Why does a kid's fever or cough always seem so much scarier at 3:30 a.m.? "Any sickness in the middle of the night can seem harder to deal with, because it's disorienting," says Laura Jana, a pediatrician In Omaha, Nebraska, and coauthor of Heading Home with Your Newborn (AAP). It's dark; no one else is awake; doctors' offices aren't open—"you feel more helpless and on your own." Sheer exhaustion, especially for parents of small babies, adds to the confusion: "When my daughter was an infant and had a high fever, I had to call my medical-practice partner in the middle of the night to ask if she thought we should get a spinal tap," Jana says. "When she asked me what I would tell a patient, I had to say I was so sleep-deprived that I would never be giving out medical advice in that condition." To help you and your patient through those murky predawn hours, we asked a panel of doctors (all moms themselves) for advice on how to soothe and treat five common—but still frightening—conditions.
FEVER
The fever itself isn't the worry, says Jennifer Shu, a pediatrician in Atlanta with a 7-year-old son and coauthor of Heading Home with Your Newborn. "It's a sign the body is responding to an illness, such as the flu." Don't panic if the number's high: Even temperatures of 104 degrees and higher usually aren't associated with brain damage.
how to treat it
Talk to your doctor about trying a fever reducer, like acetaminophen (such as Children's Tylenol) or ibuprofen (Children's Motrin). A high fever can take as long as two to three hours to come down, but you'll often see some response—and your child will feel a lot better—within a half hour.
when to call the doctor
If a fever reducer hasn't worked after a few hours or your child is very uncomfortable—for instance, he has difficulty breathing, is unresponsive, shows signs of confusion, or has a stiff neck or a severe headache—call a doctor. And if your newborn (under 3 months old) has a fever of 100.4 or higher (taken rectally for the greatest accuracy), go to the emergency room; it could be a sign of meningitis, says Shannon Forshey, a pediatrician and a mother of triplets in Phoenix.
VOMITING/STOMACHACHE
Vomiting can be caused by many things, including viral stomach infections and bladder infections.
how to treat them
Guard against dehydration. Altmann recommends giving kids tiny amounts of fluid: "Once vomiting has subsided, give toddlers a teaspoon of water, Pedialyte, or LiquiLyte every 15 minutes." Try giving bigger kids a little more, up to three ounces. If you have Gatorade on hand, Altmann says, that's okay, too, as long as you mix it with an equal amount of water. Flat ginger ale is acceptable in a pinch. Robertson also recommends chamomile, ginger, and peppermint teas to soothe upset stomachs.
when to call the doctor
If your kid has severe pains, especially in the lower right of the stomach—or if that area feels rigid and hot—it could be appendicitis, and you should call a doctor. Ditto if he can't keep even small amounts of fluid down, if he vomits for longer than 24 hours, or if there's blood or bile (a yellowish green fluid) in the vomit. Blood could mean a small tear in the intestine that will heal on its own, and bile can be a sign of bowel obstruction. Either way, a doctor needs to evaluate the child.
Next Page: Cough, Earache, Diarrhea
