 | ||
|
| |    Fever: Nine Months to Three Years by Laura Jana, M.D., F.A.A.P. reviewed and revised by Lynn Cates, M.D., F.A.A.P. Not every child who feels warm has a fever Healthy babies and toddlers have normal changes in their body temperature over the course of a day. They can feel warm to the touch after a lot of crawling or running around, or if they are dressed particularly warmly. When to take fever seriously Fever often serves a useful purpose in helping your child's body fight an infection. After nine months of age, babies and toddlers generally fight infections pretty well. Rather than just paying attention to whether your child has a fever, it's more important to assess how long the fever lasts, how high it goes, and, most importantly, how sick your child seems. How high a fever goes doesn't necessarily predict how serious your child's illness will be. When in doubt, ask your child's healthcare provider: "At what point should I call again?" Often when children have temperatures above 101.5 degrees F (38.6 degrees C) or so, they tend to appear very sick. If you are unable to get the fever down with medication, or if your child still appears to be very ill, seek medical attention. Fevers often help to follow the course of an infection, so many health professionals want to be informed if fevers continue more than a certain number of days without resolving. (I generally use five days as a rough rule of thumb.) Don't depend on fever as your only sign of infection If your child is irritable, lethargic, not feeding well, or just looks sick to you, whether or not she has a fever, you should suspect an infection. Don't assume that a fever has to be present before seeking medical attention if you have concerns about your child's health. Common causes The most common causes of fever in a child this age are generally the same as for you or me, viral infections. If your child has symptoms of a viral infection (such as the common cold or diarrhea), especially if she has been exposed to others with the same symptoms, she may well have the same infection. Infants may become much sicker than older children and adults with the same infection. The same cold that causes a simple runny nose in an eight-year-old can cause fever, congestion, poor sleep, poor feeding, and even vomiting in a baby. The best approach is to limit your child's exposure to people who are sick, especially people with fevers. Keep in mind, however, that babies at this age benefit greatly from being around other kids, and it's not practical to avoid every child with a runny nose for fear of a fever or cold. How fever affects your child's eating Babies and toddlers with fevers tend to be disinterested in food. You may find that your child is more interested in eating when the fever has come down. If she does not show any interest in food, don't worry. During a normal cold or fever, it does not matter if your child does not eat as long as she continues to get enough to drink. Instead of focusing on food, direct your attention toward making sure that she gets enough to drink and doesn't become dehydrated. Keeping track of your child's fluid intake is much more important when she has a fever. Pay attention to how much and how often your child is drinking compared to her normal intake. Fever, as well as vomiting and diarrhea, can lead to dehydration. Even if they don't have vomiting or diarrhea, smaller children can become dehydrated more quickly than larger children and adults, but not as quickly as when they were infants. Offer small amounts of fluids more frequently. For toddlers who are not drinking well, you can be a little more creative in your attempts by offering items such as popsicles, ice cream, and Jell-O. Discuss with your child's healthcare provider any concerns you may have. Taking your child's temperature Getting an accurate temperature reading can be important, especially if your child has a high fever. While I find that children up to 12 to 18 months still do well with a rectal thermometer, most parents as well as healthcare providers have opinions on which types of thermometers are most convenient and accurate. If you have questions, don't hesitate to ask your child's healthcare provider, and even request a demonstration. Also see: Thermometers and techniques Treating your child's fever Many healthcare providers will ask that you not use medication to treat your baby's fever so that you can follow the course of the fever, especially in a baby who appears well, is eating and sleeping fine, and behaving normally. Although healthcare providers may have slightly varying approaches to fever, there are a few accepted rules to follow. Types of medication Acetaminophen (found in Tylenol®, Parasol®, Tempra®, etc.) is available in liquid, chewable, and suppository forms. It should not be given more often than every four to six hours. Ibuprofen (found in Motrin®, Advil®, etc.) is available in liquid and chewable forms. Check with your baby's provider before using ibuprofen in a child under one year of age. Do NOT use aspirin for fever in children. Dosing If you are giving your child a liquid form of acetaminophen, be sure you know exactly what type of liquid form you have, as there are many types available and the strength of medication will vary. Dosing is based on your child's weight, so be sure to ask your child's provider for an appropriate dose. It may change as your child grows. Read labels of all medications carefully. Giving medication your baby or toddler There is no universally effective method to get babies to take medications. I personally have listened jealously to parents who tell me that their toddler simply opened her mouth and took her medicine happily, while in my own house I would more often than not end up with stains on my shirt, a sticky floor, and an indignant (and feverish) child in tears. The bottom line is that you should try to figure out which method best suits your child and try to do it with as little confrontation as possible. Check with your pharmacist or your child's provider about the possibility of mixing or crushing medicine in with foods or drink. Never assume it's OK, since certain mixtures may make the medication ineffective. Never tell your child that medications are candy in an attempt to get her to take it. From as early as the toddler years, teach your child that medications should be taken only when she is sick and when given to her by an adult. Rectal suppositories are not generally the first choice at this age. However, they are very quick and easy. More than half the parents I talk to shudder at the thought, and there are definitely toddlers who won't tolerate insertion of a suppository. However, when children are very sick, vomiting, or refuse other forms of medicine, this is a reasonable alternative if medication is necessary to bring down a fever. I find it easiest to have your toddler lay on her back with legs folded up to her belly (like I'm changing a diaper). Using a little petroleum jelly on the suppository, you can easily and gently slide it into your child's rectum. Gently hold your baby's buttocks together to keep the suppository from slipping out. Be aware that every now and then, inserting a suppository can trigger your child to have a bowel movement. If this occurs immediately following the suppository, you can repeat the dose. But if it occurs more than a few minutes after inserting a suppository, discuss with your child's provider when another dose should be given to avoid overdosing your child.
| |  | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| About Us |
Contact Us |
Our Partners Privacy Policy | Ethics | Advertising Policy | Terms of Service © Copyright 2004 The Dr. Spock Company. All Rights Reserved. THIS SITE DOES NOT PROVIDE MEDICAL ADVICE. The information drSpock.com
provides is for educational purposes only and is not a substitute for
professional medical advice. Always seek the advice of your health care
professional if you have a specific health concern. Mention or advertisement
of any product, service, or brand does not constitute endorsement, guarantee,
or recommendation by The Dr. Spock Company. Please read our full
Terms of Service. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
