By Karen Sheehan, MD
There are few things that are more stressful for a parent than a sick child. I am reminded of this each time I work a shift in our emergency department. My most recent shift was on our “lower acuity” side — the kids without cancer, heart disease or major trauma. Of course, parents don’t think in terms of “high” or “low” acuity. Any time you think your child is sick enough to go to the emergency department, it is a major life event.
Fortunately, for most children, viral illnesses are just an uncomfortable, self-limited nuisance. But even without an underlying medical problem, influenza, a viral illness in the news lately, is a miserable disease — high fevers for a week, muscle aches, runny nose, cough. For younger children, there’s the added bonus of vomiting and diarrhea. If you haven’t already, think about getting the influenza vaccine for you and your family. (I have heard all of the stories about why people don’t want to vaccinate their children, but I have never had the parent of an unvaccinated child who has contracted influenza tell me “I am sure glad I didn’t get my child vaccinated.” If you’re on the fence, Vaccinate Your Baby has more information.)
But even with this protection, your child may still become ill with influenza or a similar disease not covered by the vaccine. If your child gets sick, what can you do to make them feel better?
1. Fever is a by-product of your body fighting infection; in the big picture, it is a good thing, but it can make one feel lousy. Acetaminophen and ibuprofen can help decrease fever and body aches. These medicines do not cure your illness and their effectiveness lasts only as long as the medicine is designed to act. In other words, expect the fever to come back four to six hours after acetaminophen and six to eight hours after ibuprofen.
If your child has a recurrent fever after taking these medications, it does not necessarily mean your child is getting sicker. Look at how your children are acting. If you are exhausted from chasing them around the room, even if they have a temperature of 103, they are probably okay. Don’t freak out if a child has a high temperature. Some kids just have higher temperatures when they are ill. Some of the sickest kids I have taken care don’t have much of a fever at all. It is all about how they look.
I do have an exception to this rule; every child younger than two months with any fever needs to see a doctor immediately. Their immune system isn’t well developed yet, and they can have a harder time fighting infection.
2. Don’t worry about whether a sick child eats well for a few days, as long as they get enough to drink. Some clues that can tell you if they are hydrated: their mouths are moist, they are making tears when they cry, and they urinate at least a little bit three times a day.
3. Be prepared for the fact that no one sleeps well when a child is ill. Children younger than three usually can’t blow their noses, so when they lay down, they get post-nasal drip and cough and cry because they feel miserable and tired. Suck out their nose with a bulb syringe and use a humidifier to make cold, dry winter air easier to breathe. Absolutely avoid over the counter cold medicines, because they can make kids agitated and even cause death from heart arrhythmias. And besides, they simply don’t work.
The human body is amazing. An otherwise healthy person can usually fight off colds and flu on their own, but if you think your child is dehydrated, has trouble breathing or you are worried that there is something different about this illness and their response, of course, see your doctor or come see us.
Dr. Karen Sheehan is a general pediatrician and a pediatric emergency medicine specialist at Ann & Robert H. Lurie Children’s Hospital of Chicago. After taking care of kids who fell from windows, or were shot, or were hit by cars, it occurred to her that it would be better to prevent such injuries in the first place. She now focuses on prevention and maximizing a child’s health and well being.