Cold in the infant

introduction

In some cases you should definitely contact the pediatrician.

Babies and toddlers are much more likely to have a runny nose than adults. This has different reasons and also different causes.

Not always a proper infection, in the sense of a disease happening, must be behind it, if a baby's nose runs. The baby's nose is naturally very tight. More specifically, it is the nasal passages of the infant ( Meatus nasi ), which still represent an anatomical bottleneck in the first year of life. As a result, a number of stimuli (for example, bacteria, viruses, allergens, physical stimuli) can lead to obstruction of breathing and a runny nose.

As a rule, "infectious rhinitis", ie an infectious inflammation of the nasal mucosa is called "common cold".

In a broader sense, one counts in everyday life, however, any other symptoms caused by the common cold, which is characterized by a disabled breathing and a runny nose. Infants often have up to 10 colds in their first year of life, which can lead to colds. For babies, such a cold can be extremely distressing, since not only breathing is impeded, but also food intake and sleep can be very difficult.
In general, the children stand out in a restless and whiny way. Whether this is "normal" in this sense depends on the course of the disease, the other general condition of the child and many other factors that can only be clarified by a doctor. Therefore, you should go to the doctor with a snuffled baby, especially if the symptoms last longer than a few days and the child is feverish.

The following is an overview of various possible causes of rhinitis in the infant and the possible therapeutic approaches. This overview does not claim to be exhaustive and should only be read as general information.

The common cold ("rhinitis acuta")

Acute rhinitis is an infectious cold for which various germs may be responsible.

There are hundreds of different germs that can cause a cold. Most commonly, however, rhinoviruses and adenoviruses are the cause of a viral cold. The cold takes usually a few days and is self-limiting. So these are harmless infections.
Adenoviruses have an incubation period of 5 to 8 days and are transmitted by droplet infection and faecal-oral. Serotypes 1-3 and 5-7 are responsible for respiratory infections. In addition, these viruses are also the second most common cause of childhood diarrhea (diarrhea).
In addition to adenoviruses, rhinoviruses are particularly involved in the development of colds in infants. Rhinoviruses belong to the picorna virus family and are also transmitted fecal-oral or by droplet infection. The incubation period is slightly shorter than for the adenoviruses and is 1 to 3 days. With up to 50% they are the main cause of the cold in infants. The disease then lasts about a week and has two frequency peaks in spring and autumn.

A virus that can cause much more severe respiratory infections in infants and toddlers is RSV (respiratory syncytial virus). The incubation period is 3 to 7 days. The virus is highly contagious and transmitted by droplet and smear infection. The came in addition to a cold in the worst case severe respiratory infections such as bronchiolitis, pneumonia and severe sinusitis trigger. For infants, the germ is particularly relevant as a hospital germ on pediatric wards. This means that infants can catch the germ during hospital stays.

But other viruses, such as influenza viruses, can cause rhinitis acuta in the infant. Therefore, scared people should keep away from babies. Viral infections of the nasal mucosa may pave the way for bacterial superinfection in the infant. This means that it is easier for bacteria by the pre-damage of the nasal mucosa in the context of the cold and by the attacked immune system, also einunisten. This manifests itself, for example, in an altered appearance of the nasal secretion (see Symptoms).

causes

A running, stuffy nose in the baby can also be the result of dry indoor air. Especially in heated rooms, the air is quickly very dry.

But why is this bad for the infant's nasal mucosa? The nasal mucosa is a natural barrier against pathogens, dirt and other foreign bodies. It also has the function to heat the breath, to moisten and to cleanse of said foreign material. In order to perform its function well, the mucous membrane must be intact. This also means that it is sufficiently moist.
Dry indoor air thus dries out the nasal mucosa, thereby hindering its natural function. This makes the infant more susceptible to infections and the onset of a cold.

Similarly, poor air quality, cigarette smoke and other pollutants affect the nasal mucosa. You can prevent this by using a humidifier in heated rooms or by hanging damp towels over the radiators. This increases the humidity in the room.

As a trigger of a cold, various pathogens and corresponding diseases come into consideration. The symptoms of the diseases in question are sometimes very similar and sometimes differ only in severity, so that a distinction is difficult. The main causative agents include rhinoviruses, influenza and parainfluenza viruses, and respiratory syncytial virus ( RSV ).

Rhinoviruses are the cause of classic cold and not responsible for cough or similar symptoms. There is no drug for these viruses, but the body can handle the fight on its own. After about a week, the infection is under control.

Respiratory syncytial virus ( RSV ) infection often starts in the upper respiratory tract with runny nose, dry cough, and sore throat, spreading to the lower respiratory tract within a few days. Increased productive cough occurs, respiration accelerates and is more difficult. The disease usually lasts between 3 and 12 days, and individual symptoms such as coughing can accompany the person over 4 weeks. Most of these infections occur in the winter months, because the viruses can survive longer in cold air and thus remain infectious for a longer period of time. As a result, the virus is a frequent trigger for colds during this time. It is distributed and transmitted via droplet infection, for example sneezing, in the environment. Transmission through touching contaminated surfaces, such as hands and objects, also seems possible. It comes in one season to recurrent infections, which is favored by the proliferation and prolonged infectivity of those affected.

Complications are more likely in children with already existing underlying respiratory diseases. It can then lead to pneumonia, otitis media or asthmatic complaints.

The disease is symptomatically performed with increased fluid and possibly with nasal rinses. Antibiotics use only something, if in addition also an infection with bacteria is present. There is no vaccine.

The true flu, also known as influenza, is perhaps most likely to be distinguished from the other colds by a very sudden onset of illness. Among other things, it comes to general symptoms such as head and muscle pain, irritable cough, fever and sweating. In rare cases, vomiting and diarrhea are possible. The disease can also be very mild.

The flu also appears more in winter and is transmitted by droplet infection or contact with areas covered with viruses. At risk of influenza are mainly elderly or immunocompromised people and children under 2 years. Vaccination is therefore useful for these individuals and should be done every year in October or November. After vaccination, the body needs about 2 weeks to train the immune system and use the protection. The yearly refresher is necessary, because there are very many subgroups of the virus and the virus constantly changes. Every year vaccines are developed against the most common types of influenza. This means that you can not be vaccinated against every subset of the flu, but the most common ones are covered.

The sometimes very classic occurrence of symptoms in influenza patients gives a good indication for the diagnosis, the final proof is given only by smear examinations, for example, of nasal secretions.

In severe cases, therapy against the virus makes sense, the further therapy is more related to the relief of symptoms.

symptoms

In addition to a runny nose, typical symptoms of cold in infants are restlessness, frequent sneezing, and possibly fever.

The symptoms of a cold in the baby are quite clear. The secretion of a viral cold is clear and fluid, whereas bacterial agents bring about a rather viscous, yellowish secretion.

In general, the children are very restless, sleep bad, cry a lot and have to sneeze. The cold may be painful, as the affected nasal mucosa is very irritated.
It can cause a fever and when it spreads to the lower respiratory tract also cough and difficulty breathing.

The swollen nasal mucous membrane makes nasal breathing of the infant more difficult, which can also lead to problems when eating. The infant then makes himself very heavy while sucking the food and finally refuses to eat in case of severe discomfort and a difficult air intake.
Learn more here: Swollen nasal mucosa

Not infrequently, the pathogens also spread to other neighboring structures, so that a cold may be associated with, for example, a paranasal sinus or a middle ear infection. This usually leads to greater pain and even more restlessness in the child.

therapy

A cold in the infant should be resolved without complications usually after 2 to 10 days.

It is important to keep a close eye on the child and to consult a doctor as soon as possible in case of complications and uncertainties. This is the case if the child has a fever, the symptoms worsen and after 7 days not abate by itself or additional ear pain occur. An indication of the latter may be that the baby keeps touching his ears with his hands. In addition, the refusal of food intake, refusal to drink, weakness, shortness of breath and rash are reasons to visit the pediatrician. But even with existing medical conditions, the pediatrician should be visited.

Otherwise there are measures that can effectively help the infant recover. Care should be taken to ensure adequate hydration of the infant. This helps liquefy the mucus.
It also helps flush the infant's nose with saline. This dissolves the mucus and helps to remove the pathogens from the nose. You can carefully remove the mucus, or the secretion, after rinsing with a pipette. Nasal rinses with essential oils or other additives should be avoided, since they can cause irritation of the sensitive baby nose.
Decongestant nose drops contain so-called a-sympathomimetics such as xylometazoline and tramazoline. These are also available in small doses for infants. They narrow the nasal mucosa and so have a decongestant, which facilitates the outflow of mucus and breathing. However, they are to be treated with caution as they can lead to a so-called rebound effect. The decongesting effect decreases after about a week, so that the nasal mucosa swells due to the drug. This in turn favors the further taking of the nose drops. Therefore, you should use such drugs sparingly and discuss the intake with a pediatrician first. This also applies to antiviral drugs. As a rule, no medicines are necessary for a simple cold.

The irritated nose skin can be cared for with an ointment. In the case of fever, fever-reducing agents are already available for infants, which the pediatrician can prescribe with a dosage adapted to the body weight. This also applies to cough-reducing juices. For side effects such as rashes or vomiting, the medicine should be discontinued and the pediatrician immediately contacted. In general, a lot of rest and sleep are very important for the weakened infants to recover quickly.

complications

Through the connection of the middle ear by a passage in the nasopharynx it can come by means of a migration of the exciters to a middle ear inflammation. Since it can be very painful, the children express themselves with increased crying or often cling to the affected ear with their hands.

Germs also enter the lungs through the throat and trachea, and can cause coughing and fever, which can spread to pneumonia. RSV in particular can cause infections of the small bronchi or pneumonia, but more likely in children with a previously existing respiratory or immune system problem.

An inflammation of the paranasal sinuses or frontal sinuses ( sinusitis ) can also arise. The various paranasal sinuses open at different points in the nose. They serve the weight reduction of the skull and are also lined with a mucous membrane. If these cavities become inflamed, there is often a pressure pain between the eyes or over the affected areas.

Sore throat infections are a conceivable complication as this area traverses the natural pathway to the lungs of microorganisms.

As long as it is a simple cold, you can treat it at home and cure it. In the first few months of life, it can be very difficult to tell a common cold from other infections. Therefore, the pediatrician should be paid for a cold, cough or fever. But there are some signals from the infant that should not make you hesitate to go to a doctor.

This includes a fever over 39 ° C or if it lasts longer than a day, at least for very young children. Even dehydration is dangerous, it can be caused by pronounced drinking discomfort or heavy sweating. Most of the time it is due to a smaller amount of urine than usual or through dry mucous membranes.

An accelerated breathing with nostrils or even bluish lips is also a warning signal, which should be checked as soon as possible.

In case of strong and productive cough, a visit to the pediatrician is also required. Perhaps in these cases certain medicines or measures are important to avoid further deterioration. If a cold proves flu or complications occur, hospitalization may be necessary. Sometimes it is easier to get a grip on the situation in a targeted stay.

prophylaxis

Infants often suffer from a cold. This can not be completely prevented. There are, however, measures that the parents can take to at least prevent infection of the infant.

The contact of the infant as well as the own person with sick persons, ie cold friends, relatives, children etc. should be avoided, in order to avoid an infection. In addition, it is recommended to use a humidifier in heated rooms to prevent the nasal mucous membrane from drying out.
A good hand hygiene of the persons, who have contact with the baby, is also recommendable, because over the hands very many germs can be transferred.
It is also generally true that breastfeeding babies is very good for a good immune defense. Therefore, mothers should breastfeed their children whenever possible to strengthen their immune system.

Avoid infection

Once the child has become infected, one should avoid going to a community meeting with the child, at least during the high phase of the illness. If the child has played with his toys, you can wash them off in between times. At this time, it should certainly be kept away from tobacco smoke in order not to irritate the respiratory tract. Visits from friends or relatives may be postponed to a time when everyone involved is as healthy as possible.

Even as a parent, you can of course be affected by a cold. You can try to avoid infecting your child, even if that is usually difficult.

For example, you can wash your hands regularly to reduce the germ count on your hands. Also 1x handkerchiefs reduce the germs, since they can be disposed of directly. Regular ventilation ensures a good room climate and reduces the airborne pathogens. When sneezing or coughing rather sneezing under the arm, not in the hands.

The fact that family members can infect each other, but is also quite normal.

Summary

Already in infancy children can be affected by cold. This can happen up to 10 times in a cold season. The immune system has yet to get to know many pathogens in order to form a suitable defense. Against some pathogens, the immune system can only provide an answer after contact with the same.

Equally important in the development or prevention of runny nose are the mucous membranes in the nose, mouth and throat. Its nature forms a barrier against pathogens of all kinds, dust and dirt. It is equipped with movable cilia, which transport particles from the air back to the outside. At the same time, the mucous membrane is covered by a secretion, in which particles are bound and thus prevented on their further way into the body.

To be able to perform their function sufficiently, therefore, the mucous membranes must always be moistened. Dehydration due to dry indoor air or a too cool environment favors a colonization with viruses and bacteria. Colds are much more often triggered by viruses, but bacteria sometimes use the temporary weakness of the immune system and also occupy the mucous membranes.

Matching the small body size, the connections between the nasal passages and the nasopharynx are correspondingly small. If the mucous membrane of the nose swells a little, the baby gets bad air through the nose and begins to breathe increasingly through the mouth. The mucous membranes continue to dry out and make colonization easier for viruses. After sufficient proliferation, the barrier is finally broken and an infection is triggered.

By colonizing the nose, it can also quickly lead to an extension of the infection in adjacent areas such as ear or throat or lungs. Again, the close proximity of the various areas favors easy expansion.

In the case of a common cold, the cold will also heal itself in an infant without causing major problems. It can disappear within a week, but it can last for 2-3 weeks. Most commonly, colds occur in the winter months.


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