Cold season is well under way. For most of us, this means putting up with a week or two of sneezing, nasal congestion and cough. For babies, though, the same viruses that are a nuisance for their parents and older siblings can pose a real danger.
December and January typically see a peak in a number of respiratory viruses. Among them are respiratory syncytial virus, or RSV, plus a host of other viruses that have similar effects. Most people infected with RSV, young and old, develop an upper respiratory infection— basically cold symptoms from the neck up. The younger the patient is, though, the higher the risk of developing more serious illness. Infants, especially young babies born prematurely, are at higher risk of developing a lower respiratory infection, involving the lungs.
A quick note on terminology: Most adults have heard of (or suffered through) bronchitis, an illness involving the large airways of the lungs, the bronchi. Viruses such as RSV can cause damage to the small airways, called the bronchioles, causing an illness called bronchiolitis. Both the nose and the damaged airways produce copious amounts of thick mucus. Additionally, the irritation in the respiratory tract can lead to wheezing, much like in an asthma patient. Babies with bronchiolitis have thick nasal secretions, a wet cough and wheezing, and it can last a couple of weeks. An infant with these symptoms should be seen by a doctor.
What Can Be Done?
For premature babies, a vaccine is in limited use, but unfortunately there is no routinely available prevention. Since the illness is viral, antibiotics do not help, either. Over the years, we have tried many therapies for bronchiolitis, but none have shortened the duration of the illness or made it less severe. The current strategy is to do less, not more, and to recognize when a baby is running into trouble with his breathing.
The mainstays of treatment are saline drops in the nose, gentle suctioning of the nasal mucus and close observation. Sometimes infants need to be admitted to the hospital for extra oxygen and closer monitoring. Since we can’t predict who will get worse or prevent it from happening, it is important for parents and caretakers to recognize certain warning signs. If an infant is working harder to breathe, he may have fast, shallow breathing, a grunting sound with every breath or flaring nostrils. He may also start to use the muscles around the ribs and abdomen to get the air in and out. These are red flags and can develop even in a baby who looked okay earlier that day. Contact your pediatrician if your baby has you concerned.
Dr. Suzanne Condron is a board-certified pediatrician at Kelsey-Seybold Clinic – Fort Bend Medical and Diagnostic Center whose clinical interests include obesity, nutrition, allergies, asthma, childhood development, literacy, infectious diseases and preventive medicine.