First Year Survival Guide

Common infant ailments and how to cope

Your baby’s first year is full of milestones: The first smile, the first tooth, the first frantic call to your pediatrician. There’s no way around it — sooner or later, your infant will get sick. “The average infant gets six to eight colds each year for the first two or three years,” says Sue Mahle, M.D., a pediatrician in Minneapolis.

But the good news is that with each illness, your baby builds antibodies. That’s small comfort at 2 a.m., of course, when your baby is feverish and fussy. So invest in a solid baby reference book (for some ideas, see Sights & Sounds) and find a good pediatrician (experts say to start interviewing in your second trimester). Make sure you find one who can handle your middle-of-the-night calls.

Here’s a guide to some of the most common infant ailments you may encounter, what you can do to help and how to get through them.

Jaundice

This yellowish skin color is caused by an excess of a chemical called bilirubin in the baby’s blood. Bilirubin is normally processed by the liver, but immature livers of newborn babies can fall behind in this task. About 15 percent to 20 percent of newborns develop jaundice by their third day. Jaundice usually disappears within a week to 10 days.

If you suspect that your baby has the condition, you should contact your health care provider. Treatment involves placing the baby under an ultraviolet light (available for home use) and giving her extra fluids. You also can try shading her eyes and placing her next to a window in the sunlight for several minutes a few times a day. A quick trip outside is good, too, but be careful about sunburn.

Clogged Tear Ducts

Although crying is what babies do best, it’s not unusual for infants’ tear ducts to become blocked. The result — eyes brimming with tears — can be alarming for a parent to see, but most clogged ducts clear up on their own. (Call your doctor if your baby’s eyes become reddened or a heavy discharge appears.) Try gently massaging the duct by applying pressure near the corner of the eye.

Colds

“A cold is primarily a nuisance,” Mahle says. The telltale sign is a runny nose, with discharge that can be clear and watery or thick and yellowish or greenish. Your baby also may be sneezing, coughing, feverish and cranky.

You can keep the baby comfortable by placing a humidifier in the nursery, increasing his fluids (breastfeeding is best, but if your baby’s getting a bottle, you can dilute one or two feedings a day with sterile water) and using saltwater drops to soften the mucus in his nose and then suctioning it with a rubber bulb syringe. You also can let baby sleep secured in his car or infant seat so gravity can help drain the nose.

“If mucus is thick and green, it’s more likely that there’s something bacterial going on,” says Marc Wager, M.D., a pediatrician in private practice in New Rochelle, N.Y. “An infant with a clear, runny nose and no fever can be treated at home, but if fever is present, or fever with green [mucus], a visit to your pediatrician may be indicated.”

Respiratory Syncytial Virus

RSV is a cold with attitude. This virus may appear like a cold at first, but it can progress to a lung infection characterized by rapid breathing and wheezing in infants. “It’s especially hard on babies under 4 months of age,” Mahle says. “RSV can be serious. If your infant develops wheezing or you see him working harder to breathe, consult your pediatrician at once.”

Ear Infections

Second to colds, ear infections are the most common childhood illness. Most children suffer through at least one by age 3. Babies and young children are particularly prone to ear infections because their eustachian tubes — the ducts that connect the middle ear to the throat — are short and easily blocked. This can lead to fluid buildup in the middle ear, which can be a breeding ground for bacteria.

Ear infections often follow a cold and can be very painful. Babies may pull or rub their ears, cry when sucking or have trouble sleeping (lying down increases pressure on the eardrum). They also may run a fever.

If you suspect that your baby has an ear infection, call your pediatrician. Standard treatment is a 10-day course of antibiotics. You can ease your baby’s discomfort with a pain reliever such as acetaminophen or ibuprofen. Never give aspirin, even baby aspirin, to a child: It has been associated with Reye’s syndrome, a serious disease that affects the liver and brain.

Help relieve ear pressure by feeding baby in a more upright position and elevating her head with a pillow at night. After the medication is finished, your baby will require a follow-up doctor’s visit.

Diarrhea

Diarrhea, or frequent runny stools, usually is caused by a viral infection, but it also can result from too much fruit in the diet or food sensitivity. Diarrhea also can be caused by a response to teething or antibiotics.

“You need to figure out if it’s infectious,” Mahle says. “If there’s an acute onset accompanied by fever and vomiting or lack of appetite, then you’re dealing with a virus. It’s self-limiting and will go away.” But, she adds, it may take from four days to two weeks.

If it is a bug, the current thinking is to continue baby’s regular feedings. If your baby is eating solid foods, you might want to stick to the “BRAT” diet: bananas, rice, applesauce and toast. If your baby is vomiting, it’s important to prevent dehydration; try an over-the-counter oral rehydration fluid such as Pedialyte for 12–24 hours. Check with your pediatrician if diarrhea persists longer than a day, if baby continues vomiting and develops a fever, or if there is blood in the stool.

Fever

“Generally fever is not a bad thing because it helps the body fight off infection,” Mahle says. “It’s extremely rare for a fever to do any harm: less than 1 percent of children have seizures during a fever.”

If you suspect that your infant has a fever, take his temperature. For an infant under 2 months, any fever over 100.4° warrants a call to the pediatrician, but in older babies, a low-grade fever shouldn’t be cause for alarm. Check to see that your baby isn’t overbundled and, if your doctor approves it, try a pain reliever such as acetaminophen or ibuprofen to reduce the fever. You also can place a tepid washcloth on his forehead and body.

“Any fever over 103° [for older babies] that lasts more than 48 hours should be evaluated by your doctor,” Wager says. But, like most doctors, he says your baby’s behavior is a better measure of health than body temperature alone. If he’s fussy and crying inconsolably, or is sluggish and just not himself, call the pediatrician.

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