Keeping Baby Hale and Hearty

Last Editorial Review: 1/30/2005

Keeping Baby Hale and Hearty

WebMD Feature

Lydia Hurlbut admits she was a bit nuts the first six weeks after bringing home her new baby, Kyra. She wouldn't allow children -- healthy or sniffling -- within eyesight of the newborn. She admitted adults to her home only after she carefully screened them for colds and other illnesses and even then she send them off first thing to wash their hands.

"I was a total freak about it, absolutely psychotic," says Hurlbut, who is a registered nurse in Pasadena, Calif. But she's convinced that those draconian measures -- along with breast-feeding almost exclusively for Kyra's first year -- paid off by keeping her baby healthy. "Kyra didn't even get a cold until she was 8 months old."

Pediatricians say infants typically don't get sick much in the first few months after birth, primarily because they're born with antibodies they've acquired in the womb. Breast-feeding can also help protect against certain ailments, such as ear infections and some respiratory illnesses.

Build That Immunity

Nonetheless, it's important to minimize exposure to germs in the first three months because babies' immune systems aren't developed until then, and their bodies aren't as good at battling illnesses on their own yet. Premature infants are at greatest risk of getting sick since they haven't had as long in utero to acquire their moms' antibodies.

"In those early weeks, their bodies don't respond as efficiently as they will when they get to be 3 to 6 months of age," says Dr. Lillian Blackmon, associate professor of pediatrics at University of Maryland School of Medicine and a member of the American Academy's committee on fetuses and newborns.

Even the common cold can be tough on infants since they breathe only through their noses during the first few months and can't cough to clear mucus from the backs of their throats. Their airways are smaller, too. "They get into a lot of distress," says Dr. Blackmon. "They'll be irritable, they won't feed well, they'll cry, and they won't sleep very well."

Avoiding the 'Day-care Flu'

Parents can do a lot to stave off illnesses. "Number one, wash your hands a lot because that's one of the major ways that things are transmitted," says Dr. William Kanto, chairman of the department of pediatrics at Medical College of Georgia and another AAP member of the fetus and newborn committee.

Other popular pediatrician tips:

  • Stay current on immunizations
  • Keep infants, especially under 3 months, away from adults and children who are sick
  • Avoid crowded grocery stores, malls and other public places
  • Choose child care carefully

If you have to send your little one to child care, try to find a situation that minimizes the risks -- not an easy task, since even the best day-care facilities, with the most conscientious staffs, can be awash in germs.

It will also help to limit the number of day-care providers you use: Find a good day care and stick with it, and select a place that separates infants from other children. "Think about whether this will be a family day care with a few children or a large day care," advises Blackmon, "because every time you expand the number of families, you expand the infection risk."

Worried? Call the Doc

The most common illnesses babies get during the first year of life are colds and upper respiratory illnesses, gastrointestinal viruses and ear infections. Most will come down with about six illnesses with fever in the first year, says Dr. Kanto. Those born in the winter, when germs breed indoors, or who live with smokers or toddlers tend to get sick more often.

New parents often have difficulty judging when to call the doctor, but most doctors say it's better to be safe than sorry, and many offices offer call-in times or nurse practitioners to discuss concerns.

Dr. Blackmon tells new parents to call her if their baby:

  • Has a fever, particularly over 100.2 degrees, or a temperature below normal
  • Won't eat
  • Is listless and lethargic
  • Cries continuously
  • Coughs
  • Has loose stools or stools mixed with mucus or blood
  • Vomits most of what he's just eaten

A sick infant's condition can change rapidly, so many doctors suggest a call as soon as parents observe a fever in an infant under 3 months old. Don't simply chalk up a fever to teething, either, since many teething children don't exhibit such symptoms, says Pamela Lemons, a pediatric nurse practitioner at James Whitcomb Riley Hospital for Children in Indianapolis. (Children cut teeth between 3 months and 2 years.)

Gather Your Thoughts

Hurlbut says that calls to the doctor's office will go more smoothly if parents arm themselves with as many observations and bits of information as possible, ahead of time. She realized this recently when Kyra, now 2, had symptoms of a cold that turned out to be pneumonia.

Before You Call the Doctor
Write Down:

  • Symptoms and when they started, such as:

      Trouble breathing; cough or heartbeat faster than usual
      Change in sleeping pattern
      Change in behavior: irritable, crying, tired, lethargic
      Vomiting or diarrhea; number of wet or soiled diapers per day
      No appetite
      Pulling at ears
      Eyes glassy, red or have a discharge
      Skin: pale, clammy, sweaty, dry or shows a rash

  • Why you're worried:

      Are symptoms getting worse?
      Has your baby had a history of this problem or another medical problem?
      Has the baby been exposed to others who are ill?

  • What you've done to alleviate the symptoms or make your baby more comfortable, and what effect these measures have had

  • Your pharmacy's phone number

    "I was able to give the doctor's office another four symptoms that developed in a matter of hours," says Hurlbut. "The more information you have, the more credible you are, and the more they know whether this is something that just needs to be watched or seen right away."

    Above all, trust your own observations and instincts. Even if you're a novice, it doesn't take long to learn your infant's typical behavior and to notice when something is awry.

    "You gain confidence in your judgment as you learn to recognize your baby's cues," says Dr. Blackmon. "Once parents get past that point, they're going to know more about their baby than their pediatrician does."

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