When Your Child is Sick............   Frank Barnhill M.D.
 

Your child is running a fever if his temperature by rectal or oral thermometer is over 100.4.  You cannot tell when a child has a fever by touching the skin.  Skin contact thermometers are terribly inaccurate.  Please remember that a fever is just the body’s way of fighting an infection.  So, a fever under 103 is usually not considered dangerous, unless your child has a history of febrile seizures.  We like to alternate Children’s Advil® and Children’s Tylenol® every four hours to help bring a fever down.  Another way to lower a fever is by removing clothing, giving a tepid water bath (not hot and not cold to the touch), and making sure the child drinks many cool liquids.  You should never put your child in an ice bath unless told to do so by a doctor.  Sudden lowering of core body temperature can cause seizure.  If your child’s fever persists for more than 36 to 48 hours, you should call your doctor.

Not every child needs antibiotics when they are sick, running a fever or have a croupy, deep cough.  Many of these infections are viral, and some experts feel that the antibiotics actually may make the illness last longer by interfering with the body’s immune system.  Ordinary antibiotics cannot cure viral illnesses.  Inappropriate use of antibiotics may make the drug useless should your child need it in the future.

If for some reason your child should require an antibiotic, always finish all bottles and do not skip doses.  Different illnesses require different lengths of treatment.  Even though your child may feel better, the infection is probably just hanging around waiting to pop back up in a week or so.  This hidden infection is the reason some kids appear to get well then seem to develop the very same symptoms a few days after the antibiotics are stopped.

Vomiting and diarrhea are common problems with colds and the flu.  If a particular food seems to either cause or worsen the condition, by all means, avoid feeding your child that food until no vomiting, diarrhea, or abdominal cramping has occurred for 24 to 48 hours.  For young children, when abdominal cramping, vomiting or diarrhea starts, it’s time to use Pedialyte® or twice diluted Jell-O® water.  Do not use full strength Gatorade® or other sports drinks as they may contain a high content of salt and this makes dehydration worse.  Clear liquids should be used for 12 hours, and then an attempt should be made to feed bland foods, such as toast, applesauce, bananas or Jell-O®.  You should phone your doctor’s office if vomiting or diarrhea persists beyond 36 to 48 hours.  In young children, dehydration will result in no tears when crying, possible extreme sleepiness, irritability and lack of urination or sweating.  Watch for these signs carefully in babies.

Stuffy noses are a big problem at almost any time of the year.  The FDA has taken all children’s and adult’s cough and congestion containing phenylpropanolamine off the market due to the drug causing seizures.  This call back means there are very few drugs available for a cough or stuffy nose, either prescription or over the counter.  We feel that Robitussin CF® or Pediacare Cough® formula, as well as the new Advil Children’s Cold Formula are probably among the safest.  Most of the time, it is not wise to totally suppress a cough, especially if your child has bronchitis.  The cough mechanism is the body’s way of cleaning pus, mucus and debris out of the bronchial tubes.  If a cough is suppressed, sometimes this will make recovery from the illness take longer.  We’ve seen such coughs last days or in rare cases, even weeks.

We hope these general tips provide some help during your child’s illness.  The content of this handout is not intended to provide the basis for diagnosis or treatment of any specific disease.  That determination is still best made by your family physician.  If you have questions or concerns, please do not hesitate to ask your family doctor.

drhuggiebear, drhuggiebear.com and contained materials are the copyrighted and/or registered properties of Frank Barnhill, M.D. and may not be reproduced for profit without the express written permission of the author.  All materials may be photocopied in whole for educational use.  For information please contact us at drfrank@drhuggiebear.com.