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Sick Child Basics | Riley Children's Health

When your child is sick, it is natural to worry – especially when you are a first time parent. It is sometimes difficult to know when your child is seriously ill, when is the right time to call the doctor, and what are the best ways to make sure your child recovers as quickly and as comfortably as possible.

Remember, your child’s doctor is always happy to answer your questions, and would rather have you call and ask questions, than wonder and worry.

Below are some helpful tips to help you navigate your child’s illnesses as you care for them at home.

Checking for Signs of Serious Illness

If your baby is less than 3 months of age, it’s particularly important to call their doctor immediately or go to the emergency room for a temperature higher than 100.4° F, excessive fussiness, excessive sleepiness, refusal to eat, and/or coughing.

When your child is sick, he or she may have a fever. A fever is a body temperature that is higher than normal. A fever is usually a sign that the body is fighting an illness or infection. Fevers are generally harmless. In fact, they can be considered a good sign that your child’s immune system is working and the body is trying to heal itself. Have a thermometer handy at home, so that you can take your child’s temperature when they are sick. While the average normal body temperature is 98.6°F (37°C), a normal temperature range is between 97.5°F (36.4°C) and 99.5°F (37.5°C). Most pediatricians consider a temperature above 100.4°F (38°C) as a sign of a fever.

Observing other symptoms and behavior can also help you decide the seriousness of your child’s 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 while 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 six to eight wet diapers a day.
• Worrisome Signs: Your child voids dark yellow urine less frequently than usual.
• Serious-Illness-Likely Signs: Your child has very little saliva (spit), fewer tears than usual when they cry, and very little urine.

If all of the signs in all of the areas are “reassuring,” feel comforted that for the time being, your child is not seriously ill. However, remember that your child’s condition can change, so you will need to recheck signs on a regular basis. If your child has any “worrisome” signs, it is a good idea to report these to your doctor’s office and ask for advice. When “serious-illness-likely” signs are present, it is important that you make an appointment for your child to be seen promptly.

When you make the call to your doctor, give details such as when your child became ill, your child’s symptoms, and any signs that are “worrisome” or “serious illness is likely”, and any medications you have given. Do not be afraid to ask questions or have information repeated.

Unconsciousness, difficulty breathing, or abnormal color (very pale or blue), are obvious signs of a serious illness – call 911 if you ever observe these symptoms.

Common Colds – Safe Relief for Nasal Congestion and Cough

In the first 3-4 years of life, children catch an average of six to eight colds a year. The average cold can last 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 a “cold season”!

Until a child is old enough to blow his or her own nose, clearing the mucus with a suction bulb can make your child more comfortable. The use of over the counter saline nose drops (1-2 drops in each nostril) makes the mucus easier to remove. Saline nose drops can be purchased over the counter (without a doctor’s prescription).

Placing a cool-mist humidifier (vaporizer) in your child's room can help keep your child more comfortable. Be sure to clean and dry the humidifier thoroughly each day to prevent bacterial or mold contamination. Hot-water vaporizers are not recommended since they can cause serious burns.

For children over the age of one year, consider using honey to relieve a cough:

• Do not give honey to babies under one year—it is not safe.
• For children ages 1 to 5 years: Try half a teaspoon of honey.
• For children ages 6 to 11: Try one teaspoon of honey.
• For children 12 or older: Try two teaspoons of honey.

If honey is given at bedtime, make sure your child's teeth are brushed afterward.

Over the Counter Medicines

Do not use over-the-counter (OTC) medicines without first checking with your doctor. Many commonly available OTC medicines for can cause harmful side effects in children. Over-the-counter (OTC) cough and cold medicines should not be given to infants and children under 6 years of age because of the risk of life-threatening side effects. Many OTC cold medicines already have acetaminophen (Tylenol or generic) in them. Giving one of these medicines along with acetaminophen or (Tylenol or generic), would give your child a double dose.

Fever relief:

• If your child has a fever and is uncomfortable, give him or her single-ingredient acetaminophen (also known as Tylenol) or ibuprofen (also known as Motrin or Advil).
• For a baby 3 to 6 months old, give only acetaminophen. Check with your doctor first if your baby is younger than 3 months.
• Ibuprofen is approved for use in children 6 months of age and older; however, it should not be given to children who are dehydrated or who are vomiting repeatedly.
• Do not give your child aspirin, which has been linked with Reye syndrome, a rare but very serious illness that affects the liver and the brain.
• Always measure each dose using a device (syringe, cup, or spoon) that is marked in milliliters (mL).

Prevention

Healthy habits can help you and your child avoid illness and the spread of infection.

• Wash hands:
  • after changing diapers, going to the bathroom, cleaning bathrooms, washing soiled linens/clothing
  • after sneezing, coughing or blowing your nose
  • after wiping or bulb suctioning your child’s nose
  • before eating or cooking
  • after visiting sick friends or family members
  • after touching/caring for family pets
• Do not share drinking glasses, bottles, or silverware, or toothbrushes.
• Protect irritated skin from further irritation and possible infection (nose irritated from wiping/blowing, diaper irritation from having diarrhea). Petroleum jelly (Vaseline) can help a great deal with this.

How to determine that the child is ill? How to observe a child?

Young children have one feature of the body's reaction to the disease: general signs of the disease (symptoms) prevail over local signs of damage to a particular organ or system.

Most likely, a small child will not tell that he is starting to have a sore throat that he is dizzy , muscle weakness and fatigue appear, etc. Children tend to run and jump until the disease is in full bloom. This is what needs to be taken into account when assessing the state of health of the child. nine0005

One of the most common signs of illness is lethargy and loss of appetite . A healthy child is cheerful and active, eats well. If he does not sleep, then he is in a state of "perpetual motion".

Infants smile, walk, they usually have a clear alternation of periods of sleep and wakefulness, good appetite.

Older children run, jump, play, they cannot be kept in one place and do not attract attention for a long time. nine0005

The sick child becomes lethargic, does not smile and does not play, begins to "beep" for any reason, he is not interested in new toys and cartoons, he refuses his favorite food, he asks to sleep earlier than usual, sleeps more than usual (but unless he is overtired the day before). The baby begins to cry for no reason, refuses to eat, does not stop crying even in a full state. If this happens for no apparent and obvious reasons, you need to be vigilant. Perhaps these are just temporary whims. Perhaps you had guests the day before, and the child was just tired. Going to a circus or theater (stadium, cinema, long active games, etc.) at an older age can serve as a source of an excess of emotions (and we say - the child "overdid it"). nine0005

But most often these signs will be harbingers of the disease.

SO YOU SEE THAT THE CHILD IS NOT BEHAVIORING AS USUAL.

Do not rush to pester him with questions. Of course, a child of five or six years of age and older may complain of malaise himself. But even in this case, do not neglect objective observation. At a younger age, children do not localize their sensations and do not have abstract thinking. Therefore, to the question - “where does the stomach hurt”, they always point to the navel area, when asked “the head hurts?” - they answer “it hurts”, and when asked “maybe it doesn’t hurt?” The most common answer is "it doesn't hurt". nine0005

It is very important to understand HOW to supervise children correctly. Do not perceive the child initially as an improved copy of yourself, do not burden your observations with some kind of expectations based on your own life experience or knowledge gleaned from literature. Do not try to FIND THE SYMPTOMS of the disease. Just record your observations, comparing them with how much everything you see is typical for YOUR child.

Remember that the experience and habit of watching a child without pressure, in a natural environment, will help develop a psycho-emotional connection between you - after all, you will learn to understand his body language, understand the meaning of his subconscious reactions to the world around you, including yourself. It is safe to say that your parental attention and love can be realized in real assistance to the development of your child, and will return in the form of his reciprocal understanding and assistance. nine0005

OBSERVING IS A DIFFICULT THING. It in itself can be both beneficial and harmful. Since this book is about the health of the child, it would be wrong to avoid this issue. Watch the child with interest, as an independent being, and you yourself will change your worldview. You will go from dissatisfaction with the dissimilarity between you (for some reason, it seems to parents that children must somehow justify some of their expectations) to the joy of realizing your relationship. The child will certainly perceive this understanding, although not consciously, and this alone will save him from0003 psychological tension , which is the deepest root cause of many disorders that later develop into complex systemic diseases.

Observe the child's general emotional and motor state. Both excessive lethargy and increased activity should alert you, turning into hysterical excitement. Sleep disorders and restless sleep behavior are also phenomena that deserve additional attention. nine0005

Pay attention to how the child walks, whether he is limping, how he moves his arms (this may be a sign of damage to the bones, ligaments, joints or muscles), how he speaks and how quickly and accurately answers questions (this may be due to a disease nervous system or trauma), how it reacts to touch. Is he trying to turn away or cover his eyes from the bright light.

An alarming factor is change in appetite . If a child eats little and refuses his favorite foods, this may be evidence of the onset of the disease, and not necessarily from the digestive organs. nine0003 Disorders of the stool is also a sign of not only diseases of the digestive tract. Diarrhea may accompany many infectious and viral diseases, as well as nervous disorders and allergic reactions. Constipation and colic may be present with fever (for any disease) or even be the first symptom of serious acute diseases such as appendicitis, viral hepatitis or internal bleeding due to trauma. In case changes in the nature of physiological functions (frequency of stool and urination, color, composition of urine and feces), pain during administration - you should immediately contact a specialist.

If a child constantly chews something, one should not rejoice at his healthy appetite. This may be a reaction to psychological discomfort, the first sign of a malfunction of the thyroid gland or other hormonal disorders.

Increase fluid intake often indicates that the child's body is trying to make up for its deficiency (in this case, you can find that the child sweats due to nervous strain, with viral infections, etc.). The same thing happens with intestinal disorders, poisoning or allergic reactions - the body is trying to overcome intoxication, and the child is thirsty.

A change in taste preferences may also indicate malaise. For example, refusal of favorite dishes or vice versa, the desire to eat something that he previously refused. It even happens that children put inedible objects into their mouths. A well-known example is when children and pregnant women eat chalk - their body lacks calcium. nine0005

The following is an examination of the skin for changes in their condition and the appearance of various rashes . Any unusual changes in the skin, subcutaneous fat and mucous membranes must be shown to a specialist. Pay attention to the presence of hematomas (bruises), swelling, limited mobility and changes in the shape of the joints (this may be a sign of their traumatic damage).

Ask your child how he feels, whether he fell the day before, hit his head, did not take any pills, did anyone treat him to unusual sweets or foods. This is especially informative for older children. Be sure to conduct the questioning in a confidential tone, without raising your voice, explain that there is no need to be afraid of anything. Otherwise, being frightened, the child will forget or simply be afraid to tell you something important. nine0005

If you have a suspicion that the child is unwell, it is necessary to measure the child's body temperature . Elevated body temperature is the most common symptom of a wide variety of infectious diseases. It is best to do this several times a day at intervals of about three hours (the so-called three-hour thermometry). This will capture even short-term and slight fluctuations in body temperature. Body temperature is best measured with a mercury thermometer in the armpit. In infants, the use of electronic thermometers is possible, however, it is necessary to follow the instructions for its use very precisely and repeat the measurement several times in a row. Normal body temperature is considered to be from 35.5 ^o C up to 37 ^o C. In children under the age of 3 years, the body temperature can normally rise periodically and up to 37.5 ^o C. Any, even a short-term increase in body temperature above the established limits must be regarded as hyperthermia i. e. manifestation of the disease.

It is necessary to pay attention to the appearance or intensification of various catarrhal phenomena, such as runny nose cough hoarseness0004 . Children who attend kindergarten quite often have these manifestations, so it is necessary to assess not only their presence, but also their intensity.