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How to Care for a Sick Child

As a mom, you want your little one to stay young forever. But wouldn't it be great if sometimes they could just tell you what was wrong? Case in point: When they're feeling under the weather, and you can't seem to figure out how to ease their symptoms.

While your baby or toddler might not be able to verbalize how he's feeling, as a parent you can learn to how to recognize signs of illness, how to react once you see them and what you can do to possibly prevent them in the future. We spoke with several pediatricians to find out the important information you need to know in order to keep your baby healthy and happy.

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Check for a fever. Fever in babies can be caused by a host of different things, from a cold or viral infection, a reaction to a vaccine, or very rarely a serious infection, such as meningitis. Regardless of the cause, a fever in a very young baby is something that should not be overlooked. "In young infants, under 3 months of age, we worry most about fever," says pediatrician Dr. Wendy Sue Swanson, executive member of the American Academy of Pediatrics. "When we see fever in a young infant, it can herald an underlying infection." If the fever is over 100.4 degrees, and your child is less than 3 months old, get her in to see her pediatrician right away.

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But don't fear a fever. Fevers can be disconcerting, but don't jump to conclusions. You're not necessarily dealing with a medical emergency in children over 3 months old. "Any temp over 100 degrees, under 3 months of age, needs an urgent visit. After that, parents should take temps in older infants when they are suspicious," says Swanson. "I often advise parents that you don't want to treat the numbers on the thermometer. Rather, treat your child. If they have a warmer temperature than normal, say 100 degrees, they may be showing signs of a small infection. But if they are otherwise well, playful, eating well and comfortable, there is no need to reach for acetaminophen." Instead, just monitor how your child's doing. He'll most likely improve on his own.

Treat colds. You probably get a few nasty colds during the cold-weather months, and your little one likely will, too. "In infants over 6 months and older children, colds and mucus and coughs are a normal part of the winter," says Swanson. "Most children have between six to 10 colds during the school season."

That may sound like a lot, but you can help ease the effects of cold symptoms. Just arm yourself with the right tools. "Things to have on hand for infants with cold symptoms: bulb suction to help clear mucus; humidifier for the room; and patience! Some babies will have sleep disruption when they are fighting off a cold illness. They cough more at night when lying down, and it disrupts their schedules. Typically, most runny-nose and cough illnesses in infants and children should resolve in seven to 10 days." But if the virus hasn't run its course in around a week, that's when you should check in with the doc.

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Use over-the-counter meds carefully. Before you reach for any over-the-counter-medications, be extremely careful of type and dose, especially with younger children. "I don't recommend any cough or cold medicines for children under 6 years of age, as there simply isn't data that they do any good to help children recovering from mild upper-respiratory infections," says Swanson. "Tylenol is fine, but often the cough and cold meds over the counter have a combination of medications, and families get very confused with what they are dosing and how and when to use it." Bottom line: Always be cautious, and check a dosing chart before administering any medication.

Be aware of unusual behavior. Most sickness will just be a minor speed bump for your baby, but there are symptoms that should raise an eyebrow. "Moms should really trust their instincts—big changes in crying, sleeping, temperament may mean your child feels unwell," says Swanson. "What I worry about in newborns are significant changes that parents can't explain; things like a day where a baby cries much more than usual, sleeps far more than usual or refuses to feed." Bottom line? Don't wait too long if you feel something is truly not normal. "If your baby just isn't herself for a day, you may want to check in with the pediatrician or nurse," Swanson says. "They can often help triage any concerns you have."

If you see anything that you don't like, no matter the time, it's best to get immediate help. "The big ones that warrant immediate attention are a rectal temperature over 100.4 in a child under 3 months; vomiting; poor feeding for two days in a row; change in color around the lips, especially blue; trouble breathing; 'looking sick;' or inconsolable crying—those require a trip to the ER in the middle of the night," says Dr. Tanya Altmann, pediatrician and author of Mommy Calls. When in doubt about severe illness, go to the Emergency Room.

Call the pediatrician. Although you should be cautious with symptoms, don't live in constant fear of the worst. If it looks like a cold, it's probably a cold. Just call your kiddo's doc for advice on how to deal with it, and ease your mind. "Mild symptoms like a runny nose, cough and fussiness, you can call your pediatrician," Altmann says. "You should always feel comfortable calling the pediatric clinic first if it isn't an emergency," Swanson says. "They can help you determine where to go if you're seeking help."

Be prepared. If this is your first child, you should definitely ask your pediatrician which steps to take if you have health concerns. She'll be able to answer for you. "It's always a great question to ask at the first or second visit [to the doctor]," says Swanson. "Have your pediatrician tell you who to call and when, what time the nurses are around during the day, and when to call ER versus 9-1-1."

And as that time of year looms, make sure you prepare for the worst of it and know when to seek medical help. "We've had a couple of very serious flu seasons," says Altmann. "If it's a high fever and cough, your infant needs to be seen. Going into winter, this is huge. Vomiting and diarrhea is still a major cause of hospitalizations for babies and children. If it's persistent, and they can't keep fluid down, they can get dehydrated very quickly."

Also, consider the flu vaccine. It can really help guard against illness. "For children over six months, we recommend the flu vaccine. And it's a good idea for everyone who spends a lot of time with your baby to get vaccinated." The goal: Form a cocoon around her, keeping her safe from the sickness in all directions.


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