Tag Archive for: flu season

Baby’s First Sniffles? How to know when it’s RSV

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As if we haven’t spent enough time talking about viruses over the last couple of years, this winter flu/cough/cold season has gotten off to an early and rocky start. Parents of young children (especially those under two) have likely seen much about the high levels of viral activity in the area. 

We’re going to focus on RSV in babies and young children – this virus is currently keeping lots of littles (and their parents!) awake at night and sometimes sending them to the pediatrician’s office or urgent care.

What is RSV anyway?

Respiratory Syncytial (sin-SISH-uhl) Virus (RSV) is a common, respiratory viral infection. For most, it typically causes relatively mild, cold-like symptoms, usually lasting a week or two. However for young children and the elderly, it can be much more severe. It is the leading cause of pneumonia and bronchiolitis (inflammation of the small airways in the lungs) in children under one-years-old.  

How to protect babies from RSV:

  • Wash your hands frequently and require anyone who comes into contact with baby to also wash their hands
  • Encourage family members (especially siblings!) to avoid kissing or touching baby’s face and hands
  • Remind everyone to keep their hands off their face/mouth 
  • Cover coughs and sneeze (and promptly wash hands again)
  • Encourage visitors to your home to wear a mask and wear your mask in public settings
  • Clean and disinfect high touch surfaces- door knobs, light switches, railings and toys that end up in baby’s mouth
  • Avoid close contact with sick people: this includes staying out of pediatrician’s office/urgent care unless absolutely necessary

Common symptoms (older infants and toddlers):

  • Excess mucus or runny nose
  • Decreased appetite
  • Coughing/wheezing
  • Fever

In very young infants (under 6 months) you may only see:

  • Irritability or general fussiness
  • Decrease in activity 
  • Poor feeding
  • Wheezing

How to treat RSV in babies at home:

  • Prevent dehydration – fluids and frequent smaller feedings, suction nose just before feeding.
  • Saline nose drops with gentle suctioning.
  • Keep a cool mist humidifier running as much as possible.
  • Manage fever and discomfort with skin to skin, cool compresses and OTC meds – acetaminophen before 6 months of age, ibuprofen is ok after 6 months. 
Avoid the following for infants:
  • Over-the-counter cough/cold medicine (unless recommended by your doctor)
  • Aspirin or other pain relief medications
  • Vapor rubs/oils like Vicks, eucalyptus, etc either applied to skin or defused

When to seek medical care:

  • Trouble breathing – fast breathing, blue tinged skin or lips, pulling hard to breathe (see the AAP’s video on Signs of RSV in Babies)
  • Fever over 100.4 for a newborn (under 4 months of age)
  • Dehydration – fewer than 1 wet diaper every 8 hours
  • Lethargy – significant decrease in activity or alertness. Trust your instincts here – you know your baby best. 

Your pediatric care provider is able to treat the vast majority of infants and young children with RSV. In the event that your usual pediatrician is not available (after hours, booked, etc) or has recommended more immediate care, a pediatric specific urgent care is your next best option. Unless recommended by a pediatric provider, avoid the ER if possible. Our local pediatric emergency departments are flooded with patients, so if you absolutely have to go to the hospital, pack plenty of patience. 

If this was helpful, be sure to check out our tips for keeping baby healthy or traveling while pregnant or with a baby during the holiday season!

 

Pro-Tips for Keeping Baby Healthy this Holiday Season

You’ve made it! Whether you’ve traveled minutes, hours, or days, you are standing outside the door of your favorite relative’s home and are about to ring the doorbell. You made the trip fairly easily (perhaps in part because you reviewed our expert tips in the Doulas of Baltimore blog on traveling with baby for the holidays with newborns), but now are trying to talk yourself out of hopping back in the car with your 27 pieces of paraphernalia and your precious newborn because you know that on the other side of that door wait two dozen relatives fighting over who gets to hold the baby first and all you’re worried about is keeping baby healthy. But it’s ok! We’ve got you covered.

Read on to get expert tips on keeping your baby healthy during holiday visits!

Just as traveling with an infant requires preparation, so does braving a crowd of well-meaning but quite possible germy loved ones. Your advance work will require a conversation or two with the hosts of the gatherings you’ll be attending, explaining that your pediatrician (always blame it on the pediatrician) has made you promise that NOBODY will be kissing the baby, not even on the tops of their heads or on their adorable little hands. You must ask that they do messenger duty and spread the word to other guests, and inquire about their supply of hand sanitizer (offer to bring your own, and follow up on that offer).

Some will scoff and some will reach anyway, but it is your duty to stand firm. Practice ahead of time how you will deliver the message to your loved ones, and think of a few allies you can enlist to help you reinforce your stance. Babywearing is always a subtle way to minimize unwanted contact with baby. While chubby cheeks are tempting when baby sleeps in your arms or your travel bassinet, we’ve yet to meet someone willing to reach down your shirt for a snuggle when baby is well tucked in!

Here’s why this is important: germs are sneaky and usually arrive unannounced.

According to Holly Musgrove, MSN, CRNP, a pediatric nurse in the Baltimore area, many common winter illnesses can be transmitted days before symptoms appear in a host. Thorough hand washing at a sink with soap and water is essential for anyone who handles a newborn. Hand sanitizer can help if used correctly, but will not be effective in killing gastrointestinal bugs. And, of course, the best hand washing will not stop mouth-to-skin transmission.

Musgrove advises, “I would not even take them into crowds if possible, so avoid large groups of people. Absolutely no kissing. I wouldn’t let anyone kiss that baby. I would take a hard stand on the ‘everyone must wash their hands’ rule. Any sign of illness means they need to stay away.” If you do suspect that the baby was exposed, Musgrove counsels to wash their hands and face immediately, and then watch vigilantly for signs of infection.

What are you watching for, and why? Because the flu season typically is in full swing by New Year’s, there is a very real risk of infection over the holidays, and influenza or RSV can hit babies hard. According to Musgrove, babies who are very sick may be subjected to invasive procedures such as spinal taps, and there is a risk of sepsis. The kiss is just not worth the risk. She says,

“I recommend that the entire family living in a house with newborns should get a flu shot if eligible.”

When to call the doctor??

A baby with a temperature needs to be taken seriously. Musgrove says, “Any newborn with a rectal temp over 100.4 should be seen by a doctor. Rectal is the only accurate way to get a core temperature. Every parent should have a rectal thermometer. If baby is fussier than normal or are not feeding as well and are not having as many wet diapers, it’s a sign that something is or could be going on.”

Not every new parent is aware that all pediatricians have on-call coverage 24 hours a day. If you are in any way concerned about your newborn’s symptoms, call and talk to the on-call pediatrician, no matter if it’s a holiday. “Don’t take your baby to the ER, which is a germ factory, without talking to your pediatrician first,” advises Musgrove.

You’ve rung the doorbell, air-kissed Aunt Pat and Uncle Bertie, waved and blown kisses to everyone else, and have changed a diaper. Now stake out a spot in the corner and settle in! Draw an imaginary line around you and your sweet little one, and send anyone who encroaches on your space off on an errand for you. You must keep yourself fed and hydrated, after all, and people will delight in bringing you offerings. Chances are good you’ve left a few things in the car that could be fetched by others. And by all means excuse yourself to find a dark room and a warm bed for nap times for both of you.

This is not likely to be the carefree family gathering you may remember from your child-free days, but it is the start of new love and new memories. Enjoy these days, and be well!