Having a sick baby can be a terrifying experience for new parents. It’s hard to know exactly what to do when your little one’s fever is rising and they can barely breathe because they’re so congested. So, how can you help your baby feel better (since you can’t use medication)? And how do you clear all the snot and boogers from your baby’s nose so they’re more comfortable? And what’s the general rule when it comes to babies and fevers?
Your Baby's Boogers, Snot and Colds
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DR. TARA ZANDVLIET: Your baby's first cold can be a concerning time. She seems so congested. Do those nose bobs really help? Should you be concerned about the boogers and snot nose affecting her breathing? When should you call the doctor?
I am Dr. Tara Zandvliet, Board Certified Pediatrician and you are listening to Newbies.
KRISTEN STRATTON: Welcome to Newbies broadcasting for the Birth Education Center of San Diego. Newbies is your online on the go support group guiding new mothers with their baby's first year.
I'm your host Kristen Stratton. I'm also Certified Birth Doula, Postpartum Doula and Owner of In Due Season Doula Services.
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KRISTEN STRATTON: Great, let's meet our panelists, Sheila
CHAELA JAMIESON: I'm Chaela, I am 25 years old. I am a group technician at [inaudible]. I have a son named Damien, he is 5 months old and he is the cutest baby on earth.
KRISTEN STRATTON: That's awesome, Ruthii?
RUTHII SLATTUM: I'm Ruthii Slattum, I am 28 and I own two businesses. I paint pregnant bellies and I am also a clinical lactation specialist and postpartum doula. I do pretty much everything postpartum and then I have three children, I have a five-year-old boy, two and half year girl and Piper here is six months.
KRISTEN STRATTON: Yes, we have a baby in the studio
SUNNY GAULT: Yes, and she is so good, she is looking at all my computer stuff and going what is all that over there?
KRISTEN STRATTON: Great, welcome to the show.
SUNNY GAULT: Okay, so we have a news headline here that we want to chat about and it’s about food allergies and they are thinking that there might be able to predict what kind of allergies your child may have in life when they are newborn, and it’s through the blood.
Basically, they're a bunch of researchers and this happened in Australia and they studied more than one thousand newborns. It says they took blood from the children’s umbilical cord and profiled the immune size and molecules floating within, and the children were then tested for food allergies a year later. It says based on this tests the team was able to pinpoint a type of an immune cell called a monocyte and it says those numbers were higher in the code letter of kids who went to develop food allergies, does that make sense?
DR. TARA ZANDVLIET: It can, very interesting, there's a lot of different types of white blood cells, eosinophils are the ones that make you swell up with hives if you get antibiotics that you become allergic to.
Monocytes are interesting, it’s a different kind of white blood cell not very well known, and what exactly it does although we do know that when you get mono it’s called mono because monocytes are way high and they look weird
It is interesting, I wonder if the babies have the high monocytes because they are primed to become allergic, we call them “atopic” children and they are prone to get asthma and allergy some things, and maybe that is because they have a high monocytes they then develop that or is it that those kids who were born like that for whatever genetic reasons, family reasons whatever, have monocytes and that's just like a sign? I don't know, it’s interesting
SUNNY GAULT: Well it does say here immune systems are so complex. A variety of factors can influence everything so obviously, this is one thing that they are looking at.
Do we have any parents here that have kids with allergies?
CHAELA JAMIESON: Yes I do
SUNNY GAULT: You also do doctor Zandvliet?
DR. TARA ZANDVLIET: I do, my daughter has a bad walnut and tree nut allergy, absolutely
SUNNY GAULT: Would it have been helpful for you to have information like this? I mean the other option what they eat, they just break out or something happens?
DR. TARA ZANDVLIET: It just breaks out you end up going to ER
SUNNY GAULT: Yes, and it can be terrifying, right?
DR. TARA ZANDVLIET: But you don't know specifically which food it’s going to be. You just know that they are going to develop something that they could. It might have changed maybe how we introduce foods maybe earlier maybe, a little bit more aggressively so that she could not be so protected from things and we wonder, ooh what that is?
KRISTEN STRATTON: You know to keep Benadryl on hand or something
DR. TARA ZANDVLIET: Yes, exactly, how can I prepare maybe in advance? It is good to prepare always.
KRISTEN STRATTON: Then there are different levels of allergies, there is anaphylactic but then like my son has gluten, he just gets really mean and uncomfortable, he's not going to stop breathing
DR. TARA ZANDVLIET: Exactly, then we often would call that a reaction and then the allergy will kind of result in the hives and anaphylaxis but I think they are all versions of, and maybe that some of this immune cells, this white cells or maybe even the antibody type like IGE is more like the hives and emergency anaphylaxis but IGG is more that subtle behavioral staff, stomach pains, funky joint pains, weird poop. It’s like don't give him that again
KRISTEN STRATTON: We have a baby poop episode
SUNNY GAULT: Yes we do. Kristen any thoughts on this?
KRISTEN STRATTON: Yeah you know it’s interesting. It certainly would be useful information like you said you don't know exactly how the allergies are going to manifest, so predicting what the trigger would be, how severe the reaction is going to be, that kind of information we still don't have. I also recently read an article that there was research done about peanut allergies and introducing peanut butter, I don't know the method was but at earlier age because they were saying we wait till 2 or 3 but they are saying that early introduction actually lessened the
DR. TARA ZANDVLIET: In fact, this is the one bad thing about the internet. Nothing dying on it, the American Academy of Pediatrics about two years ago suggested introducing peanuts and nuts, like little peanut oil in what you fry or whatever or you let them suck a little bit peanut off your finger as earlier as four or five months old
They found that if you waited until three years old, there are higher rates of allergies and it does look like early introduction decreases your rate on non-allergies.
SUNNY GAULT: All right. We will go ahead and put a link to this on our Facebook page so guys can check it out. The article was written [inaudible]. It is a reputable source so check it out.
KRISTEN STRATTON: Today on Newbies we are discussing your baby snots, boogers, and colds during the first year of life. Our expert today is Dr. Tara Zandvliet who is certified in three separate specialties, pediatrics, internal medicine and integrative holistic medicine.
Thank you so much for joining us Dr. Tara Zandvliet on the show
DR. TARA ZANDVLIET: Thank you, good to be here.
KRISTEN STRATTON: Dr. Z, parents are often concerned the first time their infant catches a cold. What are some of the general symptoms of the common cold and what should a parent expect to see in their infant?
DR. TARA ZANDVLIET: They can get a cold as early as a couple of weeks old and it is almost always in the nose or as we say, above the neck, the head cold, so you will probably see a running nose, it going to be clear, there might be a little congested, they will be fussy, they may want to nurse a lot but not really drink a lot when they were nursing, they sneeze a lot, although new born sneeze all the time so that alone is not the symptom, they might have a little cough and a fever, but it will be low grade like 100 F if you decide to check.
As the cold progresses, they get yellower snot so yellow is not usually bad, but you get thicker yellow, the cough progresses generally and they can't eat well the more congested they get.
Babies are obligate nose breathers, they have to breathe through their nose. They don't breath through their mouths unless something happens and they cry. If they can't breathe through their nose they get very upset and they feel like they are suffocating. They open their mouth to cry and low and behold they can't breathe. They are not going to suffocate, but they don't know that and it is very upsetting to them. Usually eating is the biggest problem because they have to use the mouth to eat and so they have no way to breath.
KRISTEN STRATTON: How long does the cold usually last?
DR. TARA ZANDVLIET: It is a lot longer than you think. The average is ten days so the shortest cold is going to be seven or eight days. They actually say that by the time last symptom is completely gone you are talking three weeks.
Usually, the first week is running nose, cough, sneeze, scratchy throat. The second week is going to be thick and congestion. You will have thick snots, it is all swollen so they can't get anything through their nose, that is the second week, and then it starts to improve by the end of that. If they have a cough starting, that is when it starts to ramp up and get bad.
The third week is where everything is getting better and most of the time you even forget they had a cold except for the fact that you are still using tissues.
SUNNY GAULT: When should a parent consider contacting a child's doctor?
DR. TARA ZANDVLIET: The awful warning signs is when a child under 2 months old gets any temperature over 100 F. You go right in and talk to the doctor immediately and if they can't see you within 24 hours you then you walk right into the ER. That is my big point. Once they are older, you should at least contact the doctor if their fever is 102 F or over.
Generally, colds will not do a 102 F fever, there is something else going on generally. If when they are nursing they just can't nurse because they are so congested, or even worse if their lips turn a little purple-blue when they are breathing, you know trying to nurse and breathe at the same time. If the cough gets really wet and phlemy, I'm not talking about [make the noise] up in the nose and mouth, I am talking down deep, right?
If they are fast breathing, if their nose is faint a little lusters or flaring, if when they breathe you can see how the ribs suck in under the rib or bottom of the neck or in between the ribs, if they are not peeing and their diapers are too dry, if they won't stop crying, if they have ear pain or they seem to be in pain, they are not consolable, I mean you try to console them and they will not console, if they are whizzing and if anything turns green. Green is not necessarily bacterial but green is not a normal good color, so green is when you start being extra careful, or any blood or brown in it too.
KRISTEN STRATTON: Panelists do you remember the first time your baby was sick as an infant?
RUTHII SLATTUM: My first it was terrifying. I just didn’t know what to do and they can't breathe. It was very scary. You don't know what to do, because you think if it was an older kid you could figure out how to do, but none of the over the counter stuff is for brand new babies, it’s all for older babies so how do you help your own kid you don’t want to be overly panicking new mom and so what do you do? It was tricky that first time. The third one she has had a cold for three weeks and I am like she is not purple and she is eating fine, so you just play it for a couple of weeks and you figure it out.
KRISTEN STRATTON: What about you Chaela?
CHAELA JAMIESON: Yes, he actually got his first cold in the three months or shortly after and it is freaking me out because as soon as he started getting sick I was worried because at two weeks old he got UGI so any fever freaks me out. I called the doctor and he said to come in for a small visit but wait until two days because he sounds perfectly fine and so then when I took him in for a small visit to the doctor and he said it is just a cold, it was fun.
KRISTEN STRATTON: I actually have a funny story, so my oldest when we got discharged from the hospital, they sent us so much paperwork that said to call a pediatrician if the temperature dipped below 98 F into the 97 For if it was over 100 F. Of course, the first time mom that I was, I just took her temperature and it was like 97.4.
So I called at 3 a.m to the Naval hospital because my husband is in the military, we are at the Naval hospital was our nearest option for medical care and they called the poor Pediatrician on call woke her up in the middle of the night and the first thing she asked me when she calls me she goes is this your first baby? And I am like yes, of course like holding back tears she's like the baby is fine.
But actually she was pretty healthy, my second child was born in the winter during cold and flu season and he got a cold around like six weeks old and I was very concerned. I called my brother who's a nurse and he's like “yeah that’s what's happens when you have a baby in winter, he will be fine,” I have definitely learned the game and anxiety, and now that I have three am like yeah wherever he's fine
DR. TARA ZANDVLIET: It happens to doctors too because you know I’m a pediatrician, and I was one before I had kids then I have my first and the first cold she gets you know I slept with her am like watching her breath is she going to go and I know of the horrible things can happen,
KRISTEN STRATTON: Right
DR. TARA ZANDVLIET: So I’m watching for all the
SUNNY GAULT: Sometimes you know too much
DR. TARA ZANDVLIET: Yes, I could not go to sleep, I thought something for sure was going to happen
KRISTEN STRATTON: Well that is comforting to hear.
RUTHII SLATTUM: One the things is if you are breastfeeding and if you have a baby who their temperatures is too low or their temperatures is too high is stick him between your two breasts because breasts tissue is the only human breasts and it can help regulate the temperature and that’s one of the things people don't realize. If they are cold you know hold against me but if they are too hot I can't hold them because I will make them warmer but stick in between the lovely memories and it will help them cool down.
SUNNY GAULT: We just had that actually what it was less than a week ago maybe three or four days ago, so I am still breastfeeding my twins and they are like twenty-six months. One of my twins was really sick, she had really high temperature and when you know when your babies have high temperature they want to be near you they want mommy to hold them and she says nurse because we don’t have fun names for my boobs.
So, she did that and my mom said no that’s the worst thing, she was thinking milk will be bad, like cow's milk and stuff and you know if you have a cold and I said like mom do you know how many antibodies are in my breast milk? I can't think of a better thing to do for my child right now so I agree with Ruthii. That is something that people don't realize but it's so good for the baby.
RUTHII SLATTUM: Your body knows that you are getting sick before you do and you know you are kissing on your baby you are taking in bio sampling and so your body is generating antibodies for your sick baby before you even know your baby is sick.
SUNNY GAULT: So amazing.
KRISTEN STRATTON: Well doctor is there any other remedies for colds that you recommend or you even discourage from parents using?
DR. TARA ZANDVLIET: There are actually, so in terms of what don't do, I'll start with that because they are small in numbers. We actually recently five or six years ago took most of the cold remedies for kids off-market under two years old. The reason is pseudoephedrine and all these things even the antihistamines raise the kid’s heart rate. This makes them not dangerous but it’s not really healthy they did have a couple of deaths. A cold is not fatal but the medicine could be and so that’s why we say that’s it, so often the doctor would give you something that is very neurotic about the dosing if it is really severe.
So, that’s your big one, the other big one I would say is everyone knows the best thing for a cough is tea with lemon and honey. I’m sorry but it trumps for adults and for older kids, anything out there right.
Under one year old you do not give them honey, do not do it. I will tell you right now many of the homeopathic cough syrup have honey in them and when I was in training, we had a child in the Intensive Care Unit on life support because of bachelorism from a homeopathic cough syrup based on honey. We didn't really have a whole a lot of warning signs all over our medicines but bachelorism they can survive as long as they are getting good, medical care the child was up and growing again a month later but it was scary as how can a parent just kick themselves but how do you know, and so I’m telling you right now, no honey. No honey for your baby okay.
Other than that there are a lot of good things you can do in fact all the natural remedies are better than anything that’s on the market anyway. The first thing is and I always kind of divided up into remove obstruction and let them make feel better right. So, remove obstruction they cannot breathe through their nose because that is what bugs them the most.
Yes, booger removal. If you can get with your fingernail go for it. I have mothers who leave their pinky just a little longer, their fingernail just for that. Anyway, don't poke them. That’s where the bob’s syringes come in or the freederm. It works I will tell you dry boogers don't come out that way. They do not so this why we bring up number two which is the saltwater drops.
Right so use the saline drops to wet the booger down and suspended it in a solution that you can suck right out anywhere you want. One thing I always say to new mothers don't push down on the boob once in the nose or you are going to blow some air up in their nose they going to hate you.
Squeeze it first then stick it on the nose then suck it out. If you use the freederm, don't suck too hard because you will be tasting it so that’s the bad part about the freederm which is basically one long tube you put it in the nose and you suck it out with your mouth.
After removing the boogers, the next best one is breast milk in the nose, drop two each side it is fabulous
KRISTEN STRATTON: I use a boob syringe because apparently, I don't have that good aim with my nipples
RUTHII SLATTUM: I express some into a medicine cup personally and then I can wherever am trying to get. Because you use it, even if it is for pink eye because you are trying to get it into the baby’s eye and the baby is like why aren't you nursing me? Breast milk doesn’t just go in one direction, it goes everywhere. So that is what worked for me, I still expressed it into a little cup or something then I can
CHAELA JAMIESON: I did that but then I used the bob. I have used it in the ears
DR. TARA ZANDVLIET: It works beautifully, it has all those antibodies in it, so it’s better than any medicine out there. Another thing that works great is that if they got a really bad wet cough, make them wear humidifiers, breathing in a steam of some sort. With an infant you cannot get them to breathe steam out of a boiling water in a bowl because they will splash their hands in it, it’s guaranteed.
In a shower room you close the bathroom you turn on the hot shower, and you sit with them outside the shower so you don’t burn them, and let them breathe it in but the thyme whether it’s thyme in your kitchen, dry thyme, fresh thyme or thyme oil essential doesn’t matter you put that in that heat and they breathe in it’s an antiviral, it’s an anti-bacterial and it opens the lungs just like how albuterol does for asthmatics.
It’s beautiful for that and the last little thing if they absolutely cannot move any air through their nose and they have to eat, there is an over the counter prescriptions medicine, it is a decongestant just like the nasal spray decongestant that adults have but in a baby dose, it’s called “little noses” and it is Neo-Synephrine. You cannot use it much, one drop each nostril about ten minutes before you want to nurse they can breathe while they nurse because nursing is more important than the smaller side effect that you could get you just can't use it for more than a couple of days here and there.
KRISTEN STRATTON: When we come back we will continue our discussion about those pesky boogers and snots. We will be right back.
KRISTEN STRATTON: Welcome back to the show. We are talking to Dr. Tara Zandvleit about how to help your infants during their first cold.
Dr. Z, what is the general rule for infants over two months in regards to fevers?
DR. TARA ZANDVLIET: Okay so fevers help you, the temperatures rise for a reason. It burns out and kills the virus or bacteria’s that you. The fever is not dangerous and I always tell people if you are worried about brain damage from fever, it doesn’t even start to happen till 107 F degrees. So don't worry about 104, it’s just that at that point they are just miserable.
So you want to strike the balance between letting the fever ride but letting your child be comfortable enough so that they can eat and sleep because that’s what also going to help them. So a lot of times I would say if your kids get fever 101, 102 give them a test dose of Tylenol or Motrin and usually under six months of Tylenol over six months it can be either and see what happens.
If give them a test dose and they perk up, they are kind of themselves, they just look a little cranky, you know it’s nothing major serious. You can let the fever ride and there is no particular number at which you have to use Tylenol or Motrin. Most kids once they reach 103 /104 are going to be so miserable it is going to be worth it.
KRISTEN STRATTON: What does test dose mean?
DR. TARA ZANDVLIET: It is like one dose weight appropriate. A full dose but just one dose and see what happens, okay look they are playing, they are hitting their brother again, great. Wonderful, I don't have to use this every four hours I can let it ride and a lot of people use it at night so it can help them sleep.
KRISTEN STRATTON: Panelists what are your experiences with fevers? We will start with Chaela.
CHAELA JAMIESON: Well we had this low-grade fever when he had a cold and I only gave him some Tylenol at night to help him sleep because he wasn’t sleeping. I use the dose when I give him Tylenol at night. Yes, it was great.
RUTHII SLATTUM: For me, with fevers, I typically don't really address it until it gets 102. I will do a half dose of Tylenol before bed because I don’t want it to spike in the night when I am not on it. We also do the tepid bath as our big thing that we start with it a little warmer then you let it cool.
My poor first baby, I thought a tepid bath meant sticking them in cool water to stop the fever. No, you start with a warm birth and you let them in there long enough to cool down. That was one of those "tepid baths, I know what to do but I didn't". My poor first born, he is fine, he lived, he is hardy.
SUNNY GAULT: I love the bath idea that was some of the first things my mom told me to do. When my first baby was sick, she was like you need to bring it down right away get him into some sort of tepid bath and then just let him splash around, play with their toy and it somehow gets their mind off of it too if they are not feeling well.
That is always my go to, in fact, my three year old recently had a temperature of 106, I have never seen this and I was like I need to get home, but it turned out to be fine. The first thing I did was take him to the bath and make him feel as comfortable as possible.
DR. TARA ZANDVLIET: We add absence salt now to which helps if they are dehydrated, and it just makes them soft.
KRISTEN STRATTON: Dr. Z we sometimes hear that children should stay home from daycare or playdates if they have a running nose, when is it safe to be around friends or return to child care when the baby still has snot running down?
DR. TARA ZANDVLIET: In this country or other countries? In this country, we are pretty notorious about letting our kids just run around with snotty noses and I have to say I am on the fence and most doctors are. When they have the running nose usually the first week of the cold before it turns thick yellow, it is contagious. But, what are they going to give other kids? A cold.
In some ways, that is how we build our immunity, we have to get this cold at some point so a lot of people are like just bring him to the daycare, everybody is going to some cold and it just builds their immunity at some point and it is okay. If they have a fever, keep them home. I call that 100, I think officially AAPM most MD's will say 100.4, I would like round numbers, 100 works for me. So, if they have a temperature of 100 24 hours of no fever and then they can go back. Once the snot is thick, in general, they are not contagious anymore. It has moved on. It gets thick and yellow because the white blood cells are in it fighting it so all of a sudden it is neutralized, so then it is not as contagious.
KRISTEN STRATTON: That is good to know because more people would think the opposite. That is really good to know. When would we suspect an infection that needs to be treated?
DR. TARA ZANDVLIET: Higher fevers is a big clue. If you get a 106, I would say that most of the time it is viral. However, if it is like an ear infection, clearly the body is not fighting it well, it has gotten deep, so at that point, it needs to be treated generally. Before that they have an ear pain, you treat that, I don’t worry so much about ears.
If a cough is wet and they have a fever, definitely. If a cough is wet more than a week, you definitely want to be looking at that, like the warning signs I gave before, definitely you can say there is something deeper going on.
KRISTEN STRATTON: Panelists what have you learned about that first cold now that you are on the other side of it, Sheila?
SHEILA: Not to call the doctor and think it is whooping cough as soon as he starts coughing and 99.9 percent it is not a deadly fever and if he is not sleeping well let him stand up rather than lay down at night. That helps him actually breathe well through the night, so that was probably the biggest helper.
RUTHII SLATTUM: Oh I laugh, the older they get the easier it is to deal with it. It is really that first three or four months that is so scary because they don't breathe through the mouths, they are nose breathers. Once they start to get that under control a little bit more, and they are designed that way so they don't for a whole breastfeeding which is also important.
Now I literally keep sailing on him, I have a nose freederm, I have Tylenol somewhere in the recesses of my fridge because we get ants. It is more to make sure the kid has enough to eat and enough sleep and we don't really treat it until the fever is high or they are not sleeping or they are not eating, then we deal with it. The little babies the big things are she is eating, as long as she is eating she is not that unhappy
KRISTEN STRATTON: Thank you so much Dr. Z and our lovely panelist for chatting with us today about colds, snots and boogers. For our Newbie Club members, our conversation will continue after the end of the show when Dr. Zee will offer some tips about ways to keep your new baby healthy during cold and flu seasons.
For more information about the Newbies Club please visit our website at www.newmomymedia.com.
SUNNY GAULT: All right it is time for “baby oops” segment where you guys send us your funny stories of things that have happened between you and your baby for this first one year.
This one comes from Merissa, she writes; "After we got our daughter home from the hospital, I was very tired trying to entertain our four-year-old son and make sure he did not feel left out. When I went to bed that night I was really tired but my daughter wanted to eat. I set up some pillows in my booby and sat down on the bed to nurse her. I must have fallen asleep because I woke up to my husband laughing in the doorway, I was sitting there with my boobs hanging out and my daughter was spread out on her back across the booby with milk dueling down her cheek. My husband said he thought he was looking at an Amazon tribe, just looking at us. Not so sexy.”
All right, we are going to say thank you so much for sending this in. I have been there, I have done that. For some reason when I breastfeed I get sleepy, right, and you are already sleep deprived, so I have been there mamma, I have been there. All right, if you guys have a funny “baby oops” story that you want to share with our audience we would love to hear it. You can send us an email through our website, www.newmommymedia.com or new way you can send us a voice mail straight through our website, so head over to www.newmommymedia.com for more information.
KRISTEN STRATTON: That wraps up our show for today. We appreciate you listening to Newbies.
Don’t forget to check out our sister show:
• Preggie Pals for expecting parents
• Parent Savers for moms and dads with infants and toddlers
• The Boob Group for moms who breastfeed and
• Twin Talks for parents with multiples.
Thanks for listening to Newbies. Your go-to source for new moms and new babies.
This has been a New Mommy Media production. The information and material contained in this episode are presented for educational purposes only. Statements and opinions expressed in this episode are not necessarily those of New Mommy Media and should not be considered facts. While such information and materials are believed to be accurate, it is not intended to replace or substitute for professional, medical advice or care and should not be used for diagnosing or treating health care problem or disease or prescribing any medications. If you have questions or concerns regarding your physical or mental health or the health of your baby, please seek assistance from a qualified healthcare provider.
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