A frantic mom rushes up to the Triage window in the Emergency Department, her eyes wild. “My baby is choking!” she cries. The staff scramble to get the baby in back and assessed.
Yet in the mom’s arms is a pink, calm infant. After a few moments of reassurance by the triage nurse, the mom begins to breathe normally. Thus begins a common evening visit to the ED.
Many moms lie awake at night listening to their babies breathe. Most worry: what if she stops? Then when baby gets her first cold, mom worries that her worst fear is about to come true. Mucus in the baby’s nose runs to the back of her throat as she lies flat in bed. The baby gags, then coughs, then splutters, then gives a single sharp cry, gags and coughs and splutters again.
By this time mom is on her feet and baby in her arms in one panic-driven motion. Baby continues to gag. Mom’ mind races between suctioning baby’s mouth with the bulb syringe, giving back blows, or giving mouth-to-mouth breaths. Maybe she calls the ambulance, sometimes calls a nurse or paramedic friend who lives nearby. Eventually mom and baby end up at the triage window and baby is back to normal.
What mom has witnessed is a normal event in many little babies’ lives. Despite mom’s fears, the episode is not life-threatening. It is not the beginning of Sudden Infant Death Syndrome (SIDS), also called “crib death.” Baby will not choke to death on mucus or vomit lying on her back in the middle of the night. The coughing and gagging and spluttering and vigorous swallowing baby does are the normal reflexes babies use to clear her airway.
The fear that baby will choke to death is made worse by the stories of so many rock-and-roll stars dying of lying on their backs and vomiting. The problem with theses music icons is that their normal cough and gag reflexes have been numbed by drugs and alcohol so that they can not cough and gag and clear their airways like babies do. Thus they drown on the little pool of vomit in their throats.
Thus the recommendation by the American Academy of Pediatrics holds true- but babies to sleep on their backs. SIDS happens twice as often to babies put to sleep on their stomachs because they are more likely to smother in thick bedclothes.
So what should mom’s do to make babies with colds sleep better? One thing to try is to put baby to sleep in a car seat, swing, or bouncer. When baby is upright, the mucus does not hit the back of the throat and cause coughing and gagging. Strap baby in! Do not put baby on a pillow, which greatly increases the risk of SIDS.
A second thing to try is a vaporizer at the bedside- indoor air at night is dry, and it dries out mucus so that it is thicker and harder to clear, and airways get more dry and irritated. A vaporizer putting out mist may moisten baby’s throat and thin the mucus. Finally, it is okay to give baby tylenol for pain before bedtime- baby may have some sore throat and other pain from the virus that she cannot tell us about.
Next time your baby gets a cold, don’t panic. Try the car seat for bed, try the vaporizer, try tylenol. And if baby gags in bed, sure, go ahead and call your doctor or your medical neighbor. But if baby recovers on her own in a few minutes, take a deep breath yourself- baby is okay!