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Winterproof Your Baby

What to Wear Babies aren't as good at regulating their body temperature as older kids and adults are. But that doesn't mean your child should be bundled up like a mini-astronaut every time you're out for a short stroll. To keep her warm and comfortable when inside or out, dress her in one layer more than you're wearing yourself. (Some don't need the extra layer though, so see what works best for your child. More on how your baby should be dressed...

Outside
A hat is the number one necessity. On very cold days, be sure to use a cap that totally covers the ears; one that fastens under the chin is cozy and won't fall off.

Skip the hard-to-handle snowsuit until your baby's walking. A warm jacket's enough for her top, and you can cover up her legs with a fleece or blanket.

Thick coats should come off before the car-seat straps go on  -- the extra padding will make the harness too loose. Add a blanket or a bunting bag (a fitted blanket that goes over a car seat or stroller) over the straps instead.

Wear your baby against your body in a sling or carrier to keep her warmer than when she's riding in a stroller. You'll be able to dress her in lighter clothing (skip the coat). Keep a blanket on hand to throw over her if she gets cold.

In bed
The more comfortably babies are dressed for bed, the better they sleep. If you swaddle your baby, use a lightweight cloth. Cotton's the best bet for sleeping, since it's cozy, soft, and more "breathable" than other fabrics.

Skip the blankets in the crib until around 12 months  -- they're a suffocation risk before then, and babies just kick them off. Instead, try a coverall (a one-piece outfit with feet, also called a sleeper or a stretchie) or a sleep sack (a wearable blanket with armholes). A fitted flannel crib sheet adds warmth, too.

If your baby sleeps in your bed, she'll get extra heat from you, so she can be dressed lighter; a swaddling cloth may be all she needs. (Keep in mind that your pillows, sheets, and blankets are a suffocation risk and should be kept away from her.)

Skincare

Protect Sensitive Skin Babies are prone to heat rash and eczema flare-ups in the winter. Blame all those layers of clothes  -- and the dry, warm air circulating in your house. What to keep an eye out for:

Heat rash looks like tiny red pimples and usually appears on moist, overheated areas, such as behind the ears, in the neck folds, in the groin, or any other spots where warm clothing creates friction.

Eczema is dry skin that looks like flaky, red patches. It's most common in the winter and often shows up  -- just in time for holiday pictures  -- on a baby's face.

If either of these conditions appears, dressing your baby in lightweight, loose-fitting cotton clothing and avoiding overbundling should help. You might also want to try a humidifier. Look for one that automatically kills bacteria (like the Vicks PureMist UV Light Tower or the Honeywell QuietCare Advanced UV Tower) so you don't have to sanitize the unit every day. Keeping your baby's fingernails trimmed is also a good idea, as scratching already irritated skin can lead to secondary infections. And talk to your doctor to find out if your baby needs a topical medication.

Dr. Sears's soothers

Heat rash: Mix 1 teaspoon baking soda in a cup of cool water, and blot the area with a fluffy washcloth or cotton ball.

Eczema: After a bath, blot the area gently with a towel, leaving the patches damp. Then apply a lotion, which will seal in the moisture and help hydrate your baby's skin.

Treating colds and fever

The Truth About Cough and Cold Meds Your baby's probably better off without them. At press time, the Food and Drug Administration (FDA) was reevaluating the use of over-the-counter (OTC) cough and cold medications for kids under 6. Both the FDA and the Centers for Disease Control and Prevention recently issued warnings that these drugs may be especially dangerous for children under 2. They've never been tested for safety in kids this age, so there's no agreed-upon "safe" dose for your baby. And studies show that these drugs aren't very effective in young children. The most up-to-date advice:

Don't use OTC cough or cold medicines for your baby unless your doctor says they're necessary. If he does, be sure to stick carefully to the dose he recommends.

Never give your child more than one of these drugs at a time unless directed by your doctor. You could accidentally double up on the same active ingredient.

Use the measuring device that comes with the medicine, or one from the pharmacy that's marked for dosing. A kitchen spoon isn't accurate and can put your baby at risk of an overdose.

Be sure that sitters and other caregivers check with you before giving your baby these (and any other) medicines.

When babies get stuffy
Watching a baby suffer through a stuffy nose can be tough  -- especially before 5 months, when he hasn't learned that he can breathe through the mouth. Being stuffed up can also make feedings harder, since babies will stop sucking to try to get air. Fortunately, there's a lot you can do to help. What to try:

Saline (non-medicated) drops. They loosen nasal secretions and often stimulate babies to sneeze, so a big glob comes right out. Using a clean plastic dropper, gently squirt a few drops into each nostril. Soothe the loosened secretions out with a warm washcloth, starting from the bridge of the nose. Or use a bulb syringe.

Bulb syringe. Squeeze the bulb first, stick the tip into the nostril while gently pressing the other nostril closed, and then slowly release the bulb. Try not to use this tool more than three times a day, since it can irritate a baby's delicate nose. You may want to try a new nasal aspirator called Nosefrida

Your bathroom. Turn on the shower and close the door to fill the room with steam, and then sit inside with your baby upright in your lap. The humidity will help get his nose running.

Vaporizer. Also called a "warm-mist humidifier," this gadget emits steam to help keep mucus moving. Run it during naptime and overnight. The unit's hot water kills off bacteria and mold, but it can also burn kids; keep it out of reach of babies and older sibs.

Signs of breathing trouble
Winter ailments like pneumonia, bronchitis, and croup can make breathing hard. Go to the emergency room if:

* Your child is breathing a lot faster than normal for more than a minute
* It's becoming harder for him to get air in and out, and he pauses for more than ten seconds between breaths
* The dent just in front of his neck, or the area between or below his ribs, is caving in with each breath
* He turns gray or blue
* His nostrils are flaring
* His breathing becomes high-pitched.

If fever's a concern
An elevated temperature is a clue that your baby's battling an infection. So it's natural that fevers are common in the winter, when kids get sick more often.

Fevers in young babies can be especially serious. Most experts agree that a temperature of 100.4°F or higher in an infant under 3 months warrants a call to the doc, who will tell you if you should give your baby medication or take her to the hospital.

To bring down a baby's fever, try:

* A lukewarm bath or sponge bath
* Extra liquids to keep her hydrated. Nurse or bottle-feed more often, and give babies who drink water (around 6 months) a little more.
* A cool environment. Skip the swaddling for now.
* Medications (acetaminophen or, if your tot is over 6 months, ibuprofen) as recommended by your child's doctor. Never give a baby aspirin.

If your child doesn't improve after you've tried these remedies, call the doctor (if you haven't already!).

Older babies' immune systems are better at fighting infection, so a fever is just one symptom to consider alongside other clues, like lethargy, vomiting, and rapid breathing. Of course, you should always call your doctor if you're concerned, but for the most part, a child over 3 months who has a fever but doesn't seem all that sick probably doesn't need a visit to the doctor. Her fever is doing a good job of fighting off an infection.

William Sears, M.D., a contributing editor, is coauthor of The Baby Book.

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