You should never hesitate to call your pediatrician about your baby if “something is not right.” A mother’s intuition is often correct when it comes to her child. Your pediatrician may be able to calm your fears or to suggest an appropriate treatment.
A fever is a symptom of an illness, not a disease in itself, and may or may not be a reason to call the doctor. It can be caused by an infection, a virus, an immunization, or teething. (Doctors refute that teething can cause a fever, but mothers see it happen time and again.) Suspect a fever if your baby feels hot, has dry skin and a flushed face, and seems listless. A low temperature may also be a sign of an infection. To take your baby’s temperature rectally, dip a rectal thermometer in petroleum jelly or K-Y jelly, and insert it into the rectum just past the silver bulb tip. Hold it in place for 3 minutes, then gently remove it. Keep a towel or washcloth close by for any accidents. To take your baby’s axillary temperature, place a thermometer under his arm and hold it in place for 3 minutes. First make sure that the armpit is dry. When reporting the temperature to your pediatrician, tell him also how you took the reading. Tympanic thermometers, which read the temperature in the child’s ear, are also available, but studies are questioning their accuracy.18 If you feel the result is not accurate, recheck with a rectal thermometer. Two other products that should be avoided because of the difficulty in recording accurate readings are the forehead strip, since moisture will affect the result, and the pacifier thermometer, since the infant must continuously suck on the device for 5 minutes for an accurate result.
Immediately report to your pediatrician any temperature that is lower than 97°F or higher than 100.2°F in an infant under 3 months of age or higher than 103°F in a child of any age. You should also notify your doctor if a fever lasts longer than 24 hours and is of unknown origin. If the fever is above 101°F and the child is uncomfortable, give him a nonaspirin fever reducer according to your doctor’s orders and a 15-minute lukewarm bath. Dress your child lightly; do not bundle him up because heavy clothes and wrappers retain heat. If your child has a mild fever, he does not need any medication because a moderately high temperature stimulates the body’s protective immune defenses. Never give your child aspirin to reduce a fever because it has been linked to the sometimes fatal disease known as Reyes Syndrome. Alert your pediatrician if the fever does not go down within 24 hours or if your child shows other symptoms.
You should also alert your pediatrician if your baby repeatedly or frequently vomits following a feeding. Also call him if your baby has diarrhea (loose, watery, greenish, foul smelling bowel movements) or bowel movements that contain mucus or blood. Vomiting and/or diarrhea are reasons for concern because they can cause dehydration, often very rapidly in a tiny baby. The signs of dehydration are loss of tears or saliva (dry mouth), sunken eyes, a decrease or absence of urine, the presence of dark amber urine, and/or lethargy. Dehydration is a medical emergency and needs to be treated immediately.
- Temperature over 100.2°F or under 97°F (phone immediately if your child is under 3 months of age).
- Projectile vomiting.
- Severe diarrhea (green, foul smelling, loose bowel movements containing mucus).
- Poor appetite or a refusal to feed.
- Unusual behavior.
- Extreme lethargy (difficulty being aroused, floppy).
- Inconsolable crying.
- Few wet diapers or bowel movements.
Coughing and a stuffy or runny nose are signs of a cold. Use a cool mist vaporizer to help ease your baby’s breathing. If your baby’s nose is congested, your pediatrician may recommend that you use normal saline nose drops. To make these nose drops, dissolve 1/4 teaspoon of salt in 8 ounces of water. Hold the baby firmly in your lap on his back and place two drops in each of his nostrils using an eye dropper. Wait a moment, then suction his nostrils with a bulb syringe, compressing the bulb before you insert the tip in his nose. Give your baby nose drops before meals and at bedtime to help him nurse and sleep better. If he has a fever and is also irritable or pulling on his ears, he may have an ear infection, which requires medication. Severe hoarseness, difficulty breathing, or a “barking cough” also need to be reported.
Alert your pediatrician if your baby displays a change in temperament or habits—for example, if he cries excessively, is unusually irritable, is extremely drowsy, has unusual trouble sleeping, is restless, or has a severe loss of appetite.
If your baby has an eye inflammation or discharge, he may need medical attention. A body rash that you cannot cure by any of the methods explained on page 212 may indicate a communicable disease or allergic reaction.
Report any twitching, convulsions, or rigidity at once. Also, if your child appears to be in pain, he may require medical attention.
If your child suffers a head injury, observe him for a change in mental alertness, extreme sleepiness with difficulty waking, vomiting, discharge from the ears or nose, unequal pupil sizes, or skull deformity. Elevate his head and alert your doctor immediately. When a limb is injured, check for and report any deformity, redness, swelling, extreme tenderness, or inability to use the limb. An open wound may require suturing. For cosmetic reasons, some parents prefer a plastic surgeon to repair a facial cut.
In case your child swallows a nonfood substance, immediately call your pediatrician or local Poison Control Center for instructions.