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fever
When should I call a doctor?
We never want you to be worried at home, so if any issue is causing you concern, there is always a doctor on call for you. Specific instances in which we would like you to call would be: any temperature over 100.4 degrees Fahrenheit, increased lethargy, the baby is not arousable, less than 2 wet diapers in 24 hrs, projectile vomiting, or poor feeding. Non-urgent issues can be addressed at your well child visits or you can schedule another appointment to talk about these issues.
What is the best way to take my baby’s temperature? How often should I do it?
The most accurate way to take a baby’s temperature is rectally. The silver tip should just disappear out of sight in the rectum and then the thermometer should be held in place for about a minute. It is best to put a little Vaseline or lubricant jelly on the tip of the thermometer to ease it into the rectum. You only need to take the baby’s temperature if he or she feels warm to the touch or is not acting like himself. The temperature does not need to be taken every day. If your baby is less than one month old and has a temperature of 100.4 or greater, he or she needs to be seen by a doctor immediately.
I think my baby is congested. Do I need to give her medication?
Babies often sneeze or sound congested. It is not because they have a cold, but rather because their nasal passages are so small that there is very turbulent airflow through the nose. If the congestion is mild, intermittent, and not interfering with feedings and your baby seems comfortable,you do not need to do anything at all. For more bothersome symptoms, you can try using over the counter nasal saline drops (1 or 2 drops to each side of the nose every 4-6 hours as needed) and/or a bulb suction. If your baby has significant congestion, nasal drainage, fever or a persistent cough, you should discuss your concerns with your doctor.
My baby has a rash that looks like flea bites all over her body.
There are many newborn rashes and most of them are completely benign and will resolve on their own. If there is any rash that you notice at night, point it out to the doctor when we come for our morning rounds. The most common rash, described above as looking like “flea bites” is known as erythema toxicum neonatorum and is not an infection, is not harmful, and resolves spontaneously at about 7-10 days of age.
Ear pain is one of the most common complaints in children. As there are many possible causes of ear pain, it is important to have your child evaluated by a physician. It is difficult to assess a child’s ear pain over the phone and cannot be diagnosed appropriately. There are three main causes of ear pain, and we will discuss each one briefly.
Inner Ear Infection: Inner ear infections may be caused by either a viral or bacterial infection and therefore not all infections require antibiotics. A recent cold or nasal congestion or fluid in the inner ear places your child at greater risk of an ear infection.
a. Symptoms include: ear pain, fever, irritability and nasal congestion.
b. Treatment for inner ear infections is typically antibiotics, but in some circumstances, it is okay to watch for 48 hours to see if this will resolve without intervention. Tylenol and Motrin and numbing ear drops will help with pain symptoms.
Outer Ear Infection (Swimmer’s Ear) is an infection in the ear canal. Children who swim or have frequent contact with water are at greater risk. Water in the canal can cause irritation and can allow for bacterial infection.
Symptoms: outer ear pain, especially when pulling on ear; discharge from the ear canal. Some children will also develop a fever.
Treatment: antibiotic ear drops
Prevention: if your child develops recurrent outer ear infections, thorough drying of the ears after swimming and bathing may decrease incidence. Over the counter ear drops such as Swimmer’s Ear work well.
Teething: Even though it is the gums that are painful and swelling, a child may feel the pain in the ear and this is what is called “referred pain.” The molars are the ones that particularly cause referred pain.
Symptoms: drooling, low‐grade fever, pulling or gnawing on toys
Treatment: see teething section for more details: massaging gums with finger or a cool wash cloth, Tylenol or Motrin for severe symptoms.
Children are notorious for having many colds throughout their early years and most will have at least 8‐10 colds in the first two years of life. Since these symptoms can last for up to three weeks, it may feel like they have a constant runny nose!
Colds are caused from viruses and typically peak during the fall and winter months. They are spread directly through contact with the virus such as sneezing or coughing. Cold symptoms are coughing, sneezing, fever, nasal congestion and runny nose. Most children do not need any treatment for viruses and antibiotics are used to treat bacterial infections, NOT viral infections. The best treatment is supportive care. There are many cough and cold medications that are available but these preparations are no longer recommended for children under 4 years of age.
Young infants are susceptible to colds and because they are nasal breathers, may become fussy during feeding or have some difficulty sleeping. In this case, you may need to let your child take several breaks during feeding to catch their breath. To help their breathing, you can place a few drops of nasal saline in each nostril and then suction with a nasal aspirator. The saline helps to break up the mucous and this will help their breathing. We recommend doing this prior to feeding and sleeping. Furthermore, a cool mist vaporizer in the room may help loosen nasal secretions and ensure a more comfortable sleep.
When to call the office:
• Fever that persists for more than 72 hours
•Any difficulty breathing
• Infant less than 2 months old with a fever
• If your child is lethargic or refuses to eat
• Fever that does not respond to Tylenol or Motrin
