Know how to tell what’s wrong with your sick baby and how you can help her feel better
The younger the baby, the more important it is to seek medical help immediately.
It’s difficult to know whether to take your child to the doctor, or even the emergency department, when she’s sick – especially when symptoms come on at night.
As a rule, the younger the baby, the more inclined you should be to seek medical attention. Babies’ conditions can deteriorate very quickly, so it’s always best to be on the safe side.
As your child grows up, you will be more experienced in monitoring and treating her ailments, and probably more inclined to keep an eye on her condition and see if things improve. Whatever the age of your child, trust your instincts and always err on the side of caution. Don’t delay because you don’t want to worry your doctor with something potentially silly. Your baby’s health takes priority.
Temperatures vary throughout the day, and are influenced by activity levels. However, a high temperature is a sign of infection.
A temperature is the body’s normal response to an infection and temperatures under 38 ˚ C are normal.
A normal temperature below 38 ˚ C is not a concern and should not cause any panic.
However, higher temperatures that persist and temperatures over 40 ˚ C do need medical attention.
There are a few steps you can take to bring down your child’s temperature: • Remove any excess
clothing. • Give her medication such as paracetamol, ibuprofen or prescribed suppositories. • A baby under three months who has a fever of any temperature must be seen by a doctor.
FITS AND CONVULSIONS WHAT CAUSES FITS?
There are many causes of fitting in children. Some may be related to: • A high temperature. This is the most common cause and this kind of seizure is called a febrile convulsion. • Head injury. • Epilepsy. • Poisoning.
• Jerking movements and
stiff muscles. • Your child may bite down
on her tongue. • Your child may stop breathing or lose consciousness (it is normal in a febrile convulsion to briefly stop breathing. Breathing should return spontaneously when the fit is finished). • Your child’s face may turn
bluish or grey. • Her eyes may roll upwards. • She may drool or foam at the mouth and may lose control of her bladder or bowel (wee or poo uncontrollably). • Your first priority is to prevent your child from hur ting herself. • If the child is a known epileptic and has fits, you do not need to call the emergency services as your
doctor would have told you what to do in the case of fitting. • If your child does not stop fitting, or if the child has stopped fitting and then starts fitting again, call the emergency services for assistance. • If this is your child’s first fit and you don’t know what the cause is, call the emergency services and follow the steps below.
FOLLOW THESE STEPS
• Secure the airway by putting the child on her left side. • Lay her down and place a cushion or something soft under her, and loosen any tight clothing she may be wearing. • Do not try to hold her down or try to force anything into her mouth. Do not give her anything to drink. • Any child who has a seizure should be seen by a doctor to determine and/or treat the cause. • It is common for a child to
be drowsy after a seizure.
Seizures usually last for only three to four minutes. Febrile convulsions are fairly common (two to five percent of children get febrile con- vulsions), and usually do not require treatment. Children generally grow out of febrile convulsions by the age of five.
Children who have had a febrile convulsion are at risk of having another one whenever they get a high fever.
Any child who has a seizure should be evaluated by a doctor to rule out other causes, such as epilepsy.
There are various conditions that can cause breathing problems in babies and young children. A doctor should always see a baby or child who has difficulty breathing. In severe cases, call an ambulance or visit the emergency department of a hospital. You should seek medical attention immediately if a cough is accompanied by laboured or abnormal breathing.
This is a chronic inflammatory lung disease that causes the airways to narrow. Symptoms include coughing, wheezing, shortness of breath, chest tightness, increased heart rate and perspiration. It can be life threatening, so if an attack is severe, seek medical attention immediately or call for an ambulance.
A viral infection of the small airways in the lungs that affects babies under one year. Creating a steamy atmosphere, using a humidifier or a pan of boiling water, will ease the breathing. Take your child to the doctor.
Inflammation of the lining of the bronchial tubes. Most cases are mild, but in severe cases, the child may have difficulty breathing, in which case you should take him to your doctor or the hospital, or call an ambulance.
Croup is caused by a viral infection and involves the inflammation and narrowing of the upper airway to the lungs. This results in a characteristic barking cough. It normally affects children between three months and five years of age. Steam helps to ease the constricted airways. Use a cool mist humidifier if you have one and get the child to breathe in the moist air through his mouth.
Alternatively, mist up the bathroom with hot shower steam and have the child sit in it for about 10 minutes.
If your child has difficulty taking a breath, if there is
stridor (a high-pitched noise when he is breathing in), or if she is pale or bluish around the mouth, seek medical help.
This inflammation of the lungs may be particularly severe in young children. It generally responds well to antibiotics if treated expeditiously. If your child is not well, see your doctor immediately.
COLDS AND FLU
Flu or a common cold generally lasts about a week. Unless there are complications, treat the child at home: • Give plenty of fluids, as both illnesses are dehydrating. • Make sure the child gets
lots of rest. • Give your child paediatric paracetamol or ibuprofen if necessary to help with aches and pains. Antibiotics will not help simple colds and flu. They are prescribed if your child develops a bacterial infection like an ear infection or pneumonia (see above).
A blocked nose is an annoying side effect of a cold. Babies’ small noses get blocked very easily. They battle to breathe and suck, which can be distressing for them and you. Try these tips: • Use a bulb syringe to suck
out fluid from the nose. • Use a humidifier in her room to keep the mucus soft and moist. • Ask your pharmacist for eucalyptus- based drops to add to the humidifier, or put a few drops on her pillow. • To help break up clogged mucus, use a drop of saline solution or expressed breastmilk in her nose. • Tickle her nose with the corner of a tissue to encourage her to sneeze.
Children sometimes lose large amounts of water and salts (electrolytes) through fever, diarrhoea or vomiting. This can cause dehydration and, in some instances, result in death.
The younger and smaller the child, the greater the danger, so be very vigilant if your baby has diarrhoea or vomiting. Don’t wait until you see the warning signs!
To prevent dehydration, give your child small sips of liquid regularly. Tiny chips of ice to suck are sometimes more acceptable. If you suspect your child is in danger of dehydration, give her rehydration solution rather than water, and take her to the doctor or emergency department. Specially prepared electrolyte solutions are balanced with salt and minerals. If a child has bad diarrhoea or vomiting, it may be difficult for you to rehydrate her adequately at home, in which case she may be hospitalised and given fluids through a drip.
If you see signs of dehydration, contact your doctor immediately, or take your child to the emergency department.
SIGNS AND SYMPTOMS
• Dry mouth. • Few or no tears when cry
ing. • Producing fewer than six wet nappies a day (for an infant). • No urination for six to eight
hours (in older children). • Fontanelle looks flatter than normal, or somewhat sunken.
IN SEVERE CASES, YOU MAY ALSO SEE THE FOLLOWING
• Skin that appears dry, wrin
kled or doughy. • Inactivity or weakness
(lethargy). • Sunken eyes or fontanelle. • Excessive sleepiness or
disorientation. • Muscle cramps. • Deep, rapid breathing, or
fast or weakened pulse.
These infections are usually short-lived, but there is a danger of dehydration. Call your doctor if your child has: • Fever, vomiting and diar
rhoea together. • More coming out of either end than is going in through the mouth. • Signs of dehydration. If your child has fever and vomiting without diarrhoea, keep the child hydrated and see if the child starts to improve.
A CHILD NEEDS TO BE SEEN BY A DOCTOR OR GO TO AN EMERGENCY DEPARTMENT IF
• She vomits up blood. • Vomits something that looks like dried coffee grounds (this is blood mixed with stomach acid). • Starts projectile vomiting.
MENINGITIS AND ENCEPHALITIS
Encephalitis is the inflammation of the brain. Meningitis is a general name for inflammation of the meninges (sheaths that cover the brain and spinal cord) and the cerebrospinal fluid (the fluid that circulates in the spaces in and around the brain and spinal cord). Meningitis can be caused by bacteria, virus- es, fungi and other organisms. The severity and the symptoms will depend on the cause. However, a child can deteriorate quickly and meningitis can be fatal, so getting medical attention immediately is essential. Take your child to the doctor or emergency department immediately if you suspect meningitis or encephalitis.
SIGNS AND SYMPTOMS OF ENCEPHALITIS AND MENINGITIS
• First signs are fever, lethargy, vomiting and irritability. Older children may complain of a headache. • A stiff neck or body. • Bulging fontanelles. • Jaundice. • Seizures occur in about a third of patients with bacterial meningitis and are sometimes the only symptoms. • As the disease develops, symptoms may include increased irritability with a high- pitched cry (especially in infants) and difficulty breathing. • Newborns with meningitis sometimes don’t display the classical signs described above and may simply be extremely irritable or lethargic. • An infant who isn’t feeling well is usually comforted when her mother picks her up. Babies with meningitis sometimes display “paradoxical irritability” and picking up and rocking a child may make her more distressed. This can be a sign of irritated meninges. • Meningococcal meningitis ( bacterial) may be accompanied by a rapidly spreading purplish rash that does not fade when pressed.
Many combination cold and cough medications contain fever- lowering drugs. Check their labels carefully and don’t give your child a separate fever reducer if she is already taking one of these combination products. Do not use combination medicines for children under six years.