• Fever and pain management. Acetaminophen (which is found in drugs like Tylenol) or ibuprofen (which is the active ingredient in drugs like Motrin or Advil) can help your child feel better by bringing down his temperature and easing his sore throat. Since the throat pain associated with mono can be quite severe, you also may want to have him suck on hard candy. It's important, however, to make sure that the candy does not pose a choking risk. Only offer it to your child if he is over the age of four years and is fully alert; never give it to him when he is drowsy.
  
  If he is old enough to gargle, you can also have him gargle salt water--just add one-half teaspoon salt to one cup of comfortably warm water. While salt water may not seem very appetizing, it can offer a surprising amount of pain relief, it can be repeated as often as needed, and it is safer for children than gargles that contain pain-relief medication, such as lidocaine. Such medications should only be used if recommended by your child's doctor or nurse practitioner.



• Steroids. Some doctors prescribe steroids, which suppress the immune system, to help alleviate the symptoms of mono more quickly. However, experts in infectious diseases regard this practice as potentially risky. The virus that causes mono can result in serious disease and even cancer in individuals with decreased immunity. Therefore, giving immunity-suppressing drugs like steroids to a child with mono may lead to later problems with the immune system, or could predispose the child to malignancy later in life. However, steroids are sometimes indicated for certain serious complications of EBV, such as blockage of the airway from severely swollen tonsils, severe hepatitis, heart inflammation (myocarditis), neurologic abnormalities, or severe anemia.



• Antibiotics for a secondary bacterial infection. If your child is found to have bacterial infection in addition to mono, such as strep throat or an ear infection, his doctor may prescribe antibiotics. Ampicillin and related antibiotics such as amoxicillin and Augmentin should be avoided because they often cause a rash in people who have mono.

• Rest. Young children usually are better than teens and adults in regulating their activity, resting when their bodies need it. They don't have to be kept in bed, though; just let them lounge around and gradually resume their normal activities as they gain the energy to do so. Teens may be another matter, though, since (like adults) they tend to overdo it. Be sure that your teen recognizes the need to pace himself until he fully regains his strength, as some children will relapse if they resume their regular activities too soon. And lest you worry that your teen is overdoing it on rest and has turned into a couch potato, be aware that the fatigue associated with mono can be quite pronounced and may last for several weeks.



• Fluids and nutrition. Even though your child may have difficulty swallowing early in the course of his infection, it is important that he get plenty of fluids, especially if he has a high fever. Dehydration is one of the most common problems with mono, and keeping him well hydrated will help him feel better faster.
  
  It also is a good idea to encourage him to eat, even if he isn't very hungry, particularly after he has been sick for a few days. The sore throat tends to make foods that are soft and cold (like ice cream, pudding, and smoothies) the most appealing. If his illness persists for several weeks, good nutrition is all the more important to help him regain his strength, but it may be easier to get him to eat if you let him select the foods he craves.



• Avoid trauma to the abdomen. It is crucial that children with mono--especially those whose spleens are enlarged--avoid any potential blows to the abdomen, such as those sustained in contact sports or from a fall on bicycle handle bars. Such injuries can rupture the spleen and cause life-threatening internal bleeding. Your child's healthcare provider can tell you when it is safe for him to resume his usual activities.

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