Baby's first illness

Until now, you’ve fretted over dirty diapers and baby acne. But then comes your baby’s first sniffle, fever or tummy trouble. Like every new parent, you’re worried. What to do? The basics boil down to two simple rules:

Rule One: Whether it’s an upset tummy or a stuffed nose, keep giving liquids (Hydration help). That means if you’re breastfeeding — don’t stop! Breastmilk offers extra protection against germs. And bottle-feeding moms should keep giving formula. Liquids are not only the key to combating colds (they help clear mucus and fight fever), but they also keep babies with stomach bugs hydrated.

Rule Two: If your baby’s under three months, see a doctor at the first sign of sickness. A newborn’s immunity takes three months to build up, so any fever should be checked out. For infants older than three months and up to a year, this symptom-by-symptom guide will help you keep baby comfortable — and help you keep your cool.

Fever

If your child is happy and alert, a temperature up to 38.5°C (101.3°F) isn’t in itself cause for concern, just nature’s way of helping baby battle a bug. “A fever can be a good thing — it means baby is fighting well,” says Danielle Grenier, medical affairs officer for the Canadian Paediatric Society (CPS). Your child’s behaviour and demeanour are more important than the thermometer number in judging how sick he is.

At-home help: Make sure your little bundle isn’t bundled too warmly; over-wrapping can cause your baby to overheat and appear feverish. To take his temperature, use a rectal thermometer for the most accurate reading. To bring down fever, try acetaminophen or ibuprofen. But first make sure baby is well hydrated and don’t exceed the recommended dose. Doctors recommend 15 milligrams of acetaminophen per kilogram of body weight.

Visit the doctor when your tot’s temperature is over 38.5°C (101.3°F) or you observe a change in his behaviour, such as unusual drowsiness, crankiness or a change in feeding habits. Fevers can point to a more serious condition, such as a urinary tract infection, even meningitis.

The first sign of tummy trouble is usually vomiting, followed by diarrhea. The good news is, stomach bugs are usually gone within 24 to 48 hours, and breastfed babies often have milder symptoms that go away quickly. Parents of regular spit-uppers can recognize virus-induced vomiting — it will show up at other times than after feeding and it will likely be accompanied by diarrhea.

At-home help: For vomiting and diarrhea, the advice is the same. Give your infant small amounts of liquids more frequently. You can supplement feedings — of breastmilk or formula — with a hydration solution, such as Pedialyte, which works faster than water to rehydrate baby.

Visit the doctor when baby’s not eating, can’t keep anything down, or diarrhea is constant.

Stuffy nose

How can you tell when baby’s plugged nose is the sign of a bug? If the discharge is thick, and yellow or green, she likely has a cold. If the mucus is clear, the cause could be environmental, such as sensitivity to cigarette smoke or air conditioning.

At-home help: Clean baby’s nose 15 minutes before feeding with the help of a salt and water solution, such as Salinex, available in drops or spray. To use the drops, lay her down and put one or two drops in each nostril. For the spray, simply squirt once in each nostril. Then use a nose suction bulb (available at drugstores for about $3) to suck the salt water back and get the secretion out; dab petroleum jelly under baby’s nose to reduce irritation. To help with congestion, try adding a few drops of menthol, eucalyptus or pine oil to a bath. And a cool-mist humidifier can help keep her more comfortable at nap time and at night. Stay away from hot-water vaporizers; the CPS does not recommend them because of the risk of burns. Also, putting a towel or two under the head of the crib mattress (never directly under baby’s head!) may help her sleep better by elevating her head slightly. Warning: Medicines with decongestants are not recommended for children under three.

Visit the doctor when your little one’s runny nose has a thick, green discharge for more than two weeks.

A tiny cough is often harder on parents’ ears than it is on your baby. It helps clear mucus from his airways. “If a child has a cough now and then, it’s usually of no great significance,” says David Smith, medical director at the General Pediatrics Clinic of BC Children’s Hospital in Vancouver.

At-home help: Run a hot shower to create an impromptu steam room. Sit baby on your lap and let him breathe in steam until he calms down. (The exception is croup, which is characterized by a dry, barking cough; new evidence shows steam doesn’t improve croup, which is best treated by cold humidity and a trip to the doctor.) Giving baby water can also calm his cough, but cough medicines are a no-no. “With tiny babies, we use the least amount of medicine,” says Grenier.

Visit the doctor when your child has wheezing and congestion (possible signs of respiratory syncytial virus), or if the coughing is causing vomiting, lasts more than a week or sounds like croup.

Keeping Bugs at Bay

• Breastfeed if you can; breastmilk fights germs and builds immunity. • Keep babies under three months away from people with colds. • Ask family members to wash their hands before holding baby. • Keep baby away from smoke and insist that smokers go outside. • Try to avoid sharing toys that get chewed — and wash them regularly.

Although a sick child may want to drink less, liquids are the key to beating bugs. So when baby is fighting a cold or other illness, Danielle Grenier, medical affairs officer for the Canadian Paediatric Society, recommends giving lukewarm water in addition to regular feedings — even to breastfeeding babies. “Exclusive breastfeeding refers to the milk product, meaning beastmilk over formula,” says Grenier. “But lukewarm water is always welcome.”

Though straight water is best, if baby is over three months and won’t take it, Grenier suggests adding juice for taste and colour. “Mix about one-eighth juice with seven-eighths water.” Note: Be sure to boil water to sterilize it for a baby younger than three months, and always check it’s not too warm before you give it to her.

For babies with stomach bugs, electrolyte solutions, such as Pedialyte or Gastrolyte, help prevent dehydration. (Some come in freezer-pop form, pictured here. These are fine for little ones who are older than 12 months; offer them only under adult supervision.) Breastfeeding moms should give the hydration solution between feedings. Bottle-fed babies who keep throwing up formula will find this mix of sugar and electrolytes goes down more easily. As soon as vomiting stops, however, return baby to formula. Babies recuperate more quickly if they aren’t fasting, says Grenier. “If the baby is satisfied, she sleeps better and gets better faster.”

Warning: Dehydration Dehydration can be life-threatening, so get medical help immediately if you suspect it. Here’s what to look for in a sick baby:

• few or no tears • baby won’t eat or drink • dry mouth • ongoing diarrhea or vomiting • general listlessness • fewer or no wet diapers (A hydrated baby should wet five or six “heavy” diapers a day.)