Navigating the Seas of Snot: Tips for Managing Your Child’s First Upper Respiratory Infection (and the others yet to come.)

Your child will likely experience many cough and runny nose episodes in the first year of life. Most of the episodes are caused by viruses and are self limited. Even though most upper respiratory infections (URIs) improve with time; it can be upsetting when your child has a cold, especially the first cold. Seeing your child uncomfortable, coughing and sneezing is bothersome as a parent. They are little and can’t blow their noses. It can sound scary when babies are coughing. This article is meant to help you understand how to best make your child comfortable when they have a URI and when to be concerned and seek further medical attention.

What is an URI?

Upper respiratory infections are what we tend to think of as colds. Believe it or not, young children can get between 6-10 URIs a year and are often concentrated in the winter months. It can feel like your child almost always has a cold! URIs can be caused by many different viruses. Children typically get these from touching the hands of someone who has the virus or surfaces which have the virus on them.

What symptoms accompany a URI?

Symptoms of URI include nasal congestion, nasal discharge and cough. URIs can be accompanied by fever as well. Children often exhibit decreased appetite and throat soreness.

How can I help my child?

URIs are caused by viruses. There is no magic medicine to make a URI go away. Antibiotics are not useful in URIs since they do not work against viruses. Luckily, there are many ways to help your child feel more comfortable and alleviate the symptoms of a URI. Young infants breathe through their noses so when congested can feel very uncomfortable. In infants you can use nasal saline drops 4-5 times a day to help with congestion. You can use the bulb suction aspirator as well, but be careful not to over suction. Do not suction more than 2-3 times a day at most. Over suctioning can create irritation of the nasal passages which will increase the child’s congestion. For cough, using steam can be extremely helpful. To create a steamy environment, turn on the shower as hot as it goes and allow the bathroom to steam up. Then sit in the bathroom (not in the hot shower) with your child for 10-15 minutes. You may need to do this multiple times a day during the course of the illness. Using a cool mist humidifier is helpful as well. It is important to make sure the humidifier is properly cleaned. In children older than one year old, giving a teaspoon of honey before bed time can help decrease the severity of the cough. NEVER give honey to children under the age of one year.

Encourage your child to drink plenty of liquids. Do not force your child to eat. When you have a cold, your appetite is often decreased. The same is true for your child. Make sure they are drinking frequently and monitor their urination. Your child may be uncomfortable with a cold. You may use acetaminophen or ibuprofen (if greater than 6 months old) to help them feel more comfortable. If your child’s throat is hurting, they may not want to drink as much. Try to give them pain medication and then encourage hydration with liquids about 45 minutes afterwards.

Fever can commonly accompany an URI. If your child has a fever you can give them medication to feel more comfortable. For more information about fevers see this previous article. It is NOT recommended to use cough or cold medications in young children.

How long do URIs last?

Symptoms usually start about 1-3 days after exposure to the virus. Most URIs last 5-7 days but a child can have lingering symptoms for up to 2-3 weeks.

What can I do to prevent URIs?

Hand washing is the best prevention. All caretakers should wash their hands after sneezing or before food preparation. Do not share food, drinks or towels. Wash your child’s hands often especially after playing in a common space.

When should I seek further medical attention?

-if your child is under 2 months old and has a temperature of 100.4 or greater

-fever lasting greater than three days

-if your child hasn’t had a wet diaper in over 8 hours

-if your child is complaining of ear pain

-if your child is making a high pitched sounds on breathing

-if your child is working harder to breathe meaning you notice the belly moving up and down or pulling in of the area between the ribs

-nasal congestion lasting greater than 2 weeks

-cough lasting greater than 3 weeks

-unusual irritability or sleepiness

So now you can survive the first fever and the first cold. Unfortunately, children get frequents URIs and it is likely your child will get sick again at some point in the future. It is always hard when your baby isn’t feeling well but, now you are prepared for how to help them and what to look out for. In most cases these are self limited episodes and there are things you can do to make your child more comfortable (and as a benefit the steam is good for your skin). Luckily, as children get older and don’t put things in their mouths as much these episodes tend to lessen in frequency. Happy hand washing!

Photo credit: Michael Cramer