Cough and Cold

By Dr Yong Sin Chuen

Consultant Neonatologist and Paediatrician


Pantai Hospital Kuala Lumpur


Is it normal for my baby to get cough and cold?


It is quite normal for any infant and child to get cough and cold.  Most people associate cold with having a runny or blocked nose.  Sometimes the infant may have sneezing episodes.  Although most babies have received some antibodies from the mother during pregnancy, exposure to new viruses can cause these symptoms.



What causes it?


For children below the age of five, most cases of cough and cold are caused by many different viruses, unlike chicken pox which is caused by a single virus.   Thus, the end of one episode of cold does not mean your baby is immune to another.  Some of the more common viruses which cause cough and cold are adenovirus, parainfluenza and respiratory syncytial viruses (RSV).  RSV can cause symptoms that range from mild to severe cough and cold, and can cause very severe symptoms in premature babies.  The virus is most frequently encountered in rainy seasons in Malaysia and winter in seasonal countries.


Cough and cold can also be caused by bacteria, but this is quite uncommon.



How do I differentiate this from flu?


Most of the time, cough and cold are classified as simple cold.  However, babies can also develop flu like avian or swine flu, which are not caused by the viruses stated above, rather from but influenza viruses like H1N1.  The following features help you differentiate between a simple cold and flu.


Features                                 Cold                                        Flu

Fever                                       None or mild                          High

Duration                                 3 – 4 days                               1 – 2 weeks

Tiredness                               Very mild                              Intense

Aches/pains                         Mild                                         Severe

Cough                                      Mild                                          Severe, dry, painful

Sneezing                                 Usual                                       Sometimes

Chest discomfort                Mild                                         Common

Complications                     Very uncommon                Pneumonia, bronchitis



Are there any complications arising from cough and cold?


In a majority of cases, there are no complications.  Even without treatment, infants can recover fully.  During the illness, some babies may experience feeding problems due to blocked nose.  However there are occasional cases of secondary bacteria infections and these can progress to bronchitis or pneumonia.


How do I prevent my baby from getting cough and cold?


All cases are transmitted through saliva droplets of infected people.  So, it is important that your baby is kept away from those who are ill.  If you or the caregiver has a cold, it is best to wear a face mask to prevent the droplets from infecting the baby.  It is best to continue breastfeeding so your antibodies will pass through the breast milk to provide protection for your baby.  Regularly washing your hands before handling the baby or his toys is also helpful in preventing the cold from spreading.


Does my baby need treatment for cough and cold?


Most of the time, the answer is no.  Your baby is able to fight off the infection quite easily.  However, infants are known as obligate nasal breathers.  This means if the nose is blocked, he will find it very difficult and uncomfortable to breathe through the mouth.  In this case, there is some benefit in using saline drops or sterilised sea water spray to clear the nasal passage.  Your baby may also benefit from elevating the upper body as this position may help drain the mucus from the nose and throat.  In most cases, it is not recommended to give cough syrups (most of which are suppressants) or antihistamines to the baby.  In more severe cases where the baby cannot feed well, then a short stay in the hospital may be required to administer a nebuliser and perform a suction of the upper airway.


My newborn baby makes some sounds while feeding.  Is this a symptom of cold?


Most parents would assume there is phlegm or mucus in the baby’s throat.  However, unless he/she has a cold or flu, there is no reason for this to happen.  The sound most likely comes from excessive saliva in the throat.  If there is some floppiness of the larynx (voice box), there may be some noise during feeding or during excessive crying.  However, it gets better as the baby grows older.

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