Overview

A common cold is a viral infection of your baby's nose and throat. Nasal congestion and a runny nose are the main indicators of a cold.

Babies are especially susceptible to the common cold, in part because they're often around other older children. Also, they have yet to develop immunity to many common infections. Within the first year of life, most babies have up to seven colds; they may have more if they're in child care centers.

Treatment for the common cold in babies involves easing their symptoms, such as by providing fluids, keeping the air moist and helping them keep their nasal passages open. Very young infants must see a doctor at the first sign of the common cold to make sure croup, pneumonia or other more serious illnesses aren't present.

Symptoms

The first indication of the common cold in a baby is often:

• A congested or runny nose
• Nasal discharge that may be clear at first but might thicken and turn yellow or green

Other signs and symptoms of a common cold in a baby may include:

• Fever
• Sneezing
• Coughing
• Decreased appetite
• Irritability
• Difficulty sleeping
• Trouble nursing or taking a bottle due to nasal congestion

When to see a doctor

Your baby's immune system will need time to mature. If your baby has a cold with no complications, it should resolve within 10 to 14 days.

If your baby is younger than 3 months of age, call the doctor early in the illness. In newborns, it's especially important to make sure that a more serious illness isn't present, especially if your baby has a fever.

Most colds are simply a nuisance. But it's important to take your baby's signs and symptoms seriously.

If your baby is 3 months old or older, call the doctor if your baby:

• Isn't wetting as many diapers as usual
• Has a temperature higher than 100.4 F (38 C)
• Seems to have ear pain or is unusually irritable
• Has red eyes or develops yellow or greenish eye discharge
• Has trouble breathing
• Has a persistent cough
• Has thick, green nasal discharge for several days
• Has other signs or symptoms that worry you, such as an unusual or alarming cry

Seek medical help immediately if your baby:

• Refuses to nurse or accept fluids
• Coughs hard enough to cause vomiting or changes in skin color
• Coughs up blood-tinged sputum
• Has difficulty breathing or is bluish around the lips

Causes

The common cold is an infection of the nose and throat (upper respiratory tract infection) that can be caused by one of more than 100 viruses. Rhinoviruses are the most common.

Once infected by a virus, your baby generally becomes immune to that virus. But because so many viruses cause colds, your baby may have several colds a year and many throughout his or her lifetime. Also, some viruses don't produce lasting immunity.

A common cold virus enters your baby's mouth, nose or eyes. Your baby can be infected with a virus by:

• Air. When someone who is sick coughs, sneezes or talks, he or she might directly spread the virus to your baby.
• Direct contact. Someone with a cold who touches your baby's hand can spread the cold virus to your baby, who can become infected after touching his or her eyes, nose or mouth.
• Contaminated surfaces. Some viruses live on surfaces for two hours or longer. Your baby may catch a virus by touching a contaminated surface, such as a toy.

Risk factors

A few factors put infants at higher risk of a common cold.

• Immature immune systems. Infants are, by nature, at risk of common colds because they haven't yet been exposed to or developed resistance to most of the viruses that cause them.
• Exposure to other children. Infants spend time with other children, who don't always wash their hands or cover their coughs and sneezes, which increases your baby's risk of catching a cold.
• Time of year. Both children and adults are more susceptible to colds from fall to late spring.

Complications

• Acute ear infection (otitis media). This is the most common complication of the common cold. Ear infections occur when bacteria or viruses enter the space behind the eardrum.
• Wheezing. A cold can trigger wheezing, even if your child doesn't have asthma. If your child does have asthma, a cold can make it worse.
• Sinusitis. A common cold that doesn't resolve may lead to a secondary infection within the sinuses (sinusitis).
• Other secondary infections. These include pneumonia, bronchiolitis and croup. Such infections require evaluation by a doctor.

Prevention

The best defense against the common cold is common sense and frequent hand-washing.

• Keep your baby away from anyone who's sick. If you have a newborn, don't allow visits from anyone who's sick. If possible, avoid public transportation and public gatherings with your newborn.
• Wash your hands before feeding or touching your baby. When soap and water aren't available, use hand wipes or gels that contain alcohol.
• Clean your baby's toys and pacifiers often.
• Teach everyone in the household to cough or sneeze into a tissue, and then toss it. If you can't reach a tissue in time, cough or sneeze into the crook of your arm.

Simple preventive measures can help keep the common cold at bay.

Treatment

There's no cure for the common cold. Antibiotics don't work against cold viruses. Try to make your baby more comfortable with measures such as suctioning nasal mucus and keeping the air moist.

Over-the-counter (OTC) medications generally should be avoided in babies. You can use fever-reducing medications, carefully following dosing directions, if a fever is making your child uncomfortable. Cough and cold medications aren't safe for infants and young children.

Fever-reducing medications

OTC pain relievers such as acetaminophen (Tylenol, others) might relieve discomfort associated with a fever. However, these medications don't kill the cold virus. Fever is a part of your child's natural response to the virus, so it may help to allow your child to have a low-grade fever.

Don't give acetaminophen to children under 3 months of age, and be especially careful when giving acetaminophen to older babies and children because the dosing guidelines can be confusing. Call your doctor if you have questions about the right dosage for your baby.

For treatment of fever or pain, consider giving your child infants' or children's over-the-counter fever and pain medications such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin, others).

Don't give these medications to your baby if he or she is dehydrated or vomiting continuously.

Children and teenagers recovering from chickenpox or flu-like symptoms should never take aspirin. This is because aspirin has been linked to Reye's syndrome, a rare but potentially life-threatening condition, in such children.

Cough and cold medications

The Food and Drug Administration (FDA) strongly recommends against giving over-the-counter (OTC) cough and cold medicines to children younger than age 2. OTC cough and cold medicines don't treat the underlying cause of a child's cold and won't make it go away sooner, and can be dangerous to your baby.

In June 2008, manufacturers removed infant cough and cold medications from the market. They also modified product labels on the remaining OTC cough and cold medicines to warn people not to use them in children under 4 years of age because of safety concerns.

Lifestyle and home remedies

Most often, you can treat an older baby's cold at home.

• Offer plenty of fluids. Liquids are important to avoid dehydration. Encourage your baby to take in the usual amount of fluids. Extra fluids aren't necessary. If you're breast-feeding your baby, keep it up. Breast milk offers extra protection from cold-causing germs.
• Thin the mucus. Your baby's doctor may recommend saline nose drops to loosen thick nasal mucus. Look for these OTC drops in your local pharmacy.

• Suction your baby's nose. Keep your baby's nasal passages clear with a rubber-bulb syringe. Squeeze the bulb syringe to expel the air. Then insert the tip of the bulb about 1/4 to 1/2 inch (0.64 to 1.27 centimeters) into your baby's nostril, pointing toward the back and side of the nose.

  Release the bulb, holding it in place while it suctions the mucus from your baby's nose. Remove the syringe from your baby's nostril, and empty the contents onto a tissue by squeezing the bulb rapidly while holding the tip down. Repeat as often as needed for each nostril. Clean the bulb syringe with soap and water.

• Moisten the air. Running a cool-water humidifier in your baby's room can ease nasal congestion. Change the water daily and follow the manufacturer's instructions for cleaning the unit.

Preparing for an appointment

If you need to see your baby's pediatrician or family doctor, here's some information to help you get ready for your baby's appointment.

What you can do

Make a list of:

• Symptoms you've noticed in your baby, including any that may seem unrelated to the reason for which you scheduled the appointment.
• Key personal information, such as whether your baby goes to child care or has otherwise been exposed to someone with a common cold. Include how many colds your baby has had, how long they lasted and whether your baby is exposed to secondhand smoke. It might help to make a note on your calendar the day you realize your baby has a cold.
• All medications your baby is taking, including doses.
• Questions to ask your doctor.

For a common cold, some basic questions to ask the doctor include:

• What is likely causing my baby's symptoms?
• Are there other possible causes?
• What tests are needed?
• What's the best course of action?
• My baby has other health conditions. How can I best manage them together?
• Are there restrictions we need to follow?
• Are there over-the-counter medications that aren't safe for my child at this age?

Don't hesitate to ask other questions you have.

What to expect from your doctor

Your baby's doctor is likely to ask you a number of questions, including:

• When did your baby's symptoms begin?
• Have they been continuous or occasional?
• How severe are they?
• What, if anything, seems to improve them?
• What, if anything, appears to worsen them?
• Has the nasal congestion caused your baby to eat or drink less?
• Is your baby having as many wet diapers as usual?
• Has there been a fever? If so, how high?
• Are your child's vaccinations up to date?
• Has your child taken antibiotics recently?

What you can do in the meantime

Take steps to make your baby more comfortable. These include moistening the air in your home and using saline drops and a suction bulb to remove mucus from your child's nose.