Colds, Fevers & Ear Infections
Children's Medical Group has put together the following guide for when your child has a cold, fever, or ear infection. It includes helpful information on how you can help start to manage your child's symptoms. Remember, these are just guidelines. We are always here to assist you and you should always call if you're concerned or if your child's symptoms require immediate attention as described below.
Upper Respiratory Infections (Colds)
The average child contracts between eight and ten colds or Upper Respiratory Infections (URIs) per year. URIs are caused by viruses spread by airborne droplets dispersed when an infected person coughs or sneezes. These droplets contain virus particles which are infective when inhaled, touched or rubbed into the eyes, nose or mouth (thus the importance of covering one's nose or mouth when sneezing). Viruses can also be spread through indirect contact--such as when the virus gets on an object like a doorknob that is then touched by other people. This is why hand washing is also important! However they are transmitted, viruses resulting in URIs cause swelling in the lining of all the infected areas, resulting in congestion, a stuffy, runny, nose, full-feeling ears and coughing.
The symptoms associated with URIs last an average of five to eight days but may linger up to two weeks. Our aim in treating URIs is to alleviate these uncomfortable symptoms. The following measures are helpful when your child has a URI:
- Elevate the head of the crib by placing two to four inches of books under the upper legs or a pillow or folded blanket under the mattress. Older children should be propped up with pillows.
- Use a cool mist vaporizer or humidifier to help loosen secretions and make breathing easier.
- Use a bulb syringe or nasal aspirator to suction out debris. If this is not successful, instill 2 to 3 drops of saltwater (1 teaspoon non-iodized salt dissolved in 8 ounces of distilled water) into each nostril and suction out again. If your child is feeding well, sleeping well, and in no distress, suctioning is not necessary.
Antibiotics are not effective in treating URIs caused by viruses and may in fact cause uncomfortable side effects. Antibiotics are only used when a bacterial infection is found (strep throat, ear infection, pneumonia, etc.). Colored mucous is not necessarily indicative of a bacterial infection.
Any over-the-counter medications that you use offer only symptomatic relief and should be used only for nasal congestion or a cough that disturbs sleep or interferes with feeding. Coughing is a defense mechanism the body uses to keep foreign materials out of the lungs; it should not be suppressed unless necessary. Cold and cough medication should not be given to any child younger than six years of age.
Although URIs are viral infections usually well tolerated by children, some are accompanied by bacterial infections, which require further evaluation and treatment. These guidelines should be helpful in deciding when to consult us about a URI:
- If your child has a fever higher than 102 degrees for more than two days, especially if it is accompanied by:
- Troubled or labored breathing
- Ear pain or a sore throat that lasts for more than two days
- Persistent irritability or decreased activity
- Loss of balance, falling or bumping into objects
- A persistent cough lasting longer than a few days or a progressively severe cough
- Stridor (noisy breathing coming from the throat area) or severe croup (barky, seal-like cough)
Most of these issues can be readily addressed during office hours. However, a few, including very rapid breathing, a temperature greater than 104 degrees, respiratory distress, severe croup or stridor, and extreme irritability or lethargy, are more urgent issues. Parents should always rely on their intuition. If you feel uncomfortable or sense that your child's illness is something more than a URI, please call us.
Fever
Fever is a defense mechanism of the body that helps fight infection. In general, a rectal temperature over 100.4 degrees is recognized as a fever. Fevers in children can be both frustrating and scary. Having a plan of action is helpful in terms of judging the severity of your child's illness.
If your child has a fever, the following steps should be taken:
- Be sure that your child is not overdressed or over-wrapped in blankets.
- Undress your child to look for rashes or evidence of localized redness.
- For a temperature of over 100.4 degrees, you may try an appropriate dose of Tylenol or other acetaminophen-only product (see this chart for recommended Tylenol dosages). As an alternative, if your child is over six months of age, you may try ibuprofen, such as Advil or Motrin. (See this chart for recommended ibuprofen dosages.) Be sure not to use combination products (such as cough & cold medications) unless directed by our office.
If your child is under three months of age, always call us first before giving any fever medicine.
If your child is under six months of age, call us before trying ibuprofen.
- Giving your child a lukewarm bath 20 to 30 minutes after a dose of Tylenol may help bring down your child's temperature.
- If your child has a fever of 100 degrees or greater, they should not be sent to school in accordance with the Connecticut Department of Public Health’s flu guidelines.
Once the fever has broken, you should assess your child's character. A child who can be consoled or who looks around and intermittently smiles is usually not seriously ill. In this case, treat the fever as described above. Often in the early phases of an illness, the nature of the illness is unclear and only time will provide further clues.
- If the fever is not responding to the measures above.
- If after the fever has broken, your child remains inconsolable, lethargic or excessively irritable.
- If your child is not consuming enough fluids to urinate at least every six hours.
- If the fever lasts for more than two days.
- If at any time you are uncomfortable or have questions for the office.
- If your child has a fever and is under 2 months old.
Ear Infections (Otitis Media)
Outside of colds, a middle ear infection (otitis media) is the most common illness for which a child is brought into the pediatrician's office. There are two main types:
- Acute otitis media is a bacterial or viral infection of the middle ear thought to be caused by blockage or dysfunction of the Eustachian tube. It involves pus or fluid collecting in the middle ear. Symptoms include pain, fever, irritability, vomiting and nighttime waking. Acute otitis media is usually treated with oral antibiotics.
- Serous otitis media simply occurs when fluid fills the middle ear space. This often keeps the eardrum from vibrating normally, which may interfere with hearing. This does not always signify an infection and, therefore, is not always treated with antibiotics.
If your child complains of ear pain, you can give them a dose of Tylenol or Ibuprofen to help alleviate the pain.
If you suspect that your child has an ear infection, you should call the office and make an appointment so that he or she can be evaluated.
Please call our team today at (203) 288-4288 to schedule a wellness visit for your child or to ask any questions.