Heading into the cold and Flu season and with COVID-19 cases on the rise, here are some reminders about fevers:

WHAT IS A FEVER: 100.4 °F or above (rectal or oral most accurate)

If your child is less than 12 weeks old and has a fever call our office immediately. If your child is less than 8 weeks old we may direct you to a pediatric ER for further testing and possible hospitalization due to your baby’s young age.

If your child has a fever > 105°F call the office immediately.

Children can have a normal variation in their temperatures up to 99-100. This is not a fever. Some kids when teething will have a fever in the 100’s.

Armpit, Ear and Forehead/temporal artery thermometers can vary by multiple degrees from the true core temperature, so the best method of measuring temperatures is rectally for kids less than 2 years old and in their mouth (orally) for kids above 2 years old.

A fever is the normal body response to infection or inflammation.  A FEVER IS A GOOD THING!  Viruses and bacteria are more likely to die and less able to replicate at higher temperatures.  A fever is not dangerous in and of itself.

Do I HAVE to give a fever reducer? No!

Is there a specific fever number to give a fever reducer? No!

Fevers can make kids uncomfortable and decrease their appetite.  For these reasons we may decide to treat fevers with fever reducers like Acetaminophen (Tylenol) or Ibuprofen (Advil or Motrin). If your child has a fever and is otherwise active, eating, and not uncomfortable YOU DO NOT HAVE TO TREAT THE FEVER AT ALL.

When is a fever dangerous?  Research has shown that temperatures > 108 degrees can cause brain damage.  Below that a fever is not harmful to our bodies and can be helpful.

Shouldn’t Tylenol or Advil make my child’s fever go away? Not necessarily. Their fever will go away when they are done fighting off an infection.

Tylenol and Advil are fever reducers and are meant to lower your child’s fever.  It may go down, but not to a completely normal level. It may only go down 1-2 degrees.  This is OK – if the temperature goes down it means the medicine is working.

It’s always worth double checking the dosage of medicine to make sure you are giving the correct amount. Weight based dosing information can be easily found on APL’s website (see link below).  The fever will go away when your child’s body is done fighting off the virus. In general fevers with most viral illnesses last 3-4 days.

Can I alternate fever reducer medications? Technically yes, but in general we recommend picking one medication and sticking with it if it is working. To prevent dehydration and keep kids comfortable (for example with Hand Foot Mouth virus) or for children with a history of febrile seizures, sometimes we do alternate Tylenol and Advil every 3 hours. Please be cautious if alternating medications and do not overdose your child.

When should I come in to the office? If your child has a fever for 3 or more days (72 hours or more), they should come in to be seen to make sure a bacterial infection is not causing the fever, which may need antibiotic treatment. Examples of this would be strep throat, an ear infection or urinary tract infection. Please call when our office is open for a same day sick appointment.

Can I give fever reducers with other medications? Yes, it is ok to give fever reducers to keep your child comfortable while they are on antibiotics. You can also give fever reducers while taking Benadryl and allergy medications.

Bottom Line: When Should I worry?

How your child looks is the most telling sign of the seriousness of the infection. You as the parent know your child best.  If your child is lethargic (limp and weak), not drinking, having difficulty breathing, or any other concerning symptoms it doesn’t matter how high their temperature is – please call our office to decide if they need to be evaluated in the Emergency Room.

If your child has a 105 fever coming down with fever reducers, call the office during business hours for an appointment within 24 hours.

If your child has fevers for 3 or more days (over 72 hours) they should be seen by a physician. Please call our office during business hours for an appointment.

How to treat a Fever:

Lighter layers, less blankets at night

Lukewarm bath

Tylenol (Acetaminophen) or Motrin (Advil/Ibuprofen) – for APL dosing charts click HERE

More resources:

https://www.healthychildren.org/English/health-issues/conditions/fever/Pages/Fever-Without-Fear.aspx

March is Illinois Poison Prevention month!  More than a million American children younger than 6 years old suffer from poisoning every year.  Children are very curious and often explore the world with their mouths- it’s a normal part of their development.  The most common products that children ingest include household cleaners, personal care products, and over-the-counter medications.  Vitamin pills, especially containing iron, and Aspirin are typically safe for adults, but can cause serious reactions in a child’s body.

Keep detergents and other hazardous cleaning products out of reach of children or securely locked in a cabinet that your child cannot open.  Keep all products in their original containers to avoid confusion.  If ingested, these products can cause serious burns to your child’s mouth, feeding and breathing tubes.

If you suspect poisoning, some signs can include vomiting, an unexplained odor from their mouth or on their clothes, or a burn on their skin.  Before attempting any at home remedies, please call Poison Control right away.  If your child has any trouble breathing or has passed out call 911!

Grandparents tend to take more pills!  Make sure they keep all caps on bottles, and that the bottles are kept out of reach of children.  Child resistant caps do not always mean they are child-proof!  If they use a pill organizer, make sure this is kept in a secure place.  For any adult please avoid taking medications in front of a child, because they may try to imitate you later on.  Also, never call a medication “candy.”

Having a Party? Make sure to keep alcohol in a locked cabinet, and empty and rinse any containers immediately after gatherings to prevent alcohol ingestion by your child.

Please keep the Poison Help line handy in case you encounter one of the above situations.  Put the number in your cell phone or stop by the office to pick up a magnet for your fridge!  No question is too silly, they have probably heard it before (eating bugs, diaper cream, a plant, even poop to name a few!).  If you’re unsure, it’s better to be safe and call:

For more information:
http://illinoispoisoncenter.org/
http://ipcblog.org/
https://www.healthychildren.org/English/safety-prevention/all-around/Pages/Poison-Prevention.aspx

In the 1960’s after a long day of school and work families would come home unwind over dinner and talk about their day.  The kids would go outside to play weather permitting or play a game inside, listen to the radio or read before going to bed.

Fast forward to 2017 after a long day of school/daycare or work families are rushing to figure out what to feed the kids for dinner.  We turn on the TV or hand our children their tablet and let them distract themselves.  How about the car ride to school or the store? …. We give them distractions to keep them occupied.  What happened to talking, or listening to music, or just looking out the window in the car.  We constantly have the need to fill our time with something (adults included).  Children who aren’t allowed to experience boredom or are constantly entertained with electronics continue to feel that need as they get older and become adults. Like other addictions it becomes harder and harder to fill that need.   It’s important for children to learn to be comfortable with quiet.   It allows them time to think, be creative, use their hands, read, ect.   We all lead busy, hectic lives and I struggle as a parent trying to find ways to keep my children occupied while getting dinner on the table and raise well rounded kids in the age of the electronics.

There are great learning activities and fun apps for children to use but these things can’t replace talking with our children or one on one time interacting with them on the floor.  Research has shown that children learn best from in-person interactions where they can interpret facial expressions and body language. Children who have larger amounts of screen time (even TV on in the background) have higher rates of language delay, problems with attention, sleep, eating disorders, and obesity.  The American Academy of Pediatrics recommends no screen time for children under 2 and less than 2 hours a day for all children and teens

Teens and Social Media

Multiple studies have shown that adolescents who spend larger amounts of time on social media or who are more “emotionally invested” in social media have higher rates of anxiety and depression.  Look at your children’s’ news feed or your own for that matter.  We are bombarded with constant images of how great everyone else’s lives seem to be or conversely by the tragedy and violence in the news.  This can have long lasting impact on a developing brain.

People are less filtered on social media and are more likely to make negative comments about others. Cyberbullying occurs more often than we realize and continues after school hours.  This form of constant viscous bullying can have serious, even deadly consequences.

Our teens are comparing their lives to their peers and can develop the feeling that their own life is not quite good enough. Body image issues can arise from constantly seeing photo-shopped revealing pictures of men and women in the media.  We are also finding that children have more difficulty with social skills because they have gotten accustomed to texting friends and less in person or verbal interactions.  Teens also have less restful sleep from alerts on their phone which they often will respond to in the middle of the night The Internet also can be a gateway for risky behaviors. Monitor what your child is seeing and reading on the internet.

Technology keeps us connected in ways that weren’t possible before, but more disconnected in many ways.  There are many great things about the internet such as having access to unlimited information and the ability to connect with people across the world.  The internet and social media are a tool, but it can become an obsession or an addiction that has an impact on our mental health.

“It is the mini-moments of disconnection, when parents are too focused on their own devices and screens, that dilute the parent-child relationship,” Dr. Steiner-Adair warns. And when kids start turning to the Internet for help or to process whatever happened during the day, you might not like what happens. “Tech can give your children more information that you can, and it doesn’t have your values,” notes Dr. Steiner-Adair. “It won’t be sensitive to your child’s personality, and it won’t answer his question in a developmentally appropriate way.”

Our children need us to be present in their lives. They notice when you are distracted by your phone and not focusing on them and they begin to model that behavior themselves.  Create a “phone and screen free time” for your family.  Establish at least one hour where no one picks up the phone or turns on the screen.  Remove TVs and phones from the bedroom at night.   Turn of the background noise TV and allow there to be silence, or music, or talking especially at dinner time.

If you have any questions on this subject, always feel free to call us at the office at 847-398-0400.

Here at APL, we want everyone to look their best!  Acne, or pimples, is a normal part of being a teenager, but your teen may be concerned about their acne or even embarrassed by it.  Acne is caused by a combination of increased oil production, dead skin cells, bacteria, and inflammation.  This leads to blackheads, whiteheads, and deeper pimples or nodules.  There are numerous over the counter and prescription medications for acne to treat all of the different causes.  We recommend starting the conversation about acne here at APL!

Some common myths are that foods such as chocolate or fatty foods cause zits.  These are not true!  We always want your child to eat healthy, but your child’s diet is not related to their acne.  Some people think that sunlight improves acne.  This is not true either!  It is especially important for your child to wear sunscreen to protect their skin from damage and skin cancer.  Another myth is that you are supposed to pop pimples…unfortunately this leads to more inflammation which can make the pimple worse, and can lead to scarring of the skin.  I know it is tempting, but don’t pop the zits!

Initial treatment of acne includes washing the face with soap and water and the use of a topical cream or gel.  If your child has acne on their chest and back, we may suggest a medicated body wash or even a pill to take for the pimples.  Females can have hormonal related pimples that flare during certain times of their cycle, and if the above treatments don’t help, then sometimes we try a daily hormone pill.  Some teens with severe scarring or severe acne may need stronger treatments, and in those cases we may refer your child to a dermatologist.

Unfortunately, acne treatments are not a quick fix.  It can take up to 6 weeks for a medication to start working and for the skin to look improved.  Actually, sometimes the acne can look worse at first before it gets better.  It is important to be patient and still apply the zit cream every day.

Again, lots of pimples can be embarrassing and can cause problems with your teen’s self-esteem and mood.  If your child is bothered by their acne, let’s talk about it at their upcoming physical, or feel free to schedule an appointment so we can create an individualized “Acne Action Plan” today!

References:

http://www.healthychildren.org/English/ages-stages/teen/Pages/Zits-are-the-Pits-How-Parents-Can–

Leung, Barankin, Hon.  “Adolescent Acne Vulgaris. An Overview of Therapeutic Options.”  Consultant for Pediatricians.  February 2015.