By William Sears, M.D., Babytalk
Cuddly sweaters and crackling fires, snowmen and sleigh rides, coughs, colds, fevers and...ear infections? While on the surface these may not seem to go together, the truth is that infants do become sick more often in winter. The cause has nothing to do with the cold weather. The real reason is that people tend to congregate indoors more with the windows closed, allowing viruses and bacteria to circulate. The best defense for parents is to know the signs, symptoms and treatments of the most common winter illnesses. Here's a guide to what's lurking out there.
Nothing to Sneeze at: Colds and Flu
Colds and influenza are both respiratory infections caused by viruses and are similar in many ways; sometimes it's hard to tell the difference between the two.
What to look for: Generally, the common cold begins slowly with a tickle in the throat and progresses to a sore throat, a stuffy or runny nose, possible headache and fatigue, a mild fever and a cough. Children usually feel better in seven to 14 days. The flu hits suddenly and is characterized by a high fever, chills, a cough, possible nausea and extreme fatigue. Fever and other symptoms usually vanish in five days, but a cough and weakness may linger for another week or two.
What to do: Keep the air flowing. To relieve a stuffy nose, use a nasal aspirator to draw out mucus. A saltwater nasal spray or drops (available over the counter as nasal saline) to flush your infant's nose. Squeeze a couple of drops in each nostril 15 to 20 minutes before feeding, then suction with an aspirator.
Tug of War: Ear Infections
Infants are prone to ear infections because their eustachian tubes -- which connect the middle ear and the upper part of the throat -- are shorter, and more horizontal than in an adult, making it difficult for fluid to drain out of the ears when the tubes are swollen or blocked due to a cold. With acute ear infections, infected fluid is trapped behind your baby's eardrum and causes pain. If fluid remains in the ear for very long after the initial ear infection, the condition is called ear infection with effusion. In these cases, the fluid is not infected and, in general, the only symptom can be mild temporary hearing loss. Three out of four children will suffer at least one ear infection by their third birthday.
What to look for: Watch for crankiness, disrupted sleep and ear tugging. Many kids develop a fever at the onset of an ear infection, but some don't, so any of the previous symptoms is worthy of concern. Other symptoms: failure to respond to sounds, and fluid draining from the ear.
What to do: See your doctor. "Watchful waiting" is usually recommended for infants and children; that is, asking parents to observe the child for 48 to 72 hours before prescribing antibiotics. In general, however, antibiotics are not useful for treating middle ear infection with effusion (since the fluid isn't infected), which often gets better on its own.
Barking Like a Seal: Croup
Croup is a viral infection that causes swelling of the vocal cords and windpipe (trachea), which is responsible for its characteristic barking cough. Because the swelling of the vocal cords may obstruct the passage of air, croup is potentially a serious, though rare, respiratory infection.
What to look for: Croup begins with cold symptoms that develop into a barking cough over two or three nights. It's important for parents to recognize when croup is serious and when it's not: If your infant's cough sounds croupy but she's happy, sleeping and not having trouble breathing, it's unlikely it's serious. Still, watch for the following signs, which mean that swelling of the breathing passages is becoming more dangerous, and call your pediatrician immediately.
Take your infant into the bathroom, turn on the hot water in the shower, and close the doors and windows -- the humid air will help relax his breathing passages. Cool night air helps as well.
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