Treat the child, not the thermometer
A child who is drinking, playing in between naps and making wet diapers is usually fine, even at 103°F. A child who is listless, hard to wake or refusing all fluids needs to be seen, whatever the reading.
Good to know,
before you call.
Short, practical answers to the questions parents ask us most: what to do about a fever, how to get fluids into a child with a stomach bug, when a cut needs stitches, and which signs mean you should stop reading and get help now. Each topic ends with when to call us.
0Practical tips0Everyday topicsAfter hoursClinician on call
Read this first
When to skip the tips and get help now.
Call 911 or go to the nearest emergency department if you see any of these. Do not wait for a callback, and do not send a message.
- Struggling to breathe, breathing very fast, or the skin between the ribs pulling in with each breath
- Blue or grey lips, tongue or face
- A seizure, or a child who is hard to wake, floppy or not responding normally
- A fever of 100.4°F or higher in a baby under three months old
- Swelling of the lips, tongue or throat, or hives with trouble breathing after a food, sting or medicine
- A head injury followed by repeated vomiting, confusion, unusual sleepiness or loss of consciousness
- Bleeding that does not slow after ten minutes of firm, steady pressure
- A possible poisoning or medicine overdose with any symptoms at all
Not an emergency, but worried? Call your office. A clinician is on call after hours.
Jump to a topic.
These tips are general guidance for common situations, not a diagnosis. Every child is different. If something does not feel right, trust that instinct and call us.
Fever
Fever is the body doing its job against an infection. It is rarely dangerous on its own, and the way your child looks and acts tells us more than the number.
Measure it the right way for their age
Under three months, a rectal temperature is the most accurate. For older babies and toddlers, rectal or a well placed armpit reading works. From about four years, an oral thermometer is reliable if they can hold it under the tongue.
Medicine is for comfort, not a cure
Acetaminophen or ibuprofen can help a miserable child rest and drink. Dose by weight, not age, using the syringe that comes with the bottle. Ibuprofen is not for babies under six months, and never give aspirin to anyone under 18.
Fluids matter more than food
Fever raises how much water the body loses. Offer small, frequent drinks of water, milk or an oral rehydration solution. Appetite usually comes back once the fever settles.
Dress them lightly
Bundling a feverish child traps heat. A single light layer and a comfortable room are enough. Skip cold baths and rubbing alcohol, which cause shivering and can make things worse.
Colds, coughs and flu
Young children can catch eight or more colds a year, especially in their first year of daycare or school. Most get better on their own with time and comfort care.
Expect it to take a while
A typical cold lasts seven to ten days, and the cough can linger for two to three weeks after everything else clears. Green or yellow mucus is normal and does not mean antibiotics are needed.
Skip cough and cold medicines for young children
Over the counter cough and cold medicines are not recommended under age four. They do not work well in children and can cause serious side effects. Ask us before using them in older children.
Honey for coughs, but only after the first birthday
Half a teaspoon to a teaspoon of honey can calm a night time cough in children over one year old. Never give honey to a baby under 12 months because of the risk of infant botulism.
Clear the nose
Saline drops followed by gentle suction help babies feed and sleep. A cool mist humidifier in the bedroom can ease congestion. Clean it daily so it does not grow mould.
Know when it might be flu
Flu tends to start suddenly with high fever, body aches and exhaustion. Antiviral medicine works best within the first 48 hours, so call early if you suspect flu, especially for children under five or with asthma.
Vomiting, diarrhea and dehydration
Stomach bugs are unpleasant but usually pass in a few days. The job at home is to keep fluids going in faster than they are coming out.
Small sips, often
After vomiting, wait about 30 minutes, then offer a teaspoon or two of oral rehydration solution every few minutes. Slowly increase the amount if it stays down. Big gulps tend to come straight back up.
Use the right drink
Oral rehydration solutions have the balance of salt and sugar the body needs. Sports drinks, juice and soda have too much sugar and can make diarrhea worse in young children. Keep breastfeeding or formula feeding babies as normal.
Food when they are ready
There is no need for a strict diet. Once vomiting settles, offer normal, simple foods your child likes. Starving a stomach bug does not shorten it.
Wash hands with soap
Stomach viruses such as norovirus spread easily through a household. Hand sanitizer is less effective against them, so wash with soap and water, especially after diaper changes and before preparing food.
Sleep
Sleep affects mood, attention, growth and immunity. A few steady habits make a bigger difference than any product.
Safe sleep for babies: alone, on the back, in a crib
Put babies to sleep on their back on a firm, flat surface with only a fitted sheet. No pillows, bumpers, blankets or soft toys. Room sharing without bed sharing is recommended for at least the first six months.
Anchor the wake time
A consistent wake time, even on weekends, sets the body clock more reliably than an earlier bedtime. Bedtime tends to settle on its own once mornings are steady.
Know how much sleep is normal
As a rough guide in 24 hours: toddlers need 11 to 14 hours including naps, preschoolers 10 to 13, school age children 9 to 12, and teenagers 8 to 10. Most teens get far less.
Screens out of the bedroom
Turn screens off at least an hour before bed and charge phones and tablets outside the bedroom. The light and the content both keep the brain awake.
Regressions pass
Babies and toddlers often sleep worse for a few weeks around developmental leaps, illness or travel. Keep the routine steady and it usually resolves.
Nutrition and picky eating
Most picky eating is a normal phase. Your job is what, when and where food is offered. Your child's job is whether and how much to eat.
Offer, then offer again
Children may need to see and taste a new food ten to fifteen times before they accept it. Put a small amount on the plate next to something they already like, without pressure or bribes.
Water and milk are the main drinks
Skip juice entirely before the first birthday and limit it after. Toddlers need only about two to three cups of milk a day; more than that can crowd out iron rich foods.
Eat together when you can
Regular family meals, even a few times a week, are linked with better eating habits. Keep screens off the table so everyone notices when they are full.
Plan snacks like small meals
Schedule snacks rather than grazing all day. Pair a fruit or vegetable with a protein, such as apple with cheese or carrots with hummus, so they arrive at dinner hungry but not starving.
Cuts, burns, bumps and sun
Most everyday injuries can be handled at home with good first aid. Knowing which ones need stitches or an X ray saves time and worry.
Cuts: pressure, then clean
Press firmly with a clean cloth for ten minutes without peeking. Then rinse well with running water and cover with a bandage. A cut that gapes open, is deep, or is on the face should be seen the same day, ideally within a few hours.
Burns: cool water, for longer than you think
Hold a burn under cool running water for 20 minutes. Do not use ice, butter or ointments. Burns larger than your child's palm, or any burn on the face, hands, feet or genitals, need to be seen.
Bumps to the head
A goose egg after a fall is common and usually harmless. Watch your child closely for the next 24 hours. They can sleep, but should be easy to wake and act like themselves.
Sun protection every day
Use a broad spectrum sunscreen of SPF 30 or higher on children over six months, and reapply every two hours and after swimming. Keep babies under six months in the shade with hats and light clothing.
Medicine safety
Most medicine mistakes at home come from measuring, doubling up or storage. A few habits prevent nearly all of them.
Dose by weight with the right tool
Use the syringe or cup that comes with the medicine, never a kitchen spoon. Children's doses depend on weight, so ask us for a dosing chart and keep your child's current weight handy.
Check for doubled ingredients
Many combination cold and flu products already contain acetaminophen. Giving them alongside plain acetaminophen can lead to an accidental overdose. Read the active ingredients on every label.
Finish antibiotics as prescribed
Give the full course even when your child feels better after a couple of days. Do not save leftovers or share them. Antibiotics do not treat colds or most coughs.
Lock it up, up and away
Store all medicines, vitamins and supplements up high and out of sight, ideally locked. Keep purses and visitors' bags off the floor. Save the Poison Control number in your phone: 1-800-222-1222.
Allergies and asthma
Allergies and asthma are very manageable with a plan. The goal is a child who sleeps, plays and runs like everyone else.
Keep the action plan where people can see it
A written asthma action plan tells you, the school and caregivers what to do on green, yellow and red days. Share a copy with every adult who looks after your child.
Use a spacer with the inhaler
A spacer gets much more medicine into the lungs than an inhaler alone, at every age. Bring the inhaler and spacer to visits so we can check the technique.
Two epinephrine injectors, always together
If your child has a prescribed epinephrine auto injector, keep two with them at all times and check the expiry dates. Use it first in a serious reaction, then call 911.
Know the triggers
Common triggers include colds, smoke, dust mites, pollen, pets and cold air. Keep the home smoke free, wash bedding in hot water weekly, and plan ahead for pollen season.
Checkups and vaccines
Prevention is the least dramatic and most effective care we give. Most of it happens at visits nobody feels urgent about.
Book the well visit every year
Well visits are where growth, development, vision, hearing and emotional health are checked over time. Anchoring them to a birthday month makes them easy to remember.
A flu shot for everyone over six months
Annual flu vaccination protects your child and the babies and grandparents around them. Early fall is the best time, but it is still worth getting later in the season.
Keep your own copy of the records
Ask for a printed or digital copy of your child's immunization record. Schools, camps and sports teams will ask for it, usually at short notice.
Bring your questions in writing
Keep a running list in your phone between visits. Concerns about behaviour, sleep, school or mood are exactly what well visits are for.