Babies and Infection – My Baby has a Cold and can’t Breathe!
My baby has a cold and can’t breathe! All parents have dealt with colds that seem to all of a sudden start to crop up after 4~6 months of age. Unfortunately most parents have also experienced helplessness when they see their child struggling to breathe. It is especially distressing during this period because your newborn does not quite have the capacity to breathe comfortably through his/her mouth – thus the term obligate nose breathers.
At the time of birth, your baby is blessed with immune help from the mother – antibodies, in the form of IgG is transferred directly from the mother to the baby during the time in the womb. Babies can also receive additional immune help from the immunoglobulin IgA which is only present in the mother’s breast milk and not formula milk. (Although IgG is a wonderful protectant to the baby, IgG is less effective in fighting some bacteria namely Gram-negative bacteria.)
Pediatricians tell patients time and time again to wash/sanitize your hands before touching the newborn baby. The baby’s immune system during the first year is especially weak and it is between 5~7 months where the immune level is at its lowest. During which time, help from the mother’s IgG antibody fades away and the infant “starts” to produce effective levels of antibodies on their own. It is important to note that even at the age of 12 months the immune system as a whole is roughly 60% of the average adult. It is during the transition period where babies are particularly susceptible to colds, other viruses and bacteria. The number one reason for viral and bacterial transmission to babies is not airborne but through the hands. So please wash your hands before you handle the baby. A deeper discussion on babies, infections and the immune system will follow in later articles. This article will now focus on the what to do when your baby has a cold and can’t breathe.
Parental steps to help relieve Acute Nasal Congestion from Colds
- In any type of emergencies it is most important to keep a calm head and be in control – a calm parent will also help calm down the baby.
- Steam the bathroom with hot water from the bathtub. During which time try to calm the baby and clear the nose by lightly pinching the nose and “milking” it downward with a moistened tissue/wipes without scent – scented tissues may actually irritate the nose further causing more blockage. (Sometimes babies do not like moistened tissues touching their face. In this case use your bare hands to do the “milking” but make sure your hand is wet with water.) Fortunately the tears from your baby will moisten the nasal cavity and help loosen the thickened mucus. Do not milk more than 2 or 3 times. Further milking will cause unnecessary discomfort and irritation to the nose.
- Enter the bathroom full of steam with the baby for about 10 minutes – this will help open the sinuses by calming the inflammation and further loosen the mucus which is causing the congestion.
- [Option 1 – best choice] Afterwards, use a nasal suction to suck out further mucus in the nose. (A human-powered suction will provide most favorable results. A suction bulb does not provide enough suction for the mucus to come out. Bulbs used in the hospital are effective in suctioning out amniotic fluid out of the baby’s nose but ineffective in thickened mucus.) [Option 2] Afterwards, wet your hands and once again perform the “milking” action on the nose drawing the mucus out and wipe with tissue – do not perform more than 2~3 times.
- If very little mucus comes but a large amount of “snot” is seen in the nose, use nasal saline drops/spray for children and once again use a nasal suction. (A nasal spray is preferred because drops are less effective than sprays in moistening the mucus and nasal cavities. In some cases drops may cause greater respiratory distress because the saline drops may increase airway resistance. When applying the saline spray make sure your baby is in a position where the head is not tilted back because you want to prevent saline from flowing down to the throat causing more difficulty in breathing.)
- Finally, a cool mist humidifier should be used in the baby’s room especially during the fall and winter months where the air is dry – moistened air will help moisten the mucus and help the cilia in nose clear out the thickened mucus. (Caution to not over humidify the room. This can cause fungal/mold growth and be another cause of rhinosinusitis. The humidifier should be cleaned everyday.)
[Tips on nasal suction.] Nasal suction works best when the baby’s mouth is open. However a “wiggling” technique can be used especially with a human-powered nasal suction – after inserting the suction to the opening of the nose, wiggle the suction quickly from side to side to let air come in during suction. This will prevent the suction from sticking to the inside walls of the nose. A little skill is needed to master this. If one uses a bulb (which is not recommended due to its inefficiency) be careful not to insert the tip into the nose too deeply. Physical irritation of the lining of the nose can cause an even greater swelling of the nose. Also the midline wall of the nose has many blood vessels and damage can occur due to excessive physical contact causing nose bleeds. Do not suction the nose if the child is prone to nose bleeds, have blood disorders, or has had previous trauma to the nose involving nosebleeds for at least 2~3 weeks.
[Tips on nasal saline drops/sprays.] Do not use nasal saline drops that contain other chemicals/drugs besides normal saline and purchase nasal saline products specifically for babies. On another note, there are some mothers who perform saline drops when the baby is lying down. This is okay when the baby has an open air passage and not sick. However the nasal passage is narrowed in a child with rhinosinusitis or inflammation in the nose with congestion. Using drops will create further respiratory distress especially in babies less than 8 months old because they have a difficult time breathing through their mouths. Rather than moisten the passage, the drops will block the airway. A fine spray should be used instead of the drops with the child in an “upright” position.
It is important to note that there are other causes of stuffy noses besides viruses and bacteria. Allergies is another major cause of rhinosinusitis. In cases with allergies, apart from congestion from the mucus, sometimes it is the inflammation of the nasal tissues causing narrowed cavities and therefore causing difficulty in breathing. It is then important to determine whether your child has a cold or an allergy.
Ultimately it is the parents decision to determine whether a trip to the hospital is needed. If you feel overwhelmed and your baby continues struggling to breathe, then a trip to your pediatrician or an emergency room for that matter is the best choice.
Thank you for reading Babies and Infection – My Baby has a Cold and can’t Breathe! If you have any topics that you would like addressed. Please email email@example.com.
- Susan Blackburn PhD RN C FAAN. Maternal, Fetal, & Neonatal Physiology: A Clinical Perspective. 1992
- Richard A. Polin, William W. Fox, Steven H. Abman. Fetal and Neonatal Physiology. 2011