly known as whooping cough, has been increasing, partly due to waning immunity in teenagers and adults. It is recommended that all adult household contacts get their Tdap, since infants do not receive their first vaccine for pertussis until two months of age. Pertussis in adults is mostly an annoying cough, but it can be a deadly disease in infants.

Last, but not least on the list of preventive health strategies is regular and effective hand washing for everyone coming in contact with baby.

When, or if, treatment is necessary, normal saline nose drops should be a staple in your home medicine cabinet. The nose plays a very important role in normal breathing. Air is warmed, humidified, and cleaned as it goes through the nose. If it’s congested, children mouth-breathe. Mouth-breathing irritates the back of the throat and stimulates coughing. Keeping the nose clear of secretions during an upper respiratory infection will help with the cough. Saline nose drops can be used several times throughout the day. Before meals is a good time because babies with stuffy noses tend not to eat well. Let me warn you, instilling nose drops may not be fun for your child, but don’t let that keep you from using them. A bulb syringe is handy for clearing nasal secretions. Reserve use of the bulb syringe to those secretions you can see. Overzealous use of the bulb syringe can lead to nasal mucosal irritation. To help the saline travel back into the nose, support the infant’s neck and gently rock his or her head back towards the floor. Remember, over the counter (OTC) cold and cough medications are not recommended for use in children under two. Normal saline is all you need.

A fever-reducer should also be kept on hand. Acetaminophen is the most common OTC fever-reducer. Tylenol is the popular brand name. Given in proper doses, acetaminophen is safe and effective. But doses over the recommended amount can cause damage to the liver. Overdosing is the biggest concern in giving acetaminophen to children. An FDA advisory panel has recommended that all forms (liquid, chewable, and tablet) be one strength and dosing instructions be based on weight, not age. These changes offer some standardization. During the transition, you need to be alert. Check the strength and follow the instructions exactly. If it is liquid, use the measuring device that came with the medicine.

Also check the active ingredient list of all the medications you are using. Acetaminophen is frequently used in combination with other ingredients. It is best to avoid overdosing by using single ingredient medicines. Keep a written record of when the last dose was given and share this information with others who are caring for your child.

Jan Dalby, CPNP, is a nurse practitioner with Pediatric Associates of Richmond where she has counseled parents for over twenty years.
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