Illness

There are many reasons that illnesses are more common in children. Most will be viral and uncomplicated, i.e. no bacterial illness exists that requires antibiotics. Parents frequently want to know when the doctor should be called. In the ill child there will usually be a combination of these symptoms:
	Temperature higher than 100 degrees when taken under the arm in the infant under two months of age.
	Persisting fever, especially if unresponsive to acetaminophen and/or sponging.
	Labored breathing

	Poor color

	Apathy

	Excessive crying that cannot be comforted.

	Frequent repeated vomiting.

COMMON HEALTH CONCERNS:

*FEVERS*
	Pediatricians receive hundreds of calls pertaining to fever. Most parents are concerned that a fever of 102-103° or higher is potentially harmful to their children. Fever itself is not harmful to the body unless it reaches a height of 105-106° degrees. Fevers RARELY reach this height. Fever is generally a symptom or sign to the doctor that there is some type of disease process occurring. Most commonly, fevers are caused by infections even though there may be other causes. Doctors are more concerned about other symptoms associated with the fever such as lethargy, difficulty breathing, sore throat, earache or stiff neck. Most physicians recommend treating fever to help the child feel more comfortable. However, there is some scientific evidence that fever may actually be beneficial to the body. If your child has a fever and you are concerned about the fever or about other associated symptoms, contact our office for advice and management. Article on febrile seizures.
*COLDS*
	Colds are viral infections, can occur as often as six to eight times per year, and can last one to two weeks. Symptomatic treatment to make your child comfortable is all that is required. For the infant, humidification of room air is helpful, nasal bulb syringe suctioning with the instillation of saline nose drops can temporarily open the nose to help breathing and sucking. For the infant over six months, common over-the-counter decongestants may help but should be stopped if the infant becomes lethargic or excessively irritable. Acetaminophen is the medication of choice for fever over 100 degrees measured under the arm. Ibuprofen is an acceptable alternative. Read more about colds
*CROUP*
	Croup alarms parents and usually has its dramatic onset at night. The child wakens after going to bed well with a barking cough, hoarse voice and loud noise when he/she breathes in. The child may be apprehensive as well. Try to be calm yourself. Take your child into the bathroom, close the door and turn on the shower hot water. Hold him/her on your lap, reassure your child and let him/her breathe in the steamy atmosphere. Usually twenty to thirty minutes is enough. This should ease the breathing, but not cure it. Another home remedy for croup is a 20-minute exposure to cold air. Take your child out on the porch at night for a brief period of time; this will often help. If this does not help, you must call us. The noise he/she makes breathing is due to swelling in the windpipe from the infection and is called stridor. Failure to be improved by breathing the steam or cold air, coupled with fever and retractions of his/her chest, constitute an emergency. Read more about croup
*VOMITING AND DIARRHEA*
	This is a common pediatric intestinal illness, again, usually caused by viruses. Usually the vomiting period is first and lasts several hours. At the beginning, don't try to feed the child anything. Let him/her "empty out," wait about two hours after the last vomit, and then begin with frequent small feedings (one to three teaspoons every twenty minutes) of a clear liquid such as Pedialyte©. The diarrhea may begin at this time, but the vomiting period will be over. Over the next twelve hours the clear liquid feedings can be increased to two to four ounces at a time, maybe every thirty to forty-five minutes. Don't force the child if he/she refuses; wait a few minutes and then try again. For the infant still on formula or breast feeds, the next liquid to drink should be half-strength formula, or breast milk, for twelve to twenty-four hours followed by normal strength formula as much as he/she wants. With beginning half-strength formula you can also offer the child foods such as rice, rice cereal, mashed potatoes, macaroni and cheese, Jello, Popsicles, bananas, applesauce (not apple juice), toast, crackers, etc. The infant's/child's stools will decrease in number long before they firm up and return to normal. The diarrhea typically lasts five to seven days. Fever for longer than three days, blood in the stools, failure to take fluids, marked abdominal pain and dehydration are signs that you should notify us. Dehydration signs include failure to pass urine in the last eight to twelve hours, dry mouth, absent tears, and doughy skin in a limp child. Read more about vomiting Read more about diarrhea
*EARACHES*
	Ear pain commonly accompanies colds and may indicate infection. Temporary relief can be given by acetaminophen and local warmth such as a hot water bottle, to a few drops of warm, clear oil in the ear. For persisting pain, your child will need to be seen. Read more about diarrhea
*ACCIDENTS or POISONINGS*
	Although fever and illness in your child are important to you, accidents and poisonings are more likely to cause serious harm. Lack of fear coupled with the child's nature to inquire and explore result in the toddler and preschooler frequently putting himself/herself at risk of injury. Knowing where your child is and what he/she is doing will require more of your responsibility and attention. You may not be able to prevent accidents but you can look for ways to reduce the risk of injury. Car seats, simple toys without sharp edges, and toys that are sturdy are but a few ways to do this. Keep medicines, household cleaning products or anything of potential risk out of sight and reach. You should keep a supply of Syrup of Ipecac both at home and possibly at the sitter's or grandparents' homes.
The Poison Center at the Columbus Children's Hospital is readily accessible by calling 228-1323. Keep this number by your phone along with other emergency numbers.