A guide to coping with 7 common ailments of the first year.
Your baby's first year is full of milestones: his first smile, his first tooth … and your first frantic call to the pediatrician. There's no way around it—sooner or later, your child is going to 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.
Here's the good news: With each new illness, your baby builds antibodies that will protect him in the future. That's small comfort at 2 a.m., of course, when your baby is feverish and fussy. So invest in a solid reference book, such as The Baby Book: Everything You Need to Know About Your Baby From Birth to Age Two, by William Sears, M.D., and Martha Sears, R.N. (Little Brown and Co., 1993). Also find a good pediatrician. Start interviewing in your second trimester, and make sure you find one who can handle your middle-of-the-night calls.
Need advice now? Here's a guide to some of the most common infant ailments and what you can do to help your baby get through them.
1. Clogged Tear Ducts
Even though babies cry a lot, it's not unusual for their tear ducts to become blocked. The result—eyes brimming with tears—can be alarming, but most clogged ducts clear up on their own. In the meantime, try gently massaging the tear duct or flushing the eye with breast milk. But do call your pediatrician if your baby's eyes become reddened or a heavy discharge appears.
"A cold is primarily a nuisance," Mahle says. The telltale sign is a runny nose with discharge that can range from clear and watery to thick and yellow to even greenish. Your baby also may be sneezing, coughing, slightly feverish and cranky.
Keep your baby comfortable by placing a humidifier in the nursery, leaving windows open whenever possible, increasing his fluids (breastfeeding is best, but if your baby's getting a bottle, you can dilute one or two feedings a day with water) and using breast milk to soften the mucus in his nose and then suctioning it with a rubber bulb syringe. Another trick: Let the baby sleep secured in his car seat so that gravity can help drain his nose.
Note that many parents and day-care centers get the issue of contagion backwards: The thin, clear mucus from a runny nose at the beginning of a cold is the most contagious. The thick, green mucus that comes later, while less attractive, is actually not contagious.
Diarrhea, or frequent runny stools, usually results from a viral infection but also can be caused by a response to teething or antibiotics. "If there's an acute onset of diarrhea accompanied by fever and vomiting or lack of appetite, then you're dealing with a virus," Mahle says. "It's self-limiting and will go away." But, she adds, it may take up to two weeks. Keep your baby's bottom clean and dry—especially when he has diarrhea—to prevent rashes.
Experts' recommendation for dealing with diarrhea is to continue breastfeeding. If your baby is eating solid foods, stick to the BRAT diet: bananas, rice, applesauce and toast. If your baby is vomiting as well, prevent dehydration by continuing to breastfeed and giving an over-the-counter solution, such as Pedialyte, for 12 to 24 hours. Check with your pediatrician if your baby continues vomiting and develops a fever or if there is blood in his stool.
4. Ear Infections
Ear infections occur when the eustachian tubes, or the short ducts that connect the middle ear to the throat, are blocked by fluid and have become a breeding ground for bacteria. Ear infections are the most common childhood illness second to colds, although research shows that breastfed babies suffer far fewer than formula-fed babies.
Babies suffering from an ear infection 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 an ear infection, wait three days or so before calling your pediatrician, as some cases go away fairly quickly without medication, says Jay Gordon, M.D., a pediatrician in Santa Monica, Calif., and the author of Listening to Your Baby (Perigee, 2002). If your baby does need treatment, a 10-day course of antibiotics is standard.
You can ease your baby's discomfort with a pain reliever such as acetaminophen or ibuprofen (the latter only for babies older than 6 months). 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 your baby in a more upright position and keeping his head elevated when he's sleeping by placing a book or pillow beneath one end of his mattress.
It's extremely rare for a fever to do any harm. In fact, it can be a good thing. "Fever generally is not bad because it helps the body fight off infection," Mahle says. If your baby feels hot, first check to see that he isn't overbundled. If he isn't and you suspect he is running a fever, take his temperature. For an infant under 2 months of age, any rectal temperature over 100°F warrants a call to the pediatrician. In older babies, a fever of 103°F or higher deserves a call, according to Marc Wager, M.D., a pediatrician in New Rochelle, N.Y. Also call the pediatrician if your baby is fussy and crying inconsolably, or is sluggish and just not himself.
To help keep your baby comfortable, ask your doctor about giving him a pain reliever such as acetaminophen or, for babies older than 6 months, ibuprofen. You also can place tepid washcloths on your baby's forehead and body to help cool him.
Some parents also worry about seizures caused by fever, but less than 2 percent of children experience them. While frightening to witness, febrile seizures are completely benign, with no lasting effects.
The yellowish skin color of jaundice 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 on this task.
Approximately 15 to 20 percent of babies develop jaundice by their third day. In most cases, it disappears within about a week. When needed, treatment usually involves placing the baby under an ultraviolet light (available for home use).
Respiratory syncytial virus may have all the symptoms of a cold in the beginning, but it can progress to a much more serious illness: a lung infection characterized by rapid breathing and wheezing, and sometimes coughing and choking. It's especially hard on premature babies, infants under 4 months of age, and those who have asthma or a lung disease. "RSV can be very serious," Mahle says. "If your infant develops wheezing or you see him working harder to breathe, consult your pediatrician at once."
Since it is a virus, RSV does not respond to antibiotics. Instead, a baby with RSV will be treated with anti-wheezing drugs delivered either through an inhaler or intravenously. In some cases, a baby with RSV will need to be hospitalized.