Why is sickness in a child such a worry? If you become ill, you probably wait four or five days before even thinking of calling your doctor. If your child becomes ill, you have to talk yourself into waiting to make the call to the doctor until you have taken your child’s temperature. Most parents – especially first-time parents – call the doctor’s office more than necessary. But doctors would rather have you call too often and too early than too late.

Doctors know that it’s difficult for parents to tell when a child is seriously ill and that a child can get very sick very quickly.

Health Habits: Keep it to Yourself

Anyone who cares for your child should know and use these habits to limit the spread of infection:

• Wash hands after changing diapers, going to the bathroom, cleaning up soiled linens or soiled clothing.
• Do not share combs, brushes, or hats.
• Do not share drinking glasses, bottles, or silverware.
• Do not share toothbrushes. Purchase a new toothbrush after your child recovers from an illness. Discard old toothbrush.
• Protect skin in areas of constant moisture and irritation (nose with cold, diaper area with diarrhea) from cracks and sores that may become infected.
• Wash hands after wiping nose or using nose syringe for baby’s nose. To prevent the spread of infection from nose to eye, keep hands away from eyes after blowing nose or touching nose.

How Sick is Sick?

When your child is sick, get into the habit of checking your child’s temperature and observing your child closely. Unconsciousness, difficulty breathing or abnormal color (very pale or blue) are obvious signs of serious illness. More subtle signs (listed below) can also help you decide the seriousness of your child’s illness.

Checking for Signs of Serious Illness

Appearance
Reassuring Signs: Your child appears “bright-eyed” and alert.
Worrisome Signs: Your child appears sleepy with “dull” eyes and little expression on his or her face.
Serious-Illness-Likely Signs: Your child just stares “blankly” and has a “glassy-eyed” look.

Cry
Reassuring Signs: Your child cries in the usual way at the usual things.
Worrisome Signs: Your child’s cry sounds whiny. Your child is difficult to comfort and whimpers off and on.
Serious-Illness-Likely Signs: Your child’s cry sounds weak. Your child continues to cry or moan even when being comforted.

Activity Level
Reassuring Signs: Your child plays and sleeps normally.
Worrisome Signs: Your child is fussy when awake and sleeps more than usual.
Serious-Illness-Likely Signs: Your child is hard to awaken and has little or no interest in playing.

Appetite
Reassuring Signs: Your child asks for favorite foods and liquids and eats and drinks the requested foods and liquids.
Worrisome Signs: Your child takes liquids or food if offered, but takes only a few sips of liquid or a few bites of food.
Serious-Illness-Likely Signs: Your child pushes away or refuses all food and liquids.

Urination
Reassuring Signs: Your child voids (pees) light yellow urine with the usual frequency. A baby should have 6-8 wet diapers a day.
Worrisome Signs: Your child voids dark yellow urine less frequently than usual.
Serious-Illness-Likely Signs: Your child appears “dry” and his or her eyes appear to have sunk back into the head. Your child has very little saliva (spit) and very little urine.

If all of the signs in all of the areas are “reassuring,” feel reassured that for the time being, your child is not seriously ill. However, remember that your child’s condition can change, so you’ll need to recheck signs on a regular basis. If your child has one or two “worrisome” signs, it’s a good idea to report these to your doctor’s office and ask for advice. If your child has three or more “worrisome” signs, call the doctor’s office immediately to report your observations and to request an appointment for your child.  When “serious-illness-likely” signs are present, it is important to act quickly to make arrangements with your doctor to have your child examined without delay.

Making the Call

When you make the call to your doctor, begin with a report of your child’s temperature. Tell the doctor your child’s temperature, how it was taken, and the time and amount of the most recent fever medicine. Next, briefly go over when your child became ill, your child’s symptoms, and any signs that are “worrisome” or that “serious illness is likely.” Have pen and paper ready to write down the doctor’s instructions. Don’t be afraid to ask questions or have information repeated.

In the first 3 months of life, it’s particularly important to call the doctor if your baby is sick.  Call your doctor immediately for a temperature higher than 100.4° F. DO NOT USE ASPIRIN TO BRING THE FEVER DOWN.  If other symptoms such as excessive fussiness, excessive sleepiness, refusal to eat, and/or coughing are present, seek care immediately

Useful Info: The All-Too-Common Cold

In the first 3-4 years of life, children catch an average of 6-8 colds a year. The average cold lasts three weeks. If you add up the time that your child is catching a cold, sick with a cold, and getting over a cold, almost half of the year is “cold season.”

Until a child is old enough to blow his or her nose, mucus from the nose drains into the back of the throat and is swallowed into the stomach. By clearing the mucus with a nose syringe, you can make your baby more comfortable. The use of saline nose drops makes the mucus easier to remove. Saline nose drops can be purchased over the counter (without a doctor’s prescription).  Babies with colds sleep better if placed in a semi-sitting position in a pumpkin seat rather than flat on their backs because they are less likely to be bothered by draining mucus.

Infections Disease Alert: Your Child May Need Protection
If your child is exposed to hepatitis or meningitis, call your doctor. Provide the doctor with the name and phone number of the individual who notified you so the doctor can follow up, if necessary.

Health Alert: Over the Counter Medications

Do not use over-the-counter (OTC) medicines without checking with your doctor.

There are lots of over-the-counter medicines that adults use that should not be used for children. It’s not just a matter of adjusting the dosage. Many drugs can cause harmful side effects in children. Although the pharmacist is a wonderful source of information about prescriptions and over-the-counter medications, you should not substitute his or her advice for your doctor’s OK.

Take the following over-the-counter medication list to your child’s next well child visit. Ask your doctor about using these medications. Write down the name and the dosage of any drug your doctor OKs. Also write down any warnings.

• Cold preparations including all combination medications for a cough, fever, runny nose
• Sleep medications
• Medications to dry up a stuffy nose
• Medication for vomiting
• Medication to stop diarrhea
• Antihistamines or decongestants