Pediatrics FAQs

We know when it comes to your little one, there are moments you need a little advice.  Below are some of the frequently asked questions our Bend Memorial Clinic Pediatricians hear.  Rest assured, we are just a phone call away. Do not hesitate to reach out when in doubt.

Pediatrics

What is a fever?

A fever is defined as a temperature of 100.4 Fahrenheit or above (38 degrees Celsius).

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What causes a fever?

Fever is usually a sign that your child has an infection.  Infections are most commonly caused by viruses or bacteria.  Fever is not an illness by itself; it is a sign or symptom of the illness.  Fever caused by infection is usually beneficial in that it is a signal your child’s body is fighting the infection.

The caveat to this rule is fever caused by heatstroke.  In this case, the fever is harmful.  Heatstroke is an illness caused by prolonged sun exposure and dehydration.  This is a medical emergency.  Any child who has a fever after prolonged time outside or in a hot car must be evaluated and treated immediately.

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How do I take my child’s temperature?

In infants less than three month of age, rectal temperatures are essential because they provide the most accurate information about core body temperature.  In children older than three months, rectal is still more accurate but many parents prefer to use oral or ear thermometers.  Oral is preferred over axillary (under the arm).  Ear thermometers are usually acceptable; however, they may be inaccurate if there is too much wax in the canal.  Always use a digital thermometer and avoid mercury thermometers.

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What should I do if my child has a fever?

Try not to panic when your child has a fever.  First look for other signs or symptoms that you child may be ill.  Signs and symptoms that commonly go with fever are cough, congestion, runny nose, vomiting, diarrhea, and rash.  Make sure to make a mental note of any symptoms your child may have as this will help us to make a diagnosis.  See below for guidelines on when to call us if your child has a fever.

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How can I treat the fever?

A common myth is that fever is bad and all fevers must be treated.  Fever in the case of infection can actually be beneficial.  It is your child’s brain signaling their body to fight the infection.  Even high temperatures are not in themselves dangerous.  The reason most pediatricians treat fever is because children typically appear a lot more ill when they have a fever and this makes diagnosis difficult.  Children also use up more energy and fluids when they have a fever which can cause them to become dehydrated.  The first rule is to offer your child plenty of fluids while they are ill.

The two main medications used to treat fever are acetaminophen (Tylenol) and ibuprofen (Motrin or Advil).  Do not use ibuprofen in children less than six months of age, in children with kidney disease, or in anyone who may be significantly dehydrated (child with severe vomiting and diarrhea).  If your child is over two years of age, read the label on the bottle.  If younger than age two, refer to our dosing guideline.

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When do I call my doctor about my child’s fever?

Call us immediately or take your child to the emergency room if:

  • your child has a rectal temperature of 100.4 or greater and is less than three months of age
  • your child looks or acts very sick (fever along with severe headache, neck stiffness, confusion, or trouble breathing
  • your child has a fever after prolonged exposure to the sun
  • your child has a fever greater than 105 degrees Farenheit

Call us during the day for an appointment if:

  • your child is 3 to 6 months old (unless the fever is due to immunizations)
  • your child has a fever greater than 104 degrees Farenheit
  • your child has had a fever more than 24 hours without an obvious cause or location of infection AND your child is less than 3 years of age
  • your child has a fever longer than five days or is looking dehydrated (not urinating, sunken soft spot, no tears when crying).
  • your child had a fever that went away for over 24 hours and then returned
  • you have other concerns or questions
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Why do pediatricians get concerned when babies have fevers?

To pediatricians, there are two main categories of children with fever.  The first category is anyone under three months of age.  For infants younger than three months, a fever is never considered “normal” and is something that must be urgently evaluated.  Infants have immature immune and other organ systems.  If an infant gets a fever, it may be difficult to differentiate between the common cold and a serious illness such as a urinary tract infection or meningitis without more testing.  If your child is less than three months of age and has a fever, call us right away, even if they are acting normally.

In children older than three months of age, fever is much more common and though it may still be the sign of a serious illness, it is much more likely to be an illness such as the common cold or other viral infection.

 

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How do I know if my child is dehydrated?

When children are losing fluids through vomiting or diarrhea, and particularly if they are not drinking well to keep up, they can become dehydrated much more quickly than an adult.  Most often this is caused by a stomach virus and can be safely cared for at home.

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How can I treat my child’s dehydration?

In most cases, even a child with frequent vomiting will do fine at home if you follow a careful spoon-feeding approach.  After vomiting, wait 20-30 minutes to let your child’s stomach settle, then do the following.

Start with 1 teaspoon (5 ml) to 1 tablespoon (15 ml) of clear fluid, depending on your child’s age.  Sit with your child and give this amount of fluid every 5-10 minutes.  If there is no vomiting, double the amount you offer after every 20-30 minutes, so that they are slowly drinking more and more each time.  If they have had several episode of vomiting, don’t give in to the temptation to let your child drink as much as they want to, as they are likely to vomit further.  After 3-4 hours without vomiting, you may let them drink as much as they want, but continue to offer it frequently.  After about 6-8 hours without vomiting, you may offer your child easily digested foods – think simple carbs like crackers or toast, and steer away from very high-fat or high-sugar foods, but you do not need to stick to a strict BRAT diet, and can introduce other foods as they feel up to it.  If your child vomits during this process, go back to the beginning – give them a short rest, then start with very small amounts again, and advance a little more slowly than you did the first time.

Pedialyte (oral electrolyte solution) is the ideal fluid for this, especially for formula-fed infants.  Breastfed babies will generally do well with continued breastfeeding, limiting the time at the breast to 5-10 minutes but allowing the baby to nurse every 30-60 minutes; if they continue vomiting, try switching to Pedialyte for a few hours.  Toddlers & older children may do best starting with water, but should drink some other clear fluids as well (again, Pedialyte is ideal, but if they don’t like the taste, you might try juice, or a mixture of ½ Gatorade and ½ water).  Minimize juice intake if they are having, as the fruit sugar may worsen diarrhea.  Popsicles are also a good way to get some fluid into your child a little bit at a time, and there are Pedialyte popsicles as well.

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When should I call the doctor about dehydration?

Your child has severe abdominal pain, high fever, vomiting bright-green liquid (bile), extremely sleepy and hard to arouse, or signs of dehydration which include: no urine for more than 8 hours, dry lips or tongue, sunken eyes, or no longer making tears when crying.  If your child is vomiting but does not have diarrhea, please see the doctor if this continues past 24 hours or your child looks very sick.

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Tylenol Dosage Information

Acetaminophen (Tylenol): 4-6 hours between doses.

*** Do not give acetaminophen (Tylenol) to children under 3 months of age without first consulting a doctor;  (541) 550-4444***

Weight

(Pounds)

Infant Drops*

80 mg/0.8ml

Children’s Elixir

160 mg/5ml

6-9

0.4 ml

1.25 ml

10-11

0.6 ml

2 ml

12-14

0.8 ml

2.5 ml

15-17

1 ml

3 ml

18-23

1.2 ml

3.75 ml

24-29

1.6 ml

5 ml

30-35

2 ml

6 ml

 *The infant concentrated drops are being removed from the market. Please double check the concentration on the bottle before dosing.

 

 

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IBUPROFEN (Motrin) Dosage Information

IBUPROFEN (Motrin): 6-8 hours between doses.

*** Do not give Ibuprofen to children under 6 months of age

Weight

(Pounds)

Infant Drops

50 mg/1.25 ml

Children’s Elixir

100mg/5 ml

12-13

1.25 ml

2 ml

14-17

1.5 ml

3 ml

18-21

2 ml

4 ml

22-26

2.5 ml

5 ml

27-30

3 ml

6 ml

31-35

3.5 ml

7 ml

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