Pediatrician Jennifer Shu, MD, editor-in-chief of the American Academy of Pediatrics’ Baby & Child Health, past national chairperson of the young physicians sections for both the American Medical Association and the American Academy of Pediatrics and the mother of young children herself, took the time to answer some questions about when parents should take their children to the doctor. Especially during cold and flu season, it may be hard to determine when you should stay home and when you should go see your pediatrician. Dr. Shu has some great information and tips for parents when their children are sick.
When Should Your Child Go to the Doctor?
Dr. Shu: Parents should always seek professional care when concerned with their child’s health or if they have any unanswered health-related questions. A simple phone call to a nurse or an appointment with a doctor can help ease a parent’s mind if something just doesn’t seem right.
I suggest seeking medical care if a child is suffering from:
- High or persistent fever
- Any breathing problems, such as fast, labored or noisy breathing from the chest
- Persistent pain such as an earache, sore throat, severe headache or stomach ache
- Eye discharge that is thick, sticks the eyelids shut, and doesn’t get better during the day
More Reasons to Seek Medical Care for Your Child
In addition to the symptoms above, you may need to have your child seen for:
- Frequent vomiting or diarrhea and he isn’t able to keep down enough liquids to produce urine at least once every six to eight hours -- this could be a sign of dehydration. Severe dehydration needs to be treated in the emergency room.
- Vomit or diarrhea that contains blood.
- A stiff neck, extreme lack of energy or the illness seems to be getting worse rather than staying the same for more than four to five days.
- Has been exposed to a contagious illness such as mono, influenza or chickenpox or has travelled out of the country recently.
What to Watch for With a Fever
It’s important to pay attention to how a child is acting with a temperature. If the child has a high fever but is playful and active, the illness may be less concerning.
Paying close attention to a child’s respiratory symptoms is important, as fast or labored breathing may signal that the child has a serious illness.
When to be Concerned About a Fever in a Child
Children’s fevers may reach different heights (some tend to run high whenever they’re sick, while others rarely have high temperatures), so it is important to pay attention to how a child is acting and eating/drinking.
For newborns (under about 3 months), any fever over 100.4 F can be concerning and requires evaluation.
For children three months to three years, a fever higher than 102 F can be worrisome.
In general, there isn’t a set cutoff number for children’s fevers, but the symptoms occurring alongside the fever are very significant.
How Parents Can Help Kids With Shots
Ask the doctor about an appropriate dose of acetaminophen (Tylenol) or ibuprofen (Motrin or Advil) that can be given about 20 to 30 minutes before a vaccine. While the vaccine is being given, distraction works well (singing a song or watching a video). Try numbing the spot ahead of time (ask your doctor about where to apply a freezing spray, ice pack or lidocaine cream and make sure the cream has enough time to work). Older children may also appreciate if a parent gets a shot with them.
Importance of Flu Shots for Kids
It is important for children aged six months and older get a flu vaccine. Not only does it protect them from serious complications of the flu, but by preventing young children from getting sick, they will be less likely to spread the disease to people with relatively poor immune systems such as infants or the elderly. In addition, children under two years of age are at risk for hospitalization from problems associated with the flu, such as pneumonia. Another option is the nasal flu spray vaccine, which may be used in children age two years and older who do not have asthma.
Tips for Caring for Your Child at Home
I recommend making sure your child gets plenty of fluids and rest, and consider chicken soup, which can reduce congestion and inflammation caused by a cold. Before giving your child any medication, be sure to talk with your pediatrician about the best treatment for your child’s ailments. You should not give younger children medication meant for older kids or adults. Dosage is important, so read labels carefully.
When to Keep Your Child Home From School
Although schools and child care centers may have their own rules, two reasons that a child should not attend school are: fever over about 101 F in the last 24 hours and the inability to focus on school work. If a child is uncomfortable, tired or in a great deal of pain, he is better recuperating at home. Children with a high or persistent fever, excessive fatigue, rashes which could be contagious, difficulty breathing, frequent cough, thick eye discharge, dehydration, or repeated episodes of vomiting or diarrhea should seek medical advice before returning to school.
Dr. Jennifer Shu Interview, 06 Mar 09.