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WHEN A COLD IS NOT A COLD

By Michael G. Marcus, M.D.

Is your baby's nose running? Is he sneezing? Coughing? Must be a cold, right? Not necessarily. Sometimes the symptoms we associate with a cold actually signal another upper respiratory infection in your infant. Here's a look at how to spot and treat the common cold and two other infections that you may mistake for a cold.

Common Cold Colds generally lasts five to seven days.

Symptoms

A cold will make your baby irritable but he will still want to nurse or bottle-feed and be comforted by contact.
His nasal discharge will be clear to white and his nose may alternate between runny and stuffy.
A low-grade fever (under 101.5) may develop.
Symptoms such as joint pain and swelling, muscle ache, vomiting, skin rashes, and urinary problems are not consistent with a common cold.

Prevention The most effective way to keep your infant from catching a cold is to minimize the number of people who handle the baby. Anyone who does hold or touch her should wash hands before contact. Despite these efforts, it's not uncommon for infants to have as many as 6 to 10 colds per year, especially if they have contact with older children.

Treatment Increase your infant's fluid intake and rest. Acetaminophen can be used for fever in the age and dosage recommended. However, consult your physician for any fever that is higher than 101.5 F or that lasts longer than four to five days. Over-the-counter cold medications should be avoided unless recommended by your physician since they do not shorten the course of the infection and can cause unwanted side effects, such as irritability and high blood pressure.

Allergies Up to 10 percent of babies experience allergies to foods, dust, mold and pets. They are far more common in children where one or both parents have a past history of allergies, eczema or asthma.

Symptoms

Clear to cloudy nasal discharge, sneezing, itching and rash (hives). Symptoms may last for long periods of time when exposure is constant, or they may be quite brief if caused by a sporadic exposure, such as visiting grandma's house where a cat resides.
Allergies tend to recur whenever the child is exposed to the "trigger."

Prevention Identifying the trigger for the symptoms is very important, since avoidance of exposure to the allergen will effectively prevent the development of symptoms.

Treatment A decongestant may help some of the symptoms, but only antihistamines and/or nasal steroids will effectively treat your child. These latter two medications should only be used under the supervision of a physician.

Sinusitis Although infants can develop sinusitis, it's unclear how common it is in this age group since it is difficult to diagnose in infants.

Symptoms

Any respiratory tract infection that seems to last for more than 10 to 14 days could be a sinus infection. If your pediatrician suspects sinusitis you may need to go to a pediatric sub-specialist to confirm the diagnosis. An untreated sinusitis can become chronic and lead to significant problems.
Sinus infections will frequently start with upper-respiratory like symptoms of nasal congestion with obstruction. Frequently the discharge will appear cloudy in the start, but will rapidly progress to thick and crusting, and a stuffed nose.
A cough, especially while lying down and or sleeping, is a very common symptom of sinusitis. This cough is caused by post-nasal drip and irritation of the throat and voice box.

Prevention Address respiratory infections that lead to sinusitis promptly -- before the sinuses have a chance to become blocked and infected.

Treatment Treatment of sinusitis requires potent decongestants to decrease nasal obstruction and drip, coupled with antibiotics for a sufficient period of time (frequently three to six weeks) to fully clear the bacteria responsible for the infection. Antihistamines may actually delay healing in some cases since they can dry the sinuses too much and hinder effective drainage.

Influenza Infants can develop the flu, especially if there is contact with school-age children.

Symptoms

Fever; thick, obstructive, nasal discharge; loose or dry cough; irritability and poor appetite.

Influenza may last 7 to 14 days and affect communities in clusters over a six to eight week period each winter.

Prevention It's similar to avoiding colds: minimize the number of people who handle the baby and anyone who does hold or touch her should wash hands before contact.

Treatment Antibiotics are not helpful in treating acute symptoms, however, secondary bacterial infections can occur and if flu-like symptoms persist or worsen beyond 10 to 14 days then antibiotics might be recommended. Rest, fluids, anti-pyretics and even mother's chicken soup can all make baby feel better. Ultimately, your baby's own immune system is the best warrior in this battle.

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