It’s inevitable. Friday night, when all the doctors’ offices have closed, baby starts coughing. That little forehead feels like your cheeks after you’ve run a marathon. Those little eyes are staring at you in utter confusion, wondering why Mommy can’t just make all the misery go away.
Of course, babies get sick every day of the week, but it always seems to happen when we’re headed into a winter weekend as cold and flu season rears its ugly head.
So, do you really need to run your baby to the emergency room, or is it OK to wait it out until Monday? We talked to the experts so you can put your mind at ease.
Fighting That fever
You learned back in grade school that the average human’s body temperature sits at a cool 98.6. When baby’s temperature starts to climb above that, you need to be wary, but what you do next comes down to baby’s age, says Lavanya G. Shankar, MD, chair of pediatrics at Northwestern Medicine Central DuPage Hospital in Winfield, Illinois.
“Eight weeks and under, when they have a fever, whether they have other symptoms or not, an immediate call to the pediatrician is a good idea,” Shankar says. If you don’t hear back, don’t wait. Get in the car and drive to the closest ER or urgent care.
That fever, she notes, doesn’t mean 98.7 degrees. From a medical standpoint, doctors worry when the temperature hits 100.4 degrees in babies, and that temperature should be taken rectally (aka by sticking a thermometer in baby’s hiney).
“That’s the most accurate for babies 12 months and under,” Shankar explains.
That’s because babies that young won’t be able to keep a thermometer under their tongue the way older kids might, and there’s too much margin of error with ear and forehead thermometers.
If that rectal test shows a baby between 3 and 6 months has a fever, Shankar still recommends a call to the pediatrician, whether there are other symptoms present or not. “But you don’t need to rush anywhere,” she notes.
The urgency changes if your little one is showing other symptoms of illness, such as extreme fatigue or listlessness, glassy eyes, refusal to nurse or take a bottle, or excessive vomiting. If any (or many) of those symptoms are present, it’s time to take that trip to the ER.
Infant Tylenol and infant Motrin can help baby fight a fever, and many pediatricians suggest switching between them throughout the day for babies older than 3 months, Shankar says. Your baby’s doctor can help you determine the right dosages and whether or not acetaminophen is appropriate.
One thing not to do? Don’t buy into old wives tales about starving a fever, Shankar warns. It’s important for babies to continue to eat a normal diet. If they’re not eating, it’s a sign you need to seek medical care.
Cutting Through Congestion
When cold and flu season hits, so does congestion, and baby’s little sinuses can take a wicked hit.
Typically the cause is a virus, says Benjamin Bring, DO, a primary care physician at OhioHealth Primary Care Physicians in Dublin, Ohio. Rhinovirus, also known as the common cold, is usually responsible as baby’s immune system isn’t equipped to fight off the disease that hits some 18 million Americans every year. But babies are also particularly susceptible to coronavirus, parainfluenza virus, adenovirus, and respiratory syncytial virus (RSV).
These viruses will cause baby to cough and sneeze, and make their little noses run thanks to increased mucus production (which stuffs them up). But because they’re viral, Bring says antibiotics are generally off the table. They won’t help—and in some cases they’ll actually make things worse.
“Babies and infants should be treated with conservative measures and rarely with medications,” Bring notes.
In other words? It’s not just okay to go old school when it comes to baby’s congestion—the methods used by our grandmas are often the best, and in many cases, they’re doctor approved.
“Some good treatments include cool mist humidifiers to help break up mucous secretions and a bulb syringe to help remove the mucus,” Bring says. “Saline nose drops can help in some circumstances as well. Often parents will use the steam from a shower in a bathroom if [they don’t have] access to a humidifier to help their baby breathe better [despite] a respiratory infection.”
Congestion itself isn’t cause for immediate concern, but if baby’s struggling to breathe, has a cough that sounds like a seal barking, or their skin turns a blue or dusky color, it’s time to make a run to the urgent care or emergency room, Bring says.
“This can indicate that the baby isn’t getting enough oxygen due to inflammation of the airways from the infection,” Bring explains. “Typically oxygen levels can be measured at an urgent care or ER through use of a pulse oximeter.”
If the congestion is accompanied by fever and other signs of illness (lethargy, glassy eyes, refusal to eat, etc.), you’ll want to make that hospital run.
Stock the medicine cabinet.
The baby section of your local pharmacy has almost as many choices as the adult areas, but be wary. There are plenty of items on the shelves that doctors warn against.
“There are very few over-the-counter medications [that] are recommended for young children and almost all of the cough [and] congestion medications should not be administered to children under age 4,” Bring warns.
The American Academy of Pediatrics warns parents against OTC cough and cold medicines, and pediatricians have come out against the use of Vicks Vapo Rub on kids under age 2. Even “natural” remedies such as echinacea, vitamin C, and zinc get the side-eye from the experts.
Instead, stock up on ibuprofen and acetaminophen (e.g. baby Tylenol and baby Motrin), which your pediatrician can suggest dosing out based on baby’s age and weight. In addition to bottles of each, grab bulb syringes for your medicine cabinet (and your diaper bag!), as well as saline nasal drops.
If you can, run cool mist humidifiers in your home to keep the whole family’s sinuses moist and comfortable.
An ounce of prevention…
Avoiding illness is every mom’s goal, but let’s face it: The world is full of germs, and babies are still building their immune systems. While adults tend to get two to four colds a year, kids can get five to 10.
The best ways to ward off serious illness? Good old-fashioned hygiene!
“Parents, caregivers, and anyone around the baby should be vigilant about handwashing, especially during the winter months,” Bring says.
If your baby is 6 months or older, the Centers for Disease Control and Prevention recommends a flu vaccination to help protect them from the flu.
“Getting a flu shot does not give you the flu,” Bring notes. “The immunization gives your child’s immune system a chance to create an immune response to a dead virus prior to being infected. This gives young children a head start for their immune system to start working on fighting the flu in case they do get infected with the virus later in the season.”
If illness does hit, be proactive. Take their temperature. Watch for the signs. Call your doctor. Trust that mom’s intuition. It can make all the difference.