Whether you’re a new parent or not, questions and issues about infant and toddler health can surface at any time. At times like these, it would be great to at least have the basic knowledge of what to do first and how to go about it. Being parents of infants and toddlers don’t need to be a nerve-wracking ordeal each time your precious bundle falls sick. Although anything to do with infant and toddler well-being is no trivial matter, staying calm and positive goes a long way in dealing with young children’s health issues.

Taking your child’s temperature

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Basic knowledge

If your child feels warm or seems under the weather, it’s probably time to check his or her temperature. Sounds simple enough, doesn’t it? Yet if you’re new to it, it can turn out to be quite a challenge. Which type of thermometer is best? Are thermometer guidelines different for babies and older children? Here’s what you need to know in order to to take your child’s temperature.

Know your thermometer options

A glass mercury thermometer was once a staple in most medicine cabinets. However, they may break easily and allow the mercury to vaporise and be inhaled. Today, digital thermometers come highly recommended.

Regular digital thermometers use electronic heat sensors and can be used in the mouth, armpit or rectum. Digital ear thermometers, also called tympanic thermometers, use an infrared ray to measure the temperature inside the ear canal. Other more ‘fancier’ options include digital pacifier thermometers and temporal artery thermometer – basically an infrared scanner to measure the temperature of the temporal artery in the forehead.

If you want to get a single thermometer for the entire family, a regular digital thermometer is probably best. However, if you plan to use a digital thermometer to take a rectal temperature, get two digital thermometers and label one for oral use and one for rectal use. Don’t use the same thermometer for both purposes.

Is it accurate?

Rectal temperatures provide the best readings for infants. Ear or oral thermometers are the best options for babies and older children. However, do be aware that earwax or a small, curved ear canal may interfere with the accuracy of the temperature taken. Armpit temperatures and temperatures measured with a pacifier thermometer are considered the least accurate methods. The reliability of temporal artery thermometers is yet been verified.

Carefully read the instructions that come with your thermometer. After each use, clean the tip of the thermometer with soap and lukewarm water. For safety – and not to mention so that the thermometer stays in place – don’t leave your child while his or her temperature is being taken.

Thermometers and age appropriateness

The best type of thermometer or more accurately, the best place to insert the thermometer, in most cases, depends on the child’s age.

From birth up to three months.For newborns, use a regular digital thermometer to take a rectal temperature. Turn on the digital thermometer and lubricate the tip of the thermometer with petroleum jelly. Lay your baby on his or her back and gently insert the lubricated device ½ to 1 inch (1.3 to 2.5 centimeters) into your infant’s rectum. Do not proceed if there is too much resistance. Hold the thermometer in place for about a minute or until the thermometer signals that it’s done. Remove the thermometer and read the temperature.
From three months up to four years.For older babies and toddlers, you can use a digital ear thermometer, a digital pacifier thermometer, temporal artery thermometer or an armpit temperature. Carefully follow the instructions that come with your thermometer. To take an armpit temperature, first turn on the digital thermometer. When you place the thermometer under your child’s armpit, make sure the device touches the skin. Hold the thermometer tightly in place for about a minute or until the thermometer signals that it’s done. Remove and read.

When to see a doctor

A fever is a common sign of illness, but that’s not necessarily anything to be panicky about. In terms of health, fevers play a key role in fighting infections in the body. If your child is a year old or above and is drinking fluids without fuss, sleeping well and is active, there’s usually no reason to even treat a fever.

If you want to give your child medication to treat a fever, stick to paracetamol (Panadol for Babies/Children or others) unless otherwise advised by your doctor. It is not recommended to use aspirin to treat a fever in anyone age 18 years or younger.

In general, contact your child’s doctor if your child:

Is below three months of age and has a rectal temperature of 100.4ºF (38ºC) or higher
Is above three months of age and has a temperature up to 102ºF (38.9 ºC) and seems unusually irritable, lethargic or uncomfortable
Is above the age of three months and has a temperature of 102ºF (38.9ºC) or higher that doesn’t respond to over-the-countermedication or hasa temperature that lasts more than one day

When reporting a temperature to your child’s doctor, remember to state how the temperature was taken.

Giving a baby medicine

Which parent can’t relate to the stress of trying to get a struggling child to take medicine? In many cases, the baby senses that the parent is nervous or upset, thus aggravating the situation. In situations as these, it can be quite a challenge to remain positive. Here are some tips on how to calmly give your baby the medicine he or she needs.

Practice caution at all times

Firstly, do make sure you have been storing your child’s medicine correctly, so that it still consumable. Secondly, be sure you are administering the correct dose, or your child will be keeping poorly for longer than necessary.

Before you give your baby any medicine, read the instructions carefully and check the bottle or packet for the expiry date. If it is past the use-by date, throw the medicine out, even if the bottle is full.

There should be a note on the packaging that tells you how the medication should be stored. Some medicines need to be stored in the fridge, while others will need to be kept in a cool, dry place, away from direct sunlight.

Recap medicines and put them away as soon as you’ve used them. Although it’s easy to leave a bottle or pack of meds lying around, especially if it’s 3am and you’re sleepy and tired, always make it a habit to store medicines well out of children’s reach as soon as you’re done with them. There have been too many incidents worldwide of medicine overdose/poisoning by little ones who don’t know any better and consumed the whole bottle after finding their fruity flavoured medicine all too delectable
to resist.

Oral medicine for babies

Most children’s medicine that have to be given orally have pleasant flavours about them. Some babies take them without a fuss. Just as many, however, for some unknown reason, tend to put up a good fight!

Giving an unwilling baby medicine by mouth can be traumatic for both baby and parent. Your soothing reassurance and a loving hug when giving medicine should to some extend help calm your little one down. Other than that, here’s what you also need to do:

Wash your hands
Shake the bottle before opening
Measure out the correct amount of medicine using an oral syringe. Do not use a kitchen spoon or you will be likely to administer the incorrect dose
Hold your baby upright in your arm and gently insert the tip of the oral syringe into his or her mouth
To prevent gagging, aim at the area between your baby’s gums and the inside of her cheek
Push the plunger bit by bit to squirt small amounts of medicine into the side of your baby’s mouth
Allow your baby to swallow before continuing to push the plunger
Give your baby her usual milk or a little water afterwards to wash down the medicineQ When you’ve finished, wash the syringe in warm water

If you have a little protester at hand, try the following:

Get someone to act as a helper
Wrap your baby tightly in a towel so she can’t push the medicine away.
If she clenches her teeth or purses her lips, ask your helper to gently press your baby’s nostrils together so that her mouth opens. Once the medicine is inside the mouth, gently hold your baby’s cheeks together, making a “fish mouth”.

This will help prevent spitting. Stroke under your baby’s chin to encourage swallowing.

Administering a suppository

Your doctor may think it’s best for your baby to have her medicine via a suppository. Suppositories are usually shaped a little like a pellet. You’ll need to gently insert the suppository into the opening of your baby’s rectum.
Once inside your baby’s bottom, the suppository quickly dissolves and goes into effect.
Your doctor may also prescribe suppositories if your baby is found to be suffering constipation. Here’s how to make it an easy process:

Wash your hands.
Warm the suppository in your hands before taking off the wrapping.
Hold up your baby’s legs.
Moisten the tip of the suppository with lubricating jelly. If you don’t have any jelly, dip the suppository in some tepid water. Water that is is too hot may melt the suppository.
Hold the suppository between your index finger and thumb. Gently push the suppository with your index finger into your baby’s bottom.
Push the suppository in far enough that it doesn’t slip out again. Suppositories are usually placed rounded-tip first. In some cases, a doctor may suggest you put the blunt end first to stop the suppository from slipping out.
Hold your baby’s buttocks together for a while before putting the nappy back on.
Offer your baby a hug/cuddle and gentle words to distract from any uncomfortable feeling in his or her bottom.

Teething blues

Your baby’s first tiny tooth may be reason enough for you to smile and rejoice, but at the same time this can be a tough period for both of you. Your baby may have months of discomfort to get through before the both of you can truly heave a sigh of relief. Your baby may be well into his or her second year before there is a complete set of milk teeth to show. Here, we offer some useful tips to help you and your baby survive the teething process.

Teething can take quite a lot out of your baby (and you). Most babies cut their first tooth at around five to six months. All in, from a toothless grin to a cheeky, gleaming smile, it might take your baby all of two years or more to get through.

Your baby’s last teeth, which are the second molars, found in the upper and lower back of his mouth, should be in place somewhere in his second year.

Is teething hurting my baby?

Yes, and it probably won’t be much fun for either of you. Your baby may be in pain and drool for a month or two before his tooth appears. This could sometimes mean sleepless nights for the both of you.

To ease his suffering, your baby may start biting. Don’t get upset, as this behaviour is not out of anger but mainly because of the discomfort of teething. Give him something to bite on like a teething ring. Alternatively, you could try gently applying teething jelly to his or her gums to ease the pain.

Helping baby feel better:

Give your baby something cool to chew on, such as a chilled teething ring or a teething tusk. NOTE: Please stay close to your baby when he is chewing on anything in case of accidental choking.
Rub some teething gel onto your little one’s gums. This can be purchased from a pharmacy.
If your baby is really in distress, you can give him the correct dose of age-appropriate paracetamol or ibuprofen. Ask your doctor or pharmacist if you are unsure how much to give your baby.

Vomiting

Is it normal or is something a miss?

Vomiting is quite common for babies, especially in the early weeks, as they adjust to feeding and as their bodies develop. You can tell when your baby is vomiting rather than just regurgitating (bringing up small quantities of milk), because there will be a lot more coming out, not just a few teaspoons trickling down his chin. It can be frightening for your baby, so he’s likely to cry and this in turn could be a nervous situation for new parents.

There may be many causes for your baby to vomit – even a prolonged bout of crying or coughing can trigger this reflex. So you may have a lot of vomiting bouts to contend with in your baby’s first few years.

An attack of vomiting will generally subside six to 24 hours after it starts, without any particular treatment. As long as your baby seems otherwise healthy and continues to gain weight, there’s usually no need to worry.

When should I worry?

During your baby’s first few months, feeding problems would be inevitable to some parents and so would vomiting. In many incidents, the baby’s tummy is found to be too full. After the first few months, a sudden onset of vomiting is more likely to be caused by a stomach virus, such as gastroenteritis, which is often accompanied by diarrhea.

Your baby may also have vomiting bouts during:

a cold
a urine infection
an ear infection

However, parents should be wary of vomiting bouts as it could be a symptom of more serious illnesses. Call your doctor if you notice any of the following warning signs:

Signs of dehydration, including a dry mouth, lack of tears and fewer wet nappies than usual (less than six nappies a day)
Sunken fontanelles, (the soft spot on the head)
A bulging fontanelle
A fever, with a temperature of 38 degrees C or higher if he is younger than three months, or 39 degrees C or higher if your child is three months or older
Refusal to breastfeed or bottle feed
Vomiting for more than 12 hours
Vomiting with great force
A non-blanching rash (one that does not fade when the skin is pressed)
Sleepiness or severe irritability
Shortness of breath
A swollen abdomen
Blood or bile (a green substance) in the vomit *(see page163)
Persistent forceful vomiting in a newborn within half an hour
of feeding

*Blood or bile in the vomit:Normally, this would be no cause for worry. It may happen when the force of regurgitation causes tiny tears in the blood vessels lining the food pipe (oesophagus). Your baby’s vomit may appear a little reddish too if blood from a cut in the mouth has been swallowed or if the baby had a nosebleed in the past six hours.

However, call your doctor if blood continues to appear in your baby’s vomit or if the amount increases. Most parents would not be thinking that far but it would be a good idea to swap some of the bile for your doctor to inspect. Green bile can indicate that the intestines are blocked, a condition that needs immediate attention.

Persistent or forceful vomiting in a newborn within half an hour of eating: This may be due to pyloric stenosis, a rare condition that is most likely to begin when your baby is a few weeks old, but could show up at any time before he reaches four months.Pyloric stenosis is an abnormal condition that may affect the gastrointestinal tract during infancy. It can cause your baby to vomit forcefully and may cause other problems such as dehydration and salt and fluid imbalances. Immediate treatment for pyloric stenosis is extremely important. The baby vomits when a muscle controlling the valve leading from the stomach into the intestines has thickened so much that it won’t open up enough to let food through. The problem is simple to remedy with minor surgery, but the key is to seek immediate medical attention.

Dealing with vomiting, calmly

Children do get sick and usually it’s nothing to panic over. Like every other part of parenthood, it’s something you’ll soon get used to and there are steps you can take to help them get better:

Keep baby hydrated:A baby who is having a vomiting spell is losing precious fluids. It’s important to replace these fluids so baby won’t be dehydrated. To do this, give sips of oral re-hydration solution (ORS), such as Dioralyte, a few times an hour, alongside the usual breast milk or full-strength formula and water. Do not offer fruit juices or carbonated drinks to a sick baby or toddler.
Easing back into routine: If your baby hasn’t vomited in the past 12 to 24 hours, you can start to go back to the usual diet but with plenty of fluids. Start with easy-to-digest foods such as cereal or yoghurt if your child has been consuming it before. You can also try soups and if your child is over 12 months and fancies it, clear, ice lollies.
Encourage rest:Sleeping helps. The stomach contents empty into the intestines during sleep, relieving the need to vomit.Don’t give your child anti-nausea medicines, unless your GP has prescribed them.

If your baby attends childcare or nursery, keep him or her at home until at least 48 hours after the last episode of vomiting.