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When baby is sick...

You may feel alarmed each time your child is ill, but don’t be afraid to seek medical help even if it turns out to be a non-emergency.


Young Parents
magyoungparents@sph.com.sg

It’s particularly distressing for new parents when baby is ill, for a sick baby can't tell you his symptoms but will be more uncomfortable and more miserable than normal. He will probably cry more, feed less and sleep fitfully. Which means that parents too will be pretty miserable. Despite your best intentions, your baby will pick up germs and viruses and will fall ill at some stage. He has not built up immunity and is also meeting germs for the first time. You may feel alarmed each time your child is ill, but don’t be afraid to seek medical help even if it turns out to be a non-emergency. Especially when you have an infant, don’t worry about feeling embarrassed that you’ve panicked and it turned out to be a false alarm. You won't be the first new parent to do so.

FEVER
If your baby is uncomfortable and he feels hot to the touch, take his temperature to see if he has fever. If the reading is more than 38 deg C, he has a fever. A fever occurs when the body is fighting off infection, and is a cause for concern if baby is less than three months old. But you also need to observe your baby. If he is playing and feeding as normal, he should be all right. The best way to take baby’s temperature is rectally – coat the tip of a digital thermometer with petroleum jelly and insert it about 2cm into his rectum. Hold the thermometer until it beeps and take the reading.

See the doctor if:
• baby is under three months with a temperature of 38 deg C or higher, call the doctor immediately.
• baby is more than six months old and above, and has a temperature of 39 deg C or higher. It may be a serious problem if baby has fever and the following symptoms:
• Your baby is having breathing difficulties, even after you’ve cleared his nose with of mucus.
• Baby has small, purple-red spots on his skin that don't turn white or paler when you press on them, or large purple blotches. Use the glass test: Press a clear glass gently but firmly against the spots and if they don’t appear paler through the glass, baby might have a serious bacterial infection such as meningitis. In meningitis or other serious conditions such as urinary tract infections, baby may have a high fever without any other specific symptoms. Take baby to the doctor without delay.

What you can do:

Offer plenty of breast milk or formula to avoid dehydration. Dress baby in light cotton to help body heat escape. You can sponge or bathe him with lukewarm water to bring down his temperature – do not plunge him in ice water.

If your doctor has prescribed medication, always follow instructions to the letter, and use the measuring spoon or oral syringe provided to ensure the right dose. It always helps to write down the time you give each dose so as not to miss a dose or overdose. Not putting baby’s medication together with the rest of the family’s will help avoid a dangerous mix-up, especially when baby is looked after by other caregivers. Never give baby anything that has not been prescribed including aspirin which can lead to Reye’s syndrome, a rare but fatal illness.

COUGHS AND COLDS
Coughs and colds involve a viral infection that starts with a runny nose. Your baby may also have fever. When mucus builds up in the body, a cough develops to clear the throat and lungs. Mucus may be clear, yellow or green.

See a doctor if:
• baby has a fever of over 38 deg C.
• your infant has a cough that makes feeding or sleeping hard for him.

What you can do:
Infant paracetamol will help with the fever. Keep your child hydrated. Wipe away any mucus from his nose, and if it’s congested, a bulb syringe can help unblock it.

FLU
A flu may be difficult to differentiate from a cold and show many similar symptoms, though it may also involve fever, fatigue, abdominal pain and muscle ache, some of which your baby is in no position to inform you about. He may also have diarrhoea and throw up his feed, reducing his appetite and making him lethargic.

See a doctor if:
• baby is two months or younger and has a temperature of 38 deg C or higher. For an older baby, seek medical attention if the fever reaches 39 deg C or higher.
• she is still coughing after a few days.
• baby has breathing difficulties.
• there are signs of dehydration such as fewer wet nappies, very dry lips and mouth or a dip in the soft spot on top of his head.

What you can do:
Keep baby as comfortable as possible, and hydrated. He may be more irritable than usual – if he has body ache, even being picked up will annoy him. So be patient and let the flu run its course.

DIARRHOEA
It can be quite tricky to spot diarrhoea in babies. You need to be well acquainted with your little one’s bowel habits. See how often he soils his diaper and what colour his poo is. A breastfed baby has bowel movements that are usually yellowish and quite soft. A baby on formula will have brownish stools that is thicker. Bowel movements can differ quite a lot among babies: A newborn may soil his diaper up to 10 times a day while an older baby may empty his bowels as infrequently as once or twice a week. If baby is pooing much more frequently and it is much more watery and smellier than normal, it’s likely to be diarrhoea. Diarrhoea may also stem from changes in baby’s routine. Once baby is taking solid foods, too much fruit or juice may cause diarrhoea.

See the doctor if:
• baby is three months old or younger.
• baby is vomiting as well.
• baby has high fever.
• her poo contains blood.
• she shows signs of dehydration – much fewer wet nappies, dry lips and a depression in her fontanel or soft spot on the top of her head.

What you can do:
An infant’s diarrhoea can turn serious if he becomes dehydrated, so nurse or bottle-feed often, especially if he is also not vomiting. If he is, he will need a paediatric electrolyte solution prescribed by the doctor. If he has already been weaned, feed him his meals as normal. The frequent wettings in his diaper will irritate his bottom so don’t forget to use diaper cream.

VOMITING
Vomiting may look alarming but it’s not always serious. During the first few months, your child’s throwing up may be due to overfeeding or indigestion. Baby may also throw up during a bout of stomach flu (gastroenteritis). If this happens, he may also have diarrhoea, reduced appetite, fever and abdominal pain. Sometimes vomiting might happen even if there is no medical condition. For example, excessive crying or coughing can both result in vomiting.

See the doctor if:
• Baby may become dehydrated if he has been throwing up, and this is a serious condition in babies as they have little fluid reserves.
• He has violent, projectile vomiting – breast milk or formula is ejected forcefully, sometimes over more than a metre away. within half an hour of eating. This may be a sign of pyloric stenosis, in which the lower part of the stomach becomes enlarged and prevents food from emptying out of the stomach. Contact the doctor as soon as possible.
• He vomits for more than 24 hours.

What you can do:
• If your baby is vomiting due to mucus and phlegm, clear his nose using a bulb syringe that you can buy from the baby section of department stores or hospital pharmacies.
• Keep baby hydrated with frequent feedings. Signs of dehydration: wetting fewer than five or six nappies in a day, dry lips or mouth, extreme sleepiness or a depression in the fontanelles.
• If baby’s has tummy problems which has affected his appetite, gradually bring his meals back to normal, but avoid oily foods.


Recognising illness
When you’ve settled into being a parent, you’ll soon be a good judge of your baby’s health. You’re often the first to notice if baby is not himself.

Some signs that he needs the doctor:
• A high temperature which does not come down even after you’ve removed excess clothes and made the room cooler.
• Not feeding as normal, or vomiting continuously.
• Changes in breathing – more laboured, more noisy or faster than normal.
• Changes in skintone – his skin turns yellow, bluish, blotchy or paler than usual.
• He is floppy or drowsy, and refuses to wake up.
• He seems dazed and has a blank expression.
• He is bleeding.

TIP!
Always have the phone number of your paediatrician, or family doctor in a prominent place at home, like next to the home phone, on the fridge or stored in your mobile. In an emergency, you want to be able to retrieve your doctor’s number right away. Also have phone numbers of cab companies, hospitals and ambulance services handy.

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