Baby’s first sneeze

FROM baby’s first day out in the world, her body has had to deal with all sorts of unfamiliar foreign bodies. Her immune system is working hard to protect her from disease.

However strong baby’s immune system is, catching the occasional cough or cold will be part and parcel of her growing up.

Knowing what you can treat at home and when you need to bring baby to the doctor will help you to take care of her health, while preventing unnecessary visits to the clinic where she may be exposed to other sick children.

How will I know when baby’s ill?

In the first three months, baby has yet to develop the muscle tone and control to point to areas that hurt or are uncomfortable. You can detect her discomfort by paying close attention to changes in her breathing and feeding.

Of course, there are also obvious symptoms such as coughing and sneezing that will alert you to the fact that she’s not well.

Breathing: Baby’s breath should normally be quite silent, so pay attention to whether she wheezes or her breathing is laboured.

Baby’s breathing rate is normally faster than an adult’s but you should not be able to see the spaces between her ribs during each breath. If you do, or there is retraction of the space below her rib cage, then she is using her accessory muscles to help her breathe.

Feeding: See how much baby drinks during feeds. If she takes less milk than usual, it could be that she has difficulty breathing due to excess mucous.

Feeding makes it more difficult because she may have been using her mouth to breathe, and this won’t be possible while she’s feeding.

Sleeping: If baby wakes more frequently and seems irritable, it could be that she can’t breathe comfortably and thus can’t sleep well. If baby sleeps much more than usual, though, this could also be a sign of illness.

Coughing: Even healthy babies may occasionally cough when their throats are irritated, but if the coughing is prolonged and baby seems like she can’t catch her breath between coughs, this isn’t normal.

Sneezing: If baby sneezes frequently and has a runny nose with clear, watery mucous, she probably has a cold. An occasional sneeze however is all right.

What can I do?

Although your first response may be to rush baby to the doctor, this isn’t always necessary.

1. If baby’s nose is blocked, an infant nasal aspirator may help. This is a bulb-shaped rubber object with a tapered tip. It can be used to remove mucous from baby’s nose by squeezing the bulb, inserting the tip in baby’s nose and releasing the bulb. Avoid using this more than twice a day as it may irritate baby’s sensitive nasal membranes.

2. Gently wipe mucous away from baby’s nose with tissue paper. This is more hygienic than a handkerchief.

3. If baby coughs a lot, try raising the head of her crib by about 5- 10cm by placing a firm, stable object (such as a book or two) under the crib legs or base. Do not raise just the mattress as baby may find her way into the space between crib and mattress, and could suffocate.

4. If possible, breastfeed baby more frequently than usual. This will comfort her, and the extra fluids may help to loosen phlegm in her throat. Breast milk also contains an abundance of antibodies that will help with her recovery.

5. Cuddle baby to give her reassurance and distract her from her coughing and blocked nose.

Bring baby to the doctor if?

Ø Her breathing is laboured and/or irregular or very rapid

Ø The phlegm and mucous is not clear and colourless

Ø She has been coughing or her nose has been blocked for more than a day

Ø She has difficulty feeding or feeds less

Ø She has a temperature of 39°C or more

Ø Even if her temperature is less than 39°C, her fever has lasted two days or more

Ø She cries inconsolably and seems irritable

Ø She vomits every time she coughs and is not able to hold any milk down

Taking baby’s temperature

If possible, use a digital thermometer rather than the conventional mercury type. When you first get the thermometer, bring it to the clinic to compare its measurement with that of the doctor’s mercury thermometer.

Alternatively you can buy the type that measures baby’s eardrum temperature. Place the thermometer right under baby’s armpit and hold her arm close to her body to ensure the thermometer bulb is completely covered. When using a thermometer that measures through the ear, pull the ear backwards to straighten the ear canal and insert the nozzle of the thermometer and press the button until you hear a beep. Baby’s temperature will be recorded on the little screen.

Wait until the digital thermometer beeps or, for a conventional mercury thermometer, wait at least 90 seconds before you read the temperature.

Info: TheStar, Sunday February 3, 2008

POSITIVE PARENTING by Dr ZULKIFLI ISMAIL

> Dr Zulkifli Ismail is a consultant paediatrician, immediate-past president of the Malaysian Paediatric Association and chairman of the Positive Parenting Management Committee. The Positive Parenting Programme is managed by Malaysian Paediatric Association. For further information, please visit www.mypositiveparenting.org. The information provided is for educational and communication purposes only and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.