Tips for parents

What you should do when your little one is sick

It wouldn’t be a complete surprise if your child woke up in the middle of the night fussy and feverish. It happens in the healthiest families. Here are things you should know before you dash off to the emergency room.

Call the American Association of Poison Control Centers at 800-222-1222 whenever your child has swallowed or come in contact with a substance that could be harmful.

When it’s an emergency

For pediatric emergencies, call your doctor immediately. After business hours, call 911 or go directly to the emergency room. Pediatric emergencies include the following:

• Fever higher than 100.5 degrees (taken rectally) for infants less than 2 months old
• Fever higher than 105 degrees if cause of fever is unknown (common with strep, influenza and other viral illnesses)
• Head injury involving loss of consciousness, persistent vomiting and lethargy.
• Signs of dehydration, including dry mouth, sunken eyes, lethargy and no urination for more than 8 hours
• Lethargy or difficulty arousing a child, especially with a fever, vomiting, diarrhea or head injury
• Labored and persistent rapid breathing (greater than 60 times per minute for children younger than 1 year; greater than 50 times per minute for children age 1 and older)
• Severe pain in the right lower abdomen that persists for more than 2 hours in an ill child
• Extreme irritability or persistent inconsolable crying for over 2 hours
• An injured arm, leg or other extremity that is crooked or misshapen.

When your child’s condition is less urgent

Fevers – A fever can be beneficial in fighting an infection, as long as your child’s temperature is not excessive. If your child is uncomfortable and is older than 2 months of age, Tylenol can be given to ease the discomfort. If your child is older than 6 months, you may give Tylenol and/or Motrin if your child’s temperature is higher than 102 degrees, the fever is persistent, or if he or she has significant pain/discomfort. Call your pediatrician’s office during business hours for appointment if fever or pain persists. Fever under 106 degrees does not damage a child's brain and often can be safely observed and treated until the office opens.

Coughs – A cough is intended to clear mucus from the airways. Generally a cough doesn't require treatment unless it inhibits sleep or produces vomit. A cough may require treatment if your child has asthma, wheezing and/or labored breathing. If you have medication for treatment of asthma at home, administer a dose and observe. Call your doctor if there is no improvement after a usual treatment is given or if the condition worsens.

Coughs and congestion in children under 6 months – Use saline nose drops and bulb suction to remove nasal discharge. Elevate head of bed and use a cool mist humidifier. Over-the-counter decongestant medicine is not recommended for children under 6 years of age because of lack of efficacy and side effects.

Croup – A seal-like barking cough is a symptom of croup, which is caused by a virus. To ease the symptoms, keep your child calm, provide a cool-mist humidifier, and offer fluids. If tight cough persists, sit in a steamy bathroom with your child, or move outside into cool, moist air to decrease the cough. Go to the emergency room immediately or call 911 if the cough is still severe after 15 minutes, if the child's lips or nails turn blue or dusky, or if the child has difficulty swallowing (drooling or spitting) or is worsening at any time.

Vomiting and diarrhea – If breastfeeding, continue to do so. All others should be given Pedialyte in small amounts frequently. Slowly re-introduce foods after 12 to 24 hours. Frozen Pedialyte popsicles are an good alternative. Call your pediatrician or 911 if you see signs or symptoms of dehydration. Avoid juices (diarrhea worsens) or excessive water intake (can cause electrolyte abnormalities).

Constipation – For infants older than 4 months, give 1 to 2 ounces of prune juice, one or two times a day. For older children, prune juice, white grape juice, apple juice and fiber will help with constipation. Excessive milk or dairy intake in children older than 1 year old can cause constipation. If unable to pass stool, call your pediatrician during office hours for an appointment.

Earache – Give Tylenol and/or Motrin to alleviate pain and/or fever. Call your pediatrician during office hours for an appointment, but go to urgent care or the emergency room if pain is uncontrollable.

Sore throat – Most are the result of a viral infection, especially if associated with cold symptoms. Strep throat occurs 10-20 percent of the time and should be ruled out by a physician, especially if fever, headache and/or abdominal pain or vomiting is present. Give Motrin and/or Tylenol, along with cool liquids and popsicles. Call your pediatrician during office hours for an appointment.

Eye infection – Apply cool compress and gently wipe drainage from eye. Call your pediatrician during office hours for an appointment.

Rash without fever – Give Benadryl for itching. May bathe frequently in Aveeno, and use 1 percent hydrocortisone if complaints of itching persist. If on antibiotics, stop using the medication and call your pediatrician’s office in the morning.

Chicken pox – Give Tylenol for fever and Benadryl for itching. May bathe frequently in Aveeno. Isolate from others until all lesions have crusted over. Call immediately for stiff neck, severe headache or any change in level of consciousness. Call during office hours to talk with a nurse if you have questions.

Bee sting or bug bite – Place ice on affected area. Give Tylenol or Motrin for pain. Give Benadryl for complaints of itching. Call immediately or go to the emergency room if wheezing, difficulty breathing, or throat or chest tightness occurs or if child has had previous allergic reaction to insect bites or stings or if the incident involves more than 5 stings.