Due to their vulnerable immune systems, the first few months of a baby’s life can be beset by health issues. How are new parents to know the difference between a normal and an abnormal cold? We sought the advice of ER Physician Dr. Mijke Vankan from Oasis International Hospital to make sense of common symptoms, focusing on self-help measures and when to seek treatment from a doctor. The following information is meant as a guideline only; always consult your pediatrician when in doubt.
Colic
Infant colic is a frustrating and ill-understood condition marked by predictable bouts of excessive crying. According to the Mayo Clinic, babies with colic “cry more than three hours a day, three days a week for three weeks or longer.” Infants with this condition seem inconsolable and their crying may seem louder or more intense than usual. However, colic tends to be short-lived and is extremely common among newborns.
Self-help measures:
- Use a bottle that keeps your baby from swallowing too much air
- Have your baby sit up during feedings
- Carry your baby in your arms, a sling, or a front carrier
- Go for a car ride
- Give your baby a warm bath
- Put your baby in a baby swing
- Swaddle your baby
- Put your baby near a clothes dryer or other source of white noise
- Massage your baby’s belly
- Change your baby’s formula or avoid eating certain foods
- (such as coffee, broccoli, and spicy foods) if you breastfeed
When to see a doctor:
- Your baby cries for longer than two hours without stopping
- Your baby is vomiting, refuses to eat or drink, or has blood in their bowel movements
- Your baby does not respond to you or acts abnormally
Common Cold
A cold is a viral infection of the nose and throat, the primary symptoms being nasal congestion and a runny noise. Because they have weak immune systems and are often around other children, babies are especially vulnerable to colds. There is no cure for a cold, so treatment lies in relieving their symptoms. That being said, very young infants should see a doctor immediately because they’re at greater risk of conditions like croup and pneumonia.
Self-help measures:
- The treatment for an infant or child with a cold is different than treatment recommended for adults. Antihistamines, decongestants, cough medicines, and expectorants, alone and in combination, are all marketed for the symptoms of a cold, but no studies demonstrate any benefit in infants or children.
- Humidify the air around your child
- Use a saltwater nose spray
- Make sure your child drinks enough fluids
When to see a doctor:
- Your child has difficulty breathing or is breathing rapidly
- Nasal congestion does not improve or worsens over the course of 14 days
- Your child’s eyes become red or leak yellow discharge
- There are signs or symptoms of an ear infection (pain, ear pulling, and fussiness)
Ear Infections
After the common cold, ear infections are the second most-common condition affecting newborns. If your baby tugs or pulls at their ears, seem more fussy than usual, and develop a fever, there’s a good chance they have an ear infection. There may also be loss of appetite, diarrhea or vomiting, or a yellowish or white discharge coming from their ears.
Self-help measures:
- Make sure your child drinks plenty of fluids
- If your baby is at least 6 months old, medicine to treat pain and fever such as acetaminophen or ibuprofen can help (check with your doctor first)
- Keep your child’s head elevated to relieve pressure. If they’re older than 2, it’s OK to use a pillow to support their head when they sleep
- Apply a warm, moist towel to your child’s face near the ear
- Swallowing can drain fluid from the middle ear, so children 4 years and older can try chewing sugarless gum.
When to see the doctor:
- You should always see the doctor if you think your child has an ear infection. They may prescribe antibiotics depending on the severity of the infection.
Fever
A fever indicates that the body is trying to fight off infection. The American Academy of Pediatrics defines a normal temperature for a healthy baby as being between 36.1°C and 37°C. If their rectal temperature is higher than 38°C, they have a fever. A fever is more serious for babies 3 months and younger; call your doctor immediately if this is the case. If they’re over 3 months, the most important thing is how they look and behave. If they’re taking fluids normally, there’s no cause for concern unless it’s very high or lasts longer than 24 hours.
Self-help measures:
- Make sure your child drinks lots of fluids
- Medicine, such as acetaminophen (e.g. Tylenol) for children older than 3 months or ibuprofen (e.g. Advil, Motrin) for children older than 6 months can help bring down a fever, but they’re not always necessary. Never give aspirin to a child younger than 18 years; it can cause a dangerous condition called Reye syndrome.
When to see a doctor:
- Your child is younger than 3 months and has an oral, rectal, ear, or forehead temperature of 38ºC or higher.
- The fever persists for more than three days
- The fever is coupled with another ongoing medical condition or a new skin rash
- Your child seems very sick, fussy, or refuses to drink fluids for a prolonged period
- Your child has a seizure caused by a fever
- Your child experiences recurrent fevers, even if they last only a few hours
Gastroesophageal Reflux Disease (GERD)
GERD is basically acid reflux in babies and children. Most of the time, it’s caused by a poorly-functioning intestinal tract; most babies grow out of it by their first birthday. In older kids, GERD is often caused by issues with the lower esophageal sphincter, just like in adults. Contributing factors include obesity, overeating,
eating spicy or fried foods, and specific medications.
Self-help measures:
- Keep your baby upright after feeding. They might spit up less often if you hold them up on your shoulder for 20 to 30 minutes after a feeding instead of putting them in a
- sitting or lying position. Also, don’t try to get your baby to eat when they don’t want to.
- Quit smoking. If you or anyone else in your house smokes, this can make your baby’s reflux worse and cause other health problems.
- Switch to a milk-free and soy-free diet.
- Thicken your baby’s milk by adding rice baby cereal to the bottle. There are also special thick formulas available.
- Medication (proton pump inhibitors) prescribed by your doctor
When to see the doctor:
- Whenever you think your child has acid reflux, symptoms of which include bloody stools, severe diarrhea, recurrent vomiting, or vomiting blood
- Delayed weight gain
- The infant cries for more than two hours
- Your baby refuses to eat or drink anything for a prolonged period
- The infant is under 3 months of age and has forceful vomiting after each feed, but still appears hungry
- Behavior changes, including lethargy or decreased responsiveness
Constipation
A baby’s bowel movements vary widely depending on their age and diet. They may have constipation if they have hard, pellet-like stools or appear to be in pain when trying to pass bowel movements. Your baby may arch their back, tighten their buttocks, or cry if that’s the case. Infants often experience constipation when they switch to solid foods; constipation in older babies can possibly be corrected with simple changes to their diet.
Self-help measures:
- If your infant is at least 4 months old, try giving them prune, apple, or pear juice; other juices are not as helpful. They can have 60-120ml of 100 percent fruit juice per day for (ages 4-8 months) and up to 180ml of fruit juice per day if they’re 8-12 months old.
- If your baby has started eating solid foods, try substituting barley cereal for rice cereal. Feed them other high-fiber fruits and vegetables (or purées), including apricots, sweet potatoes, pears, prunes, peaches, plums, beans, peas, broccoli, or spinach. You can mix fruit juice (apple, prune, pear) with cereal or the fruit/vegetable purée.
When to see the doctor:
- Your child experiences severe abdominal or rectal pain
- Your child has not had a bowel movement within 24 hours of starting constipation treatment
- Your infant (younger than 4 months) has not had a bowel movement within 24 hours of their normal pattern (e.g. if an infant who normally has a bowel movement every two days goes three days without a bowel movement)
- Your infant or child does not want to eat or starts losing weight
- You see blood in your child’s bowel movements or diaper
Resources
The following international hospitals and clinics offer complete pediatric and family health services in English.
Oasis International Hospital 明德医院
Daily 24hrs (emergency care), Mon-Fri 9am- 6pm, Sun 8.30-12.30am. 9 Jiuxianqiao Beilu, Chaoyang District, Chaoyang District (400 UR OASIS) www.oasishealth.cn 朝阳区朝阳区酒仙桥北路9号
Beijing United Family Hospital 北京和睦家医院
Mon-Sat 8.30am-5.30pm. 24-hour emergency care. 2 Jiangtai Lu, Chaoyang District (400 891 9191) www.ufh.com.cn 朝阳区将台路2号
International SOS 北京国际救援中心
Mon-Fri 9am-6pm, Sat-Sun 9am-6pm. Suite 105, Wing 1, Kunsha Building, 16 Xinyuanli, Chaoyang District (Clinic: 6462 9112, 24hr Hotline: 6462 9100, china.inquiries@internationalsos.com) www.internationalsos.com, www.clinicsinchina.com 朝阳区新源里16号琨莎中心一座105室
Vista Medical Center 维世达诊所
Daily 24hrs. 3/F, Kerry Centre, 1 Guanghua Lu, Chaoyang District (8529 6618, vista@vista-china.net) www.vista-china.net 朝阳区光华路1号嘉里中心3层
This article originally appeared on page 40-43 of the beijingkids Health Guide 2014. To get your free copy, email distribution@truerun.com or view it online at Issuu.
Photos: Gail, Cherie Joyful (flickr)