109. Common Infant Concerns

Some babies spit up small amounts of milk after or in between feedings. If your baby is healthy, gaining weight and doesn’t seem hungry, you probably don’t need to be concerned.

Tips to decrease spitting up:

• Burp your baby during and after a feed
• Carry her in an upright position for 20-30 minutes after a feeding

A baby who suddenly starts to vomit large amounts of milk may be ill. Contact your healthcare provider or Health Link Alberta at 811 right away if this happens to your baby.

Also contact your healthcare provider if your baby vomits forcefully after every feeding or isn’t gaining weight.

Fever means that your child’s body is reacting to something such as an illness. The most common illness in children is infection from a virus. There are thousands of different viruses. Fever can also result from an infection with bacteria. Fever itself will not harm your child. In fact, fever is one way your child’s body fights an infection.

Taking your baby’s temperature with a thermometer is the best way to tell if your baby has a fever. A normal temperature under the arm is 36.3° to 37.2°C (97.3° to 99.5°F).

Take your baby’s temperature with a thermometer if your baby:

• feels hot to the touch or is flushed
• is fussier than usual
• is feeding poorly
• is sleeping for shorter or longer periods than usual
• appears sick

Using a thermometer

• Before taking a temperature, unwrap your baby for 5 to 10 minutes. Wait at least 15 minutes after your baby’s bath before taking his or her temperature.
• Take your baby’s temperature under the arm using an oral or digital thermometer. You can use either kind to take your baby’s temperature under the arm. We do not advise checking your baby’s temperature rectally. Ear (tympanic) thermometers are not advised for newborns or children under the age of three.
• Write down the temperature and the time you took it.

If your baby has a fever

• dress him or her lightly in a diaper and undershirt. Losing heat through the skin allows the body to lose heat and feel more comfortable. If your child starts to shiver, add warmer clothing, but remove it when the shivering stops.
• take off extra clothes and blankets
• give your baby extra breastmilk or formula

Note: We do not know if bathing really helps to bring down a child’s fever. Your child may feel more comfortable with a lukewarm bath or wet face cloths. A bath that is cool will be uncomfortable. It can also cause a child to shiver which can make the temperature go even higher. Cool baths, alcohol baths and alcohol rubs are not advised. A child’s skin can absorb alcohol and this can be harmful.

Babies younger than 6 months with a fever need to be seen by a healthcare provider because they can become sick very quickly. Babies over 6 months with a fever need to be seen by a healthcare provider if the fever doesn’t go down with recommended treatment, lasts more than 72 hours, occurs with other symptoms or if you are concerned.

Children often get colds. They are likely to have many colds when they are younger and fewer as they get older. Children who are breastfed may have fewer colds. If your baby has a cold, continue to feed her based on her feeding cues. Dress her in comfortable clothing and have her get plenty of rest. Wash your hands often.

Call your healthcare provider if your baby has a respiratory illness and:

• Doesn’t get better in a few days or seems to be coughing all the time
• Is unable to sleep
• Has to work hard to breathe or catch her breath
• Has a fever and is under 6 months old

What is Respiratory Syncytial Virus (RSV)?
RSV is a common cause of colds in winter and early spring. Most children have had the virus by the age of two, but usually only have a mild cold. RSV is very contagious and live for hours on surfaces such as toys and hands.

Children under one year of age, premature babies and those with lung or heart disease, may have a more serious illness.

The symptom of RSV may at first be similar to a cold and can include:

• fever
• red eyes, sore ears
• runny/stuffy nose
• other cold symptoms

The symptoms may then get worse and can include:

• difficulty breathing
• rapid breathing
• wheezing
• coughing for up to three weeks

NOTE: Symptoms can change very quickly in infants and young children.

Steps to follow to reduce the risk of RSV infection:

• Wash hands with soap and water before touching the baby.
• Keep other children with a cold or fever away from the baby.
• Keep the baby away from crowded places.
• Do not smoke around the baby.

Although there is no vaccine, parents of children who are at high risk for developing serious RSV infection (for example, premature babies) can also call their doctor to find out more ways to protect their child against the virus.