Dr. Fadila
New Delhi, January 23-As a practicing paediatrician, I am often confronted with worried parents of children under 5 years of age, and specially newborns who come with their child complaining of cough and cold.
Indeed, it is a troublesome issue, and can potentially lead to full fledged pneumonia, or severe respiratory distress in a child if not cared for at the right time.
But, the lurking question in every parent’s mind is when to begin worrying in earnest, to what extent can these issues be managed at home, what are the harbingers of trouble, and should we rush to the emergency at 2 am in the night on a biting cold night.
It is my modest attempt in this article to tell parents about this very common problem.
Firstly, I will begin with newborns. A sneezing newborn is a novel parent’s worry. Is it a cold? Do newborns have colds? The answer to this is do not worry.
Most newborns will sneeze due to a blocked nose. Blocked nose can occur due to a variety of reasons, and does not necessarily mean your newborn has a cold. Also , most newborns will stop feeding vigorously, and refuse to be placated by feeds when they have any serious underlying illness.
Make sure to watch for these two important behavioural changes in your newborn, before getting worried. The newborn must be kept away from any relative who is suffering from cough/ cold, and babies must always be handled with clean hands.
For infants, and all children less than 5 years of age, always look at the chest. A mother’s observation is the best since she spends the most intimate time with her child.
If ever you feel, your child’s chest is moving very fast ( >60/min for newborns, >50/min for infants, >40/min for kids between 1-5 years of age), or your child is breathing laboriously ( this is manifested as retractions in the chest, or depressions just beneath the rib cage with each inspiration), make sure you rush to the emergency.
While the child is being taken to the hospital, please make sure your child is comfortable, their neck is slightly extended, the space is not crowded with well wishers, and they should not be forced to have any food or drink until your doctor has deemed it safe to do so. Feeding a child with respiratory difficulty can lead to aspiration, and is one of the most common mistakes made by parents.
If your child vomits after a bout of cough, make sure to turn them on their left side in a child who is lying down. This will prevent the vomitus from accidently trickling down to their airways, and causing aspiration. Watery nasal discharge is most probably a sign of viral infection.
A thick yellowish nasal discharge means a bacterial infection in most cases, and your child will require an antibiotic. However, this can be managed in an OPD. Any child with a cough lasting for more than 2 weeks, however infrequent, must be taken to a doctor in an OPD.
Lastly, this article is meant for parents, and caregivers to young children, who are unaware of the extent of worry that is justified, and are confused as to when they should seek emergency medical help.
After working for years in the Pediatrics department, I have seen countless confused parents, some rushing to the emergency groggy from sleep and worried only to be told their child did not qualify for emergency help. I have seen them leave just as confused and worried. I hope this article helps and guides those parents.
(The writer is Senior Resident, Ruban Hospital For Women And Children, Patna)
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