From the pages of the Baby & Child Care Encyclopedia: Chapter 7, When Your Child is Sick

Idon’t feel well! These words strike fear into the hearts of parents around the world. But—and this probably won’t be a surprise to you—infections and illnesses are a common part of childhood. It’s expected that healthy children will have as many as eight viral infections a year and even as many as 100 in their first 10 years of life. With this in mind, we’ve rounded up some helpful information to help you manage symptoms at home, tips for when to call the doc or seek out emergency medical care and a breakdown of some of the common illnesses your kids may face.

Symptoms and signs

A symptom is what the patient notices and complains about. A sign is a physical change the doctor notes upon observation and examination. The signs are usually of more importance than the symptoms. It is what is observed that provides the most valuable information in determining just what kind of illness is present and whether or not is might be serious.

Three changes are often the first sign that something is wrong, although it may be many hours or even days before more evidence develops.

  1. Activity: One of the most common indicators that a child is unwell is when there is no interest in doing something that is usually enjoyed. Of course, a child may not feel in the mood to be active or may just be sulking, but if the change in behaviour is a sign of a potential illness, other signs will develop.
  2. Appetite: A child’s appetite can vary, so a loss of interest in food is not solid evidence of ill health, but it may be one of the early warnings.
  3. Attitude: In many children, this is often the most reliable indicator. If a child who is usually cheerful and easy to get along with seems cranky for no obvious reason, something might be up.

Fever

The presence of a fever almost always means an infection. The average fever isn’t dangerous or harmful—it’s the body’s normal reaction to the presence of foreign organisms. Parents should watch for the following complications:

  • A child’s behaviour is influenced by fever. In some children, the raised temperature makes them irritable. In others, it makes them drowsy. Irritability usually comes with moderate fever of about 38.5 C (101.5 F) to 39.5 C (103 F), and drowsiness with a fever of 39.5 C or over. Individual variations do occur. But it is likely the illness causing the irritability and drowsiness, rather than the fever.
  • The quickest way to tell if the temperature is the cause of what’s going on is to lower it. Once the fever drops, the child’s disposition changes immediately and the previously cranky, sleepy child often wants to play. Check with your physician if your child remains listless or miserable after you have successfully lowered the fever.

A fever in a baby under four months of age must always be regarded as potentially serious. Call your doctor.

How to manage a fever

A fever itself is not harmful. What counts is the cause. You don’t have to give your child anything for the fever just because it is there. A sick child’s fever is usually highest from about 6 p.m. until 3 a.m. If the fever is gone by the evening, your child will almost certainly not have a temperature the next day.

Indications for treating the fever:

  • If the child has had a previous febrile convulsion (a seizure due to fever)
  • If the fever is making the child irritable and uncomfortable If the fever makes the child sleepy and relaxed, no treatment is needed as long as they are taking adequate fluids.

What to do:

  • Try to keep the room cool and the humidity low.
  • Have a steady movement of air.
  • Keep your child undressed or in very light clothing.

Remember that your child can lose heat only through the skin when the skin is hot and flushed. If your child’s body feels cool or is shivering, wrap them up in a blanket until the skin is hot again; otherwise none of these techniques will work.

Convulsions due to fever

One of the scariest experiences for parents is watching their child have a convulsion (seizure). About one child in 20 between the ages of six months and four years suffers from seizures that are triggered by fever. In most children, these seizures (called febrile seizures) don’t happen every time there is a fever. It seems to depend on a number of factors:

  1. The temperature of the fever: Seizures are more common with temperatures higher than 39.5C
  2. The speed with which the fever develops: A rapid rise in the child’s temperature is thought to increase the risk of seizure more than a gradual rise
  3. The type of infection: Some viruses, such as roseola (baby measles), are associated with seizures more often than the common cold viruses

Most children’s seizures are of the febrile type. They usually last a few minutes and the child may be sleepy after. A child outgrows them and will not be left with any brain damage or an increased risk of seizures in later life. Most parents learn how to cope with seizures. They also learn through experience that it is not necessary to call 911 or rush the child to a hospital emergency room.

Read Medicine Cabinet Go-tos and Giving Medication to learn more about medication for treating fevers.

Treating common signs of illness

Kids are prone to a few physical reactions to illness or injury, so it’s helpful to know how to handle them when they crop up, regardless of the root cause.

Rashes Most rashes are due to either skin reactions (allergies and dermatitis) or to infections in the skin. None of these skin eruptions make the child sick or cause a fever unless there are complications. Rashes often occur in the course of viral infections. The type of rash that accompanies the fever helps your doctor recognize illnesses.

The presence of a rash with an illness does not make the illness any more serious. Usually, the rash is not itchy, but if it is, apply simple applications like calamine lotion or put your child in a bath with baking soda or a commercial baby wash recommended by your baby’s doctor.

The time for concern is in the event that the spots look like blood under the skin and don’t become paler when you press over them. Such a rash may be a sign of septicaemia (blood poisoning) and your child should be taken to a hospital immediately.

Cough and Congestion It is common for children’s infections to involve the respiratory system. The child develops a cough that at first is dry and irritating. After a day or two, the child’s nose begins to run and the cough begins to sound loose. At this stage many parents say the child is “congested” and worry that there is some trouble in the lungs. The most common reason for a loose, moist cough is that the mucous from the back of the child’s nose is trickling down the back of the throat to the top part of the windpipe. This happens easily when the child is lying down.

When mucus trickles down the throat to the windpipe, adults automatically clear our throats, but children clear their throats by coughing. Suppressing the cough deprives the child of a mechanism for protecting the lungs. It is wiser to make sure that the air the child breathes is well-humidified so that the phlegm doesn’t dry out and become thick and sticky (and therefore harder to expel).

Signs that suggest that the infection is affecting the lungs and that the child should be examined are:

  • If the cough is not accompanied by any signs of a cold
  • If the fever from the cold lasts more than three days
  • If the child seems to be breathing rapidly or seems to have difficulty breathing, especially when the child’s temperature is below 38.5 C
  • If there is any suggestion that the child’s colour is changing from pink or red to mauve or blue
  • If the child looks unusually pale


Vomiting Vomiting is usually associated with problems directly involving the stomach or bowel, but can occur in children for other reasons. Some children will vomit from high fever, and others from emotional upsets. Some children have very strong gag reflexes. In these cases, there is nothing wrong with the stomach.

Stomach flu is a common virus infection in young children. Usually the child is listless, especially after vomiting. The vomiting is not caused by coughing, and often comes with little warning. At the beginning of a stomach flu (also known as viral gastroenteritis), the child may vomit repeatedly and be unable to keep anything down. After a delay of six to 24 hours, diarrhea usually occurs.

It is important to avoid dehydration. For most children who are healthy and well-nourished before the flu starts, the risk of serious dehydration depends on excessive loss of fluid rather than a failure to take in fluids. Any healthy child, even a baby, can safely go for up to 12 hours or more without drinking much, as long as there are no fluids being lost by vomiting, diarrhea or very heavy and continuous sweating. A child with gastroenteritis usually can’t keep very much down for the first 12 hours or so, but keep offering frequent small sips of flat ginger ale or diluted apple juice—start with a tablespoon every 15 minutes, then gradually increase the amount as tolerated. Paediatricians often recommend rehydration fluid for children, which you can buy at any drugstore. Things can change very quickly with stomach flu, so if your child continues to have vomiting or loose bowel movements after a couple of days, check with your healthcare provider.

Read more from the Baby & Child Care Encyclopedia.

BCCE cover

      1. Prenatal 101
      2. Breastfeeding and the First Three Months
      3. Starting Solids and the Toddler Years
      4. An Age-by-Age Guide to Sleep
      5. Family Nutrition
      6. Kids and Mental Health
      7. When Your Child is Sick
      8. Safety and First Aid
      9. Milestones, Checklists and Charts