Anywhere there’s a parent, there’s a question for “Dr. Google.” It doesn’t matter the age of the child; most parents have questions about the basics: peeing, pooping, sleeping and what to do when the child is sick. Health professionals know that many parents will have consulted the various consumer health websites before coming to our clinic — we get it; you want answers about your child’s health now. Here are some common questions that I address with my parents about their little (and big) ones. Take a look and see how the answers compare to what you’ve been told by Dr. Google.
Toilet Troubles
How much should my child be peeing?
This question comes up frequently with newborns and when kids are sick and not eating and drinking as much as normal. A newborn baby takes several days to start urinating regularly; we expect one wet diaper in the first 24 hours and two within the second 24 hours. By day of life three or four, you’ll be changing more diapers than you can keep track of. Children pee more frequently when they’re younger, and as they (and their bladders) grow, they don’t have to go as often. Toddlers usually go every several hours and teenagers every four to six hours.
If the frequency that your child pees starts to change — either peeing more or less often than usual — it’s time to see a doctor. Doctors are concerned if your young child hasn’t urinated in more than eight hours or your older child in more than 10 hours, or if they are urinating much more frequently or having accidents (either daytime or nighttime) when they have been potty trained for several months.
My kid is constipated! Now what?
First, let’s discuss what constipation is. Constipation refers the quality of the stool and not necessarily how often stool is passed. When a child is constipated, the poop is hard, and the child often strains to get it out. They frequently can’t get the whole poop out, and it’s really painful. They may start to avoid stooling because it hurts too much, and this only makes the problem worse.
Each person will stool on his or her own schedule. Some people will naturally stool once every few days, but the stool will come out soft. This is not constipation. Newborns frequently strain every time they poop for the first several weeks, but then the poop comes out soft and mushy. This is also not constipation; this is the newborn learning how to poop.
Now that you know how to tell if your child is constipated, what can you do when he or she is actually constipated? For a child who’s eating table foods (6 months and above), you can increase the amount of fiber and water in the diet. Fiber can be found in whole grains; fruits like pears, peaches and plums; and vegetables. Kids should be eating several servings of fruits and vegetables every day. It may take several days to get things moving along.
If your child has not yet started table foods and you see blood in his or her stool, or if you add fiber and water and it doesn’t help, it’s time to go see a doctor.
[See: What to Eat, Drink and Do to Relieve Constipation.]
Sleep Baby, Sleep!
I really need my baby to sleep through the night — I’m exhausted.
Remember when you got a full night’s sleep before you had kids? Don’t worry: It can happen again. It does take some time to get there, though. As a newborn, your baby will eat anywhere from every one to three hours. As your baby gets older, he or she can eat more and sleep a bit longer. By about 4 months of age, many babies will “sleep through the night,” which really means about a six-hour stretch. The age that a child sleeps through the night also depends on whether your baby was born at term (it may take a preterm baby longer) and how much he or she weighs.
Setting up a bedtime routine even as early as 4 months of age is a good first step to help get your child to sleep. Think “B” — bath, books, brush teeth (if your child has them), bed. This will help your child prepare for bed and know what to expect next.
There are many ways to “sleep train” your baby if it’s something you want to do, and you should pick the way that is right for you and your baby. The “cry it out” method usually works the quickest, but not all parents feel comfortable letting the baby cry herself to sleep and will opt to do more graduated sleep training methods. The method that will work is the method that you will stick with.
Keep in mind that sleep can be thrown off when a child is sick or travels, when daylight savings time occurs, when he or she or is teething, or any other number of things. You may find that you need to sleep train your child again if her schedule is changed.
[See: 10 Concerns Parents Have About Their Kids’ Health.]
Common Complaints in Childhood
Help! My child has a fever!
Fever is often a sign that the body is fighting off infection. A fever is a temperature of 100.4 degrees Fahrenheit (38 degrees Celsius) or above. You do not need to treat your child’s fever if your child is acting as usual and playful. You can treat fever if your child is uncomfortable. In an infant, a rectal temperature is the most accurate. As your child gets older, you can put a thermometer under the tongue to take the temperature. Axillary (in the armpit) and forehead thermometers are not accurate ways to take temperatures.
For children less than 2 months old, a fever is often the only way we know your baby is sick. If your child is less than 2 months old and has a fever of 100.4 degrees Fahrenheit or above, he or she needs to be seen right away by a doctor. If your child is older than 2 months and does not have any other medical problems, you don’t need to go to the doctor right away, just for fever. To treat fever for a child older than 2 months, you can give acetaminophen every four hours as needed. Once your child is older than 6 months, you could also try ibuprofen for fever every six hours as needed. The doses of each of these medications are based on how much your child weighs or how old she is.
What can I do for my kid, who has a cold?
The winter is usually the worst season for colds for children, especially if your child is in day care or school (or around any other children). Even if you remember to wash your child’s hands frequently, eventually you’ll have to deal with that annoying cold. And when dealing with colds, there’s good news and bad news.
The good news: The cold will eventually go away.
The bad news: There aren’t a lot of medicines for kids with colds. Colds are caused by viruses, and antibiotics don’t work against viruses. If your child has fever, you can give ibuprofen if over 6 months old, or acetaminophen. You can use nasal saline drops or spray to help moisten up the dried mucous in the nose and suck it out with a suction bulb or something similar. Humidifiers can also help with nasal congestion. There are many cough medicines that are sold, but we as pediatricians don’t recommend them. They often don’t help and can have harmful side effects. For children older than 1 year of age, you can try giving honey to help with the cough. Don’t give honey to children under 1 year of age.
When your child isn’t feeling well, he or she may not want to eat as much. That’s OK. The appetite will come back when he or she feels better, but it’s important that you encourage your child to drink in order to prevent dehydration.
What if my child is vomiting and has diarrhea?
A child with vomiting and diarrhea is also at risk for getting dehydrated because he or she is losing a lot of fluids. Wait about 20 minutes after your child vomits, and then encourage him or her to drink a small amount (no more than an ounce for a baby; no more than 2 ounces for an older child). If the child is able to drink without throwing up for another 20 minutes, encourage another small amount of fluid. You can try Pedialyte for a child of any age. For a baby, you can give formula or breastmilk, and for an older child you can try watered down juice.
[See: 12 Questions You Should Ask Your Kids at Dinner.]
When do I take my child with a cold, vomiting and diarrhea, or fever to the doctor?
Here are a few guidelines for when to check in with your child’s doctor:
— Your child has a fever every day for five days.
— Your child had a fever for a few days, it went away for a few days and then it came back again.
— It’s been a few days and your child is getting worse, not better.
— Your child develops abdominal pain along with the fever but can still walk.
— You are worried about your child.
Call 911 or see a doctor immediately if your child has any of the following problems:
— Your child is less than 2 months old and has a fever.
— Difficulty catching his or her breath or breathing very fast.
— Breathing using his or her belly muscles.
— Nostrils flaring when breathing.
— Very sleepy and difficult to awaken.
— Vomiting blood.
— Diarrhea or stool has blood in it (red or black and tarry).
— Abdominal pain so bad that your child can’t walk, jump or play.
— You’re worried about dehydration (not peeing very frequently, dry mouth, few tears).
If you’re concerned about your child’s health, behavior or development, please let your pediatrician know. That’s what we’re here for.
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Parents: Here Are Answers to the Questions You Google Before Seeing a Pediatrician originally appeared on usnews.com