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Common Illnesses
Fever

When your child has fever (any thermometer reading above 100.4 degrees Fahrenheit), it is probably a sign that her body is fighting an infection. When your child becomes ill because of a virus or bacteria, her body may respond by increasing body temperature. It is important to remember that, except in the case of a heat stroke, fever itself is not an illness- only a symptom of one. Fever also is not a sign that your child needs an antibiotic. As always, it is important to look for the cause of the fever.

Fevers are generally harmless and help your child fight infection. They can be considered a good sign that your child’s immune system is working and the body is trying to rid itself of the infection. However, fever can make your baby uncomfortable. It increases his need for fluids and makes his heart rate & breathing faster.

To help your child feel better is the primary reason for treating your child’s fever. Reducing her temperature may make her more comfortable until the illness that has caused the fever has been treated or, more likely, run its course.

When your infant is 2 months or younger and has a rectal temperature of 100.4 degrees Fahrenheit or higher, call us immediately. This is an absolute necessity. The doctor will need to examine the baby to rule out any serious infection or disease.

Generally. a child older than 6 months who has a temperature below 101 degrees F, most likely does not need to be treated for fever, unless the child is fuzzy or uncomfortable. Observing your child’s behavior is key. If he/she is eating and sleeping well and is able to play, you may wait to see if the fever improves by itself.

In the meantime, do the following:
  • keep your child’s room comfortably cool
  • make sure he/she is dressed in a light clothing
  • encourage him/her to drink plenty of fluids such as: water, diluted fruit juices, or a commercially prepared oral electrolyte solution.
  • be sure that your child do not overexert herself &/or afford him/her more rest than usual.

Over-the-counter ‘fever-reducing’ medications can be given to reduce your child’s temperature if he/she is uncomfortable. These so-called antipyretic agents include Acetaminophen & Ibuprofen. Use of Ibuprofen is approved for children 6 months of age or older but should not be given to babies who are dehydrated or vomiting continuously. Both these drugs are safe and effective when given in their proper/correct dosage (please refer to the Dosing Chart). Don’t hesitate to call us should you have any questions or clarifications.

In some children, fever can trigger seizures, called ‘febrile seizures’. These are almost always harmless, though they should be promptly reported to your child’s Pediatrician.

When your child is having ‘febrile seizure’, immediately do the following:

  • Place him/her on the floor or bed away from any hard or sharp objects.
  • turn his/her head to the side so that any saliva or vomit can drain from his/her mouth.
  • Do not put anything into his/her mouth; your child will not swallow his tongue.

Diarrhea & Vomiting

Prolonged or continuous loose or watery stools are what we commonly call as ‘diarrhea’. There can be many causes of diarrhea, although most diarrhea in children are caused by one of the several diarrhea causing viruses and it gets better by itself within a week. As long as your child is acting well and is taking adequate amount of fluids and appropriate food, loose stools are generally not a great concern.

A child with viral diarrhea usually has a fever and often, the said illness starts with some vomiting. The major concern for diarrhea & vomiting is dehydration. If your child has repeated or forceful vomiting, or frequent watery stools, call our office for advice.

You should promptly call us for your child to be seen if he/she is less than 6 months old or when he/she has any of the following:

  • blood in stool
  • persistent frequent vomiting
  • persistent localized abdominal tenderness or extreme pain
  • urinates less frequently (wets less than 6 diapers per day)
  • no tears when crying
  • lingering high fever
  • dry sticky mouth
  • loss of appetite even for liquids
  • extreme thirst &/or listlessness
  • noticeable weight loss &/or sunken eyes

Points To Remember:

  • A 2 hour period of ‘absolute fasting’ is necessary to allow your child’s GI tract to settle down or ‘rest’. Your child maybe thirsty & fussily begging for liquid but you must stand firm and refuse to let him/her sip or eat anything for this period. Wiping his/her face with a cold, moist cloth, or allowing him/her to hold very cold barely moistened cloth to his mouth or between his/her teeth may help you get through this difficult time.
  • After the fasting period, start him/her with small sips of Pedialyte, 7-up/Sprite, Popsicles, Apple juice (diluted ½ juice- ½ water) and the like. Slowly increase to a maximum of two ounces; do not ‘overload’ your child’s stomach at any time. Offer sips every ten minutes, and slowly increase the quantity of fluids given. If vomiting recurs at any stage, STOP – rest briefly, and start again with small, frequent sips. Increase the amount as tolerated. If vomiting persists excessively, contact us.
  • Do not use over-the-counter or prescription ‘anti-diarrheal’ medicines for your baby
  • Do not give him/her any food with fat of any kind, such as whole milk, butter, salad oils, etc.

Common Cold

Every baby or child at one time or another is going to have a common ‘cold’ or a more common type of an Upper Respiratory Infection (URI). A ‘cold’ is due to a virus that is caught by the child from the nose or throat of another person through nasal secretions (sneezing) &/or hand contact.

Generally, a ‘cold’ begins with watery discharge from the nose accompanied by sneezing and watery “weak” eyes. Especially at night, some coughing may accompany the ‘cold’. Coughing serves the purpose of keeping the throat and bronchial tubes clear. There may or may not be a fever for the first three or four days. By the third or fourth day of the ‘cold’, the discharge from the nose usually becomes thicker and your child maybe bothered by a stopped-up nose and some increase in the amount of coughing.

Coughing is an important function of the body and keep infections from spreading to the lungs. Coughing occurs with colds because of the drainage of mucous (post-nasal drip) in the upper airway. During the day, children swallow this mucous. At night, the cough worsens because it is more difficult to swallow the mucous while lying down. Increasing clear fluids intake and using a vaporizer or humidifier will help to keep the cough loose. Sometimes, a decongestant or nighttime cough suppressant, maybe helpful. Chronic coughing may be caused by passive cigarette smoking, wood burning stoves or allergies.

Antibiotics have absolutely no effect on ‘colds’ (or other virus-caused illnesses), although they are used to treat the complications of a ‘cold’ such as ear infection or pneumonia. In newborns, the most effective items to use are infant ‘bulb syringe’ to remove the mucous from the nose and normal saline nose drops. The saline drops are available at your local pharmacy and are safe even for infants.

The common ‘cold’ will gradually run its course and usually disappears within two (2) weeks from the onset. CALL US IF AT ANY TIME YOUR CHILD HAS RAPID OR DIFFICULTY BREATHING, CHEST PAIN, HIGH FEVER &/OR WHEN HE/SHE LOOKS VERY ILL.

Ear Infections

Infections of the middle ear (Otitis Media) are the most common bacterial infections of childhood. It is often a complication of a cold virus. The average child from 6 months to 3 years old may have 2 to 4 ear infections a year. One important reason is that the Eustachian tube which connects the middle ear to the back of the throat, is shorter and straighter than in adults. Also, drainage from the tube is more difficult lying down ( the position in which infants spend most of their time).

As children grow, the tubes lengthen and become more vertical. This result in fewer infections. Children also have larger adenoids. They catch more ‘colds’ because they have less immunity to the viruses that cause ‘colds’.

An ear infection can also occur 1 to 2 weeks after a cold. Symptoms of infection include ear pain (which can be quite severe), drainage from the ear, poor feeding, irritable & fussy, difficulty hearing or ‘funny noises’. Call us to schedule an appointment, if you suspect your child has an ear infection. Ear infections that are untreated may progress on to more serious infections.

Points To Remember:

  • Take the antibiotics as prescribed by the Pediatrician for the entire time, no matter how much better your child feels.
  • Hot water bottle or heating pad may help reduce pain.
  • Decongestants or antihistamines may be helpful; however, if the child becomes too sleepy or refuses to take it, then it is alright not to give it or to give half of the usual dose.
  • Tylenol or Motrin may be used to help ease pain or fever.
  • Every child with an ear infection needs to be rechecked in 10 to 14 days in order to see if the child’s ears are normal again. This is important because chronic ear infections can eventually cause loss of hearing.



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