A Baby's First Cold: Stages, Prevention, Treatment - Parents

Infants don't have the antibodies to fight most colds and gastrointestinal infections. This makes them more likely than older kids and adults to get sick.

"In the first year, babies come down with about six to 12 infections, most lasting seven to 10 days," says Mary Anne Jackson, MD, a pediatric expert at Children's Mercy Hospital and Clinics in Kansas City, Missouri. "That's up to 120 days of the year they may be sick."

During those first few months, a rectal temperature above 100.4 degrees Fahrenheit warrants an automatic call to the doctor. And if your baby is under 1 month old, they may need readmission to the hospital.

"For that reason, we'd love to keep newborns from becoming sick," says Theoklis Zaoutis, MD, associate chief of the division of infectious diseases at Children's Hospital of Philadelphia. But, unfortunately, that's not always realistic.

So what's a new parent to do? Keep reading to learn germ-fighting habits that could help your baby dodge an illness all year round—or at least make your baby's first cold more bearable for both of you.

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Stages of a Baby's Cold

Babies are born with some of their gestational parent's immunity to illness. This immunity can be enhanced by breastfeeding. But that doesn't completely protect them against the ever-changing collection of viruses that cause upper respiratory infections like the common cold.

But take heart: Babies' immune systems are immature at birth, but their immune systems develop rapidly in the first three months after birth. In fact, research from 2021 has found that in some cases, infants' immune systems can respond better to new pathogens than adults.

So, what do a baby's first colds look like? They usually come on slowly and last about nine days. Some parents find it helpful to break the infection cycle into three distinct stages: three days coming, three days here, and three days going.

3 days coming

During the first three days, when your child is contagious, they may seem fussier than usual, have a slightly decreased appetite, and run a fever.

Call a health care provider's office immediately if they're under 3 months old and their rectal temperature is above 100.4 degrees F. Some good news: Once your child is a preschooler, a cold usually causes only a slight increase in temperature.

Usually, a runny nose appears on the second or third day, signaling that your child's immune system is fighting back. During this stage, the mucus is clear and thin and runs constantly.

3 days here

During the middle phase of a cold, the fever usually goes away, and your baby might be less fussy and eat better. The mucus will thicken a bit and may turn light yellow. At this stage, babies develop the classic stuffy and runny nose.

This is also the time when they may develop a cough. That's because when a baby lies on their back, mucus drips down the nasal passages to the back of the throat and sets off a cough response to keep the fluid out of the lungs. Inevitably, this can make it difficult for your child (and you!) to sleep.

3 days going

Like a houseguest who stays too long, colds can linger in babies. The mucus thickens even more in the final three days and becomes crusty. Babies generally act normal in most ways at this stage, eating well and resuming activity.

How to Prevent a Cold in Babies

While colds are generally not severe, many parents worry about a cold developing into something more serious. It's a legitimate concern, especially for young babies. Possible complications from a baby's cold include:

• Ear infections
• Sinus infections
• Pneumonia
• Throat infections

While you can't always prevent viral infections, there are steps you can take to lessen the likelihood that your baby will get seriously sick.

"Until your baby has their first round of shots at 2 months old, you should be extra cautious," says Mary Ian McAteer, MD, a pediatrician in Indianapolis. Also, newborns should avoid crowds, so keep them home as much as possible. After those first two months, here are more ways to prevent your baby from getting a cold.

Keep your baby close

When you venture out, stay 6 feet from anyone showing signs of illness like coughing or sneezing. To keep your baby extra close, consider wearing them in a carrier. Strangers are less likely to touch your baby's hands and face when your baby is attached to you. If they're in a stroller, keeping the canopy down and covering it with a light, breathable blanket can also deter well-meaning strangers.

Mind the company your family keeps

Ask guests who have been sick to hold off on visiting until they no longer have symptoms and have been fever-free (without using a fever-reducing medication) for at least 24 hours. Since little kids have less practiced hygiene skills, allow younger kids to look at the baby but not touch them, especially near places like their face and hands.

Wash your hands often

"A lot of germs are carried on your hands," Dr. Zaoutis says. So scrub your hands for at least 20 seconds—sing "Happy Birthday" twice to time it—every time you come in from a public place, use the bathroom, eat, or change a diaper. Stool is full of bacteria. If it makes its way to your infant's mouth, it can cause diarrhea and vomiting.

It's also a good idea to stash alcohol-based hand sanitizer in your bag, next to the changing table and by the front door. Be sure to keep some out for guests as well. It's convenient and almost as effective as hand-washing unless your hands are visibly soiled, Dr. Jackson says.

Keep your baby well-nourished

According to the Centers for Disease Control and Prevention (CDC), breastfeeding can protect babies from ear infections and stomach bugs. So, if you can breastfeed, continue to do so while a baby is ill to give them extra antibodies and an immune boost.

That said, not everyone can or chooses to breastfeed. So, no matter how you feed your baby, keep them hydrated and well-fed to give them essential nutrition and comfort when they have a cold.

Disinfect surfaces

Germs can live for hours on things like shopping carts and door handles. So, keep a package of sanitizing wipes in your diaper bag for when you are out and about.

At home, germs can live a long time on high-touch surfaces, like doorknobs, light switches, and countertops. So, consider running over these items with a sanitizing wipe occasionally during cold season, especially when someone in the household has been sick.

Take precautions at the pediatrician's office

Babies see a health care provider a lot during the first year. Dr. Jackson says that even if an office has separate sick and well rooms, waiting rooms are filled with germs.

Consider requesting the first or last slot of the day when you're less likely to be met with a crowd of coughing kids. Or ask to sit in your car or an exam room while you wait, rather than in the waiting area.

Don't delay or skip any of your baby's vaccines

"Following the vaccine schedule is the best way to prevent illnesses like measles, meningitis, and chickenpox," Dr. McAteer says. "Because we don't see these illnesses frequently, parents think we don't need these vaccines, but no—that's the proof that they're doing their job."

If you're worried about giving so many shots so close together, that's understandable. But consider this: Multiple shots in one visit means fewer office visits (and fewer pokes and less trauma for your baby). Plus, you can rest assured that the CDC, Advisory Committee on Immunization Practices, and the American Academy of Pediatrics (AAP) agree that the overwhelming scientific evidence is that it is safe to give multiple vaccines at once.

Get your shots, too

In particular, parents and parents-to-be should get the flu and pertussis (whooping cough) vaccines. Dr. Jackson says getting the flu shot when pregnant passes antibodies onto your fetus that should last for about six months. (Babies can't have the flu vaccine until they are 6 months old.)

Flu can be deadly in newborns, making any side effects you may experience from the jab (such as low-grade fever and body aches) minor in comparison. The CDC recommends that people get the following vaccines in pregnancy:

• Pertussis (whooping cough)
• Flu
• COVID-19
• RSV
  

In short, everyone in your baby's circle, including older siblings, should be immunized.

Boost your immunity

It's hard to get enough sleep when you have a newborn up every two hours (or more). But do what you can to get shut-eye, even if that means napping during the day. Make sure you eat well, too. Fueling your body will help you fight illnesses you could otherwise pass to your little one.

Treating Your Baby's First Colds

The simple truth is there's no quick fix for a cold. Antibiotics aren't effective against viruses, and most antiviral drugs aren't approved for babies.

In addition, decongestants and other cold medicines are not safe for infants and young children. That's why the Food and Drug Administration (FDA) advises against giving these medications to children under 2.

Instead, your best bet is to use some natural remedies to keep them comfortable, like the following:

• Suctioning mucus
• Keeping them hydrated
• Keeping the air moist with a cool-mist humidifer

When to Call the Doctor

Whether it's your baby's first cold or another illness, you should always call a health care provider if:

• Your baby is listless, not reacting to you, has poor color, or you feel something isn't right
• Your baby's cough is worsening or your child is having difficulty breathing
• Your baby is crying more than usual, tugging on their ear, or refusing the breast or bottle
• You suspect your infant has the flu, especially if they have a high fever and cough that persists for more than three days
• Your infant is under 3 months old and has a fever (rectal temperature of 100.4 or greater)
• Your child is high-risk because they have a chronic health condition or a weakened immune system
• Your baby has pus in their eyes
• Your baby has a fever that lasts longer than three days

Usually, a baby's first cold is mild and passes without complications.

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