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Playing Sherlock |
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When your child isn't feeling good, slip on your detective hat. Many ailments can cause the same symptoms. So here are some tips on tracking clues. They may lead you to the culprit. Your child is pale and unusually tired. She's running a slight fever. Clearly, she's not well. But should you call the doctor? Finding out what's wrong with a toddler, school-age child or teen often takes a little detective work since common childhood complaints - runny noses, coughs, and other aches and pains - can signal several ailments. As a parent, be aware that infants are more vulnerable than adults to many infections because their immune systems are still immature. Children in day care or school get many infections because they are exposed to many other children who have viruses and other germs. Watch for ear problems Middle ear infections are among the most common problems in children under age 6 - 75% complain of them at one time or another. Your baby or toddler may let you know about the pain by pulling on the affected ear, or getting really fussy and irritable after having a runny nose for a few days. Other symptoms include fever, hearing troubles, sleeping problems, impaired balance and even vomiting. Middle ear infections may be caused by a virus or bacteria. Call your family doctor if you suspect such an infection. The first step your doctor will take is to make your child comfortable with pain relievers, such as ibuprofen and acetaminophen. Your doctor also may recommend eardrops or a warm heating pad held over the ear to relieve the ache. If the infection is bacterial, an antibiotic may eventually be needed. However, about eight in 10 children with ear infections get better without antibiotics. If your child has frequent ear infections or if the infection causes fluid behind the eardrum that won't go away, your doctor may recommend that a "tube" be inserted into your child's eardrum. The tube allows air into the middle ear and enables accumulated fluid to drain down the eustachian tube, which connects the ear and the throat. Regarding prevention, here's some good news: Having your child immunized with the pneumococcal conjugate vaccine provides protection from a kind of bacteria that causes ear infections. If you smoke, quitting may help because children who live with adults who smoke are more likely to have ear infections. Children who nurse from a bottle while lying down also appear to have the infections more often, while breast-fed children have them less often. Finally, since the infections often occur during or just after a cold, you can help prevent an onset by taking precautions against the sniffles. Squelch the sniffles Frequent hand washing can cut down on the number of colds (and other infections) by stopping the spread of germs. But research also suggests that secondhand smoke increases the risk of colds as well as ear infections. So while you're encouraging your children to keep their hands clean, also keep them away from cigarette smoke. Be aware, however, that even your best efforts can't prevent colds entirely. It's common for infants and toddlers to get as many as 10 of them a year. Caused by microscopic viruses, they usually go away in anywhere from three days to two weeks without antibiotics or other medical treatment. But call the doctor if the symptoms are severe or your child has a sore throat and fever that last longer than 24 hours. You might be dealing with strep throat, a bacterial infection that can lead to complications unless treated promptly. Other symptoms, including aches, pains, chills, cough, fatigue, diarrhea, vomiting and high fever (102-104°F), may indicate influenza, more commonly known as flu. Getting your child a flu shot each year will usually prevent the illness. If your child gets the flu, contact your family physician right away for evaluation and possible treatment of the influenza infection and its possible complications. Over-the-counter medicines, such as ibuprofen, also can be used to reduce the fever and aches. Make sure your child drinks water or juice regularly to prevent dehydration. Scope out sore throats In addition to strep throat, a sore throat so painful that it's hard to swallow can also be a sign of mononucleosis, an infection caused by the Epstein-Barr virus. |
While it's most often associated with teenagers, mononucleosis can strike infants and young children, too. Symptoms include a runny nose, fever, fatigue, swollen lymph glands, and abdominal tenderness or pain. Though sometimes called the "kissing disease" because of one way that it's spread, mononucleosis can be transmitted by any contact with an infected person's saliva. While the disease itself goes away without treatment, it can cause serious complications - e.g., dehydration and an enlarged spleen - that require treatment. In general, mononucleosis is a more severe illness for teenagers than for younger children. In either case, if the symptoms look like mono, call your doctor. Make a rash judgment A rash can be a common indicator of infections in children. Rubella, measles and chickenpox - once three of the most common childhood viruses that cause rashes - are now uncommon in the United States thanks to vaccines. A rash's distinct pattern and location, along with other symptoms, are important clues to the cause. Chickenpox. This viral infection is marked by numerous blisters on the face, chest and back, spreading downward. Fever, aches, fatigue, sore throat and a cough also occur. Fifth disease. If your child has had a fever and then develops a bright red rash on both cheeks, a likely culprit is fifth disease. Other symptoms include a lacy rash on the arms and legs, along with a runny nose, sore throat, fever, and other aches and pains. Measles. The rash of measles appears as red, raised spots. They typically begin on the forehead and face and spread downward. Fever and sore throat may also be present. Roseola. The rash of roseola typically appears after a few days of fever. As the fever fades, the rash follows, beginning on the trunk and spreading outward toward the arms, legs, neck and face. Rubella. Symptoms of rubella may be so minor that they aren't even noticed. They may include a low fever, runny nose, bloodshot eyes and a rash. Rubella is dangerous because if a pregnant woman is exposed, her developing fetus may be damaged. Most of the viral infections listed above require no treatment, other than over-the-counter medicine to reduce fever and other symptoms. For chickenpox, your family doctor may also recommend oral antihistamines (Benadryl) to help reduce itching, as well as oatmeal baths and other topical treatments. Impetigo. This rash is caused by a contagious bacterial skin infection. It often appears around the nose and mouth and is marked by small blisters that form yellowish crusts. Impetigo can usually be treated with an over-the-counter antibiotic ointment. Because rashes are often highly contagious, it's important to keep your child away from other children until the rash disappears. It's all in the eyes You can tell much about your child's health by monitoring the eyes. Redness in the whites, accompanied by a discharge, is a sign of conjunctivitis, or pinkeye. This infl ammation is usually caused by a virus or bacteria, though it can also be linked to an allergy or irritation. Infectious conjunctivitis must be treated with prescription antibiotic eye drops or ointment. Be sure to wash your hands after applying the eye drops to avoid spreading this extremely contagious infection. A final word There are many more health problems in childhood - enough to fill entire books. But you can solve many medical mysteries at home. Just follow the clues. Susan Gilbert of Dobbs Ferry, N.Y., is the author of A Field Guide to Boys and Girls.
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