Sometimes all you want to do is to survive. This is especially true when it is 2 AM and your child has a temperature of 104 degrees and won't stop crying. Such experiences have made me much more compassionate in my approach to parents when they bring their sick children in to the office. Still, I don't really want to spend my day taking care of the "worried well," and so we have created a "survival sheet" for parents in our practice. The idea is for parents to first go to this sheet and see if it answers their questions. Hopefully this will cut down on unnecessary visits and phone calls.
Here are some of the sections:
10 Things to know about fever
1. If your child is under 3 months of age, bring them immediately to be seen.
2. Fever does not contribute to global warming.
3. The only good reason to treat a fever is for the child’s comfort. This is a good reason
4. Fever does not cause seizures or brain damage in normal children.
5. Fever goes away immediately upon entering your doctor’s office. This is caused by the fever gnomes who like to make parents feel silly.
6. If you do treat the fever, use the above doses of Tylenol and Motrin. Generally, Motrin works longer and is somewhat stronger, but Tylenol doesn’t upset the stomach. They can be given at the same time.
7. 90% of fevers happen at 2 AM.
8. The official definition of a fever is a temperature over 100.5 degrees.
9. Milk does not “curdle” in the stomach of a child because of a fever. It curdles because the stomach has acid in it. It always curdles in the stomach.
10. When you come in and your child’s fever has gone away, we believe you that they actually had one. Honest.
When your child vomits...
1. Clear liquids (Pedialyte, Gatorade, etc.), and bland food (see Diarrhea section for BRAT diet) are best.
2. Many small portions of water are better tolerated than a few large portions (even a sip every 5 minutes is better than no fluids).
3. Call for any sign of dehydration (greatly decreased urine output, very dry mouth, listlessness), or if lasts more than 3 days.
4. Stay out of the line of fire.
· There are signs of dehydration (greatly decreased urine output, very dry mouth, listlessness).
· There is blood in the stool.
· It lasts more than 5 days.
· You are in a public place and can’t hold it in.
1 If these are not the case, these tips may help you survive this wonderful illness:
- Avoid milk products and strong juices (such as apple juice).
- Children under 12 months will do better on “Isomil DF” which contains fiber to add bulk to the stool
- For older children, the BRAT diet (nice name) can be used: Bananas, Rice, Applesauce, and Toast (some people add Yogurt, to make it the “BRATY”)
- Plenty of liquids. Dehydration is the enemy!
- Kayopectate or Imodium AD may be used as directed
- Don’t go on any long car trips unless your ventilation is good or your sense of smell is bad.
I like that last line. I couldn't help myself...
When antibiotics may be useful
Antibiotics are one of the great advances of medical science history. Yet, there are times when they are not helpful, and may in fact be harmful. Although there has been suggestion by some parents to put Amoxicillin in the water supply, we generally do not call in antibiotics without first seeing your child. This is because of the possibility of creating antibiotic resistance in the bacteria if we unnecessarily prescribe antibiotics.
The following is a list of circumstances when antibiotics may be useful:
1. Ear infections. Call the office if your child is not improving in 3-4 days.
2. Strep throat with positive strep test, or if family member has positive strep test.
3. Cough lasting over a week may require antibiotics.
4. Urinary infections.
If your child appears very ill, or if you are very concerned, call to have them seen.
Antibiotics will not make a cold (or virus) get better any faster.
Click on the image of the sheet below to see the whole sheet.