Through breastfeeding, natural development and vaccination, your baby’s immune system will be developing, but the occasional mild illness is still likely during its first year.
Our guide will help you reduce the risks by recognising illness early and knowing when it’s time to call in the doctor.
COMMON COLD
The first symptoms to look out for when it comes to a cold is if your baby looks miserable or sounds ‘wet’. Mucus running down the back of her throat will make her cough and sometimes her breathing will be noisy with a blocked nose.
From the age of one month, you can give a baby a dose of infant paracetamol to help alleviate the discomfort if she has trouble breathing, eating or sleeping. Check with your doctor before giving her any other medications.
Noisy breathing and a blocked nose can persist for a long time, often six to eight weeks after the cold has gone, as babies take longer than adults to clear mucus. See your doctor if your baby loses interest in food, develops a persistent fever, becomes limp, has difficulty breathing or has blue lips.
COUGH
When coughing is associated with wheezing, a high fever, breathlessness or sleepless nights you need to see your doctor. Always seek medical advice before giving a cough suppressant to a baby or young child.
CROUP
Her cough will sound like a seal bark accompanied by a crowing noise as she breathes in because croup causes a narrowing of the windpipe. More common in toddlers than babies, it’s caused by a viral infection in the upper respiratory tract and may be accompanied by extremely high temperature spikes.
If your baby has difficulty breathing, immediately go to your doctor or the emergency department of your local hospital.
DIARRHOEA
Viral infections like gastroenteritis are a common cause of diarrhoea. You may notice loose, watery bowel motions that are often mucus-like, smelly and an unusual colour. Don’t confuse these with the normal loose green-yellow stools young breastfed babies pass.
The recommended treatment is oral rehydration fluid such as Gastrolyte or fluids that contain sugar and salt, such as (non-diet) fruit cordials diluted to a ratio of one part cordial to 20 parts water. Give these frequently in small amounts for 24 hours. If you’re breastfeeding, this is not necessary; instead, offer your baby extra feeds.
Most children respond best if their normal diet is reintroduced early on during the course of gastroenteritis, although they may vomit after eating or have further bouts of diarrhoea.
While it’s unusual for exclusively breastfed babies to get gastroenteritis in their first three months, rotavirus is the most common cause and can be prevented with an oral immunisation (ask your doctor). Most babies respond to these measures but, if not, take your baby to the hospital.
For most cases of infectious diarrhoea, medication isn’t part of the treatment, with antibiotics used only occasionally. The medications to stop adult vomiting or diarrhoea are dangerous for babies, and must not be given to them.
EAR INFECTIONS
The middle ear is the usual site of ear problems in older babies and toddlers, as their Eustachian tube, which connects the middle ear to the throat, is narrow and gets blocked easily.
Viral infections can cause the throat’s lining to swell, blocking the tube and preventing drainage from the middle ear. This in turn allows a secondary infection to grow behind the eardrum.
Infected mucus can lead to a painful acute ear infection, which may change your baby’s behaviour. She may have screaming attacks, be unsettled or develop a sleep problem. If these occur have her ears checked. Pain relief may be given to your child, but antibiotics aren’t always necessary.
Glue ear – a more chronic collection of mucus in the middle ear – is another cause of infection. It can lead to earaches, especially at night, which means disrupted sleep patterns.
Treatment ranges from observation to the insertion of plastic tubes, depending on the frequency, discomfort and extent of hearing loss.
ECZEMA
This is a dry skin condition that affects babies to varying degrees and doesn’t appear until after three months, so don’t confuse it with the normal newborn flaky skin.
Most children outgrow eczema (atopic dermatitis) before they turn five, and it’s most likely to occur in those who have asthma or hay fever in their families, though about one in five infant sufferers has no such genetic circumstances.
Treatment involves the use of moisturiser, cortisone cream, fragrance-free sorbolene, 50 percent liquid paraffin, 50 percent soft white paraffin formulations such as Dermeze, and Pain d’Alep soap. For more severe eczema, consult a skin specialist.
NAPPY RASH
Ammonia dermatitis – commonly called nappy rash – will appear as small red dots on your baby’s bottom, with an inflamed area of broken skin or even pus-filled spots in more serious cases.
Breastfed babies are less prone to nappy rash, which can occur if a baby is left in a wet or dirty nappy for too long. But some babies will suffer regardless of frequent changes.
The bacteria from your baby’s stools breaks down the urine to ammonia, which irritates and burns the skin. Loose bowel motions, which often occur when your baby is ill, can have this effect after just one nappy. The following treatments may help.
• Start using nappy rash cream at the first sign of broken skin. If it’s persistent, try a cream that is zinc-based and contains an anti-fungal ingredient.
• Don’t use plastic pants (pilchers), as they prevent the evaporation of urine. Use one-way fabric training pants or acrylic nappy covers instead.
• Be aware of nappy preparations or wipes that aggravate the condition.
• After your baby’s had nappy rash, it’s important to allow her skin to be aired between changes for up to 20 minutes.
• In severe or persistent cases, seek your doctor’s advice.
ORAL THRUSH
This infection is very common in babies. It can be acquired if mum had vaginal thrush during labour, if baby or her breastfeeding mum is on antibiotics, or from objects coming into contact with baby’s mouth.
Oral thrush looks like milky transparent bubbles, mostly inside the cheeks and on the inside of the lips. A white tongue can be a sign of thrush, although this is also seen in young babies without the infection. Mild thrush in the mouth of a healthy baby usually doesn’t cause discomfort.
Anti-fungal gels are sold at chemists (use it on your nipples, too). You will also need to boil any feeding equipment, as the fungus that causes thrush can still survive in sterilising solutions.
WHEN TO GET HELP
Seek help or get a second opinion if you suspect your baby is ill and:
• is under three months old, is sick or was born prematurely
• has a high fever
• vomits repeatedly, or the vomit contains grey material or blood
• appears to have severe tummy pains
• has continual diarrhoea or her faeces contain blood
• becomes drowsy and has a dry mouth or dry nappies
• has a severe cough
• has difficulty breathing or her lips are bluish
If you’re worried about a sick child in the middle of the night, you can speak to a registered nurse about your child’s symptoms by calling Healthdirect Australia’s 24-hour helpline on 1800 022 222.
