BY JOANN PETASCHNICK
When to Call the Doctor
Most childhood illnesses run their course without any big worries. Knowing how to recognize that your child needs medical attention is important. Watch for:
— Vomiting and diarrhea. When it lasts for more than just a few hours in a child of any age, call your physician.
— Dehydration. Your child may have sunken eyes or, if he’s a baby, a sunken fontanel (soft spot on baby’s head), may seem extremely lethargic, or his mouth might be sticky or tacky to the touch. Also, beware if the child is urinating fewer than three or four times a day.
— Fever. In newborns, any elevated temperature warrants a call. For infants 3 to 6 months old, phone if the fever hits 101 degrees; for older babies and children, the threshold is 103 degrees. The American Academy of Pediatrics says to call your pediatrician right away if your child’s temperature repeatedly goes above 104 degrees.
— Breathing difficulty. You can usually recognize that your child is having trouble breathing if he is breathing fast and hard, if you can see his ribs moving in and out, or if it seems like he can’t catch his breath.
— Not eating. It’s normal for a sick child to have little interest in food, but if your kid is eating or drinking less than half of what she normally would for two days or longer, check in with your doctor.
Are you having a baby? Selecting a pediatrician — a doctor who specializes in the care of children – and learning about common childhood diseases are likely top concerns for you. As the happy day draws near, the following information should help calm your trepidations.
Choosing a Doctor
If you have never looked for a pediatrician, talk to your friends and family who have children. “Asking friends is a great way to find out why they chose a particular pediatrician and how long they have been with him or her,” says Dr. M. Sarah Hambrook with Shoreview Pediatrics in Shorewood. “Word of mouth is one of the best ways to learn about doctors in your area.”
Another good way is to look at physician practice websites. These web pages typically will provide office hours, insurance and after-hours care information.
An up-to-date website could also tell you a lot about a physician. If the site looks professional and current, it could be a good indicator as to whether the doctor is up to date with medical knowledge and technology. Review the doctor’s background, credentials and possible feedback from clients. Certification by the American Academy of Pediatrics (AAP) means the doctor has graduated from an accredited medical school, completed an accredited residency program, and passed the board exam in pediatrics.
Most important, set up an appointment so you can interview the doctor. You’ll be visiting this doctor six times in the first year alone for routine and well-baby visits, and it’s important to find someone who’s a good fit. “Many pediatricians offer free consultations, so you can see if your personalities match,” says Dr. Kristin Bencik-Boudreau with Children’s Hospital of Wisconsin. “If not, you should feel comfortable moving on to another physician.”
If you choose a doctor and later feel you made a mistake, talk to the doctor about your concerns. If your worries aren’t addressed, don’t hesitate to change doctors. “You need a doctor you can trust and communicate with. This is a relationship that is 18 to 19 years long,” says Hambrook.
Common Childhood Diseases
When a child gets sick, parents naturally worry. “The most common thing that makes kids sick is viruses. There are multiple viruses that can be mild or serious, and there is no treatment for them. You have to wait them out,” Hambrook says. “There are a few anti-viral medications like Tamiflu, but there are very specific guidelines for giving it.”
Ear infections are common with children, but most will resolve within two to three days without antibiotics. The days of hastily implanting ear tubes are gone, says Bencik-Boudreau. “We follow strict guidelines; there have to be four ear infections in six months to consider tubes. We’re also not as quick to operate on tonsils and adenoids as in the past,” she says.
In infants, fever is the biggest concern, says Hambrook. “If a baby has a fever of 104 degrees or higher, that’s a baby who needs a complete evaluation to look for serious bacterial infections. It’s crucial to seek medical care,” she adds.
Some upper respiratory viral or bacterial infections, such as colds, bronchitis, strep throat and croup, are quite common and difficult to avoid, especially when children are together. (See “When to Call the Doctor” sidebar.)
Urinary tract infections (UTIs) are common, especially among girls. Bacteria normally found in the bowel cause most UTIs in children.
Pertussis, or whooping cough, also should be a big concern for parents. “It’s very important to get the pertussis shot, the Tdap. And, make sure that any caregivers are also vaccinated,” Bencik-Boudreu recommends.
Hambrook brings up another issue. “We are concerned about parents using virtual appointments and retail walk-in clinics like those in a drug store when their child is sick. Even if it is just for a sports physical, we like to look at the whole person — the emotional as well as the physical. There could be missed subtleties if children don’t receive care from a pediatrician who knows them well. We have seen some missed diagnoses, so we don’t recommend the clinics. We encourage families to make sure they are getting complete care for their children,” she says.
There has been some confusion and misunderstanding about vaccines, but our experts say vaccination is a very important part of family and public health. Vaccines prevent the spread of contagious, dangerous and even deadly diseases like measles, polio, mumps, chicken pox, whooping cough and diphtheria.
The Centers for Disease Control and Prevention sets the U.S. childhood immunization schedule based on recommendations from the Advisory Committee on Immunization Practices, a group of medical and public health experts. The AAP and the American Academy of Family Physicians also approve this schedule. “All clinics have the same schedule, and everyone gives the same vaccine,” Bencik-Boudreau says.
“We really encourage parents to get children vaccinated. There is no evidence that links exist between vaccines and autism,” Hambrook says. “Routine vaccinations have been so successful that most young parents have never seen the effects (that) diseases like polio, measles or pertussis can have on a child or community. We try to work with parents to counteract anecdotal information and help them understand that this is their child’s life.”
For more information and the recommended childhood immunization schedule, go to cdc.gov/vaccines/parents.