Winter Illness Symptoms

When You Should Worry and When You Can Relax

Fever

Relax

I know it’s hard to hear, but parents do NOT need to stress about the number on the thermometer.  As long as a child is over 3 months old, drinking fluids and acting ok, it doesn’t matter much if the number is 101 or 104, even in the middle of the night.  If she is uncomfortable, treat the fever with an appropriate dose of Acetaminophen.  Ibuprofen is another choice for over 6 months of age.  It lasts longer so many parents choose it to help get through the night.

Worry

If your baby is under 3 months and has a temperature of 100.4 degrees or higher, I give you permission to worry, because newborns can get sick very quickly so call your pediatrician or get to the ER.

For older infants and children, I want parents to call me if a child really looks sick, isn’t drinking fluids, is lethargic, has pain or the fever lasts more than 4 or 5 days because that could be sign that we may be dealing with  something more serious than a simple viral infection.

Return to School – Kids should be home from school or day care until 24 hours after fever resolved and they are feeling better.

Cough

Relax

Kids catch coughs often during the winter and it can linger for weeks. Sometime it’s just a bit of postnasal drip causing the cough. As long as the cough isn’t interfering with breathing, eating or sleeping, give it a week or two.

Worry

If in addition to a cough, there are any signs of trouble breathing such as wheezing or skin sucking in above and below the ribs, high fever, or he is looking sick, call your pediatrician right away.

Return to School

If your child has a really bad cough, that’s causing heads to turn, you might need to keep him home.  If the cough is mild and your child is otherwise acting fine, send him to school.

Runny nose

Relax

A runny nose is rarely dangerous, it’ usually caused by a common cold virus and will get better with time. There’s no magic medicine.

Worry

Call your doctor if the runny nose lasts more than a week or two, there is also high fever, pain, or if it interferes with feeding, sleeping or breathing.  Once in a while, especially if it’s smelly, there may be a small toy stuck that needs to be retrieved.

Return to School

If you kept your child home every time he had the sniffles he’d never be in school, so if there’s no fever and the runny nose isn’t a faucet or interfering with activity, send him to school.

Vomiting and Diarrhea

Relax

It’s can be hard to relax if your child throws up all over everything, or has an exploding diaper, but as long as he can keep down fluids, isn’t in severe pain or looking really sick, you can keep him home and continue small sips of fluids.  For diarrhea, give fluids and slather on a thick diaper ointment with zinc oxide to prevent a rash.

Worry

True vomiting in a newborn, not just a little spit up, needs to be evaluated right away, especially if it is projectile, forceful or happens after 2 or more feedings in a row.

With older children, if he can’t keep down even small amounts of fluids, is showing signs of dehydration, or looks really sick, see your pediatrician.

For diarrhea, give plenty of fluids. If your child looks lethargic or sick then it may be time to worry and get evaluated for IV fluids and other treatment.

Return to school

24 hours after the vomiting and diarrhea have resolved he can return to school.  Stomach viruses are usually very contagious, so make sure everyone continues to practice good hand washing techniques, especially if changing diapers.

Sore throat

Relax

Minor sore throat usually isn’t a problem and may just be part of a cold or virus.

Worry

If your child has a more severe sore throat, especially if there is a fever, she looks sick, or she can’t swallow, she should be evaluated and tested for strep throat, which needs antibiotic treatment.

Return to school

After 24 hours on antibiotics, or if antibiotics aren’t needed, 24 hours after your child is feeling better, she can return to school

Rash

Relax

Rash is tough to determine without looking at it.  Many things can cause rashes from dry skin to infections.  My general rule of thumb for parents is that if the rash isn’t bothering your child, it doesn’t bother me.

Worry

If the rash is severe associated with fever, facial swelling, trouble breathing or your child looks sick, see your pediatrician

Return to school

 If there’s no fever and the rash isn’t bothering them they can usually be in school.

Watch Dr. Tanya’s tips on when to call your pediatrician on the Today Show.