What to Expect the Toddler Years (206 page)

Dietary guidelines.
Forget the adage, “starve a cold, feed a fever”—it has no foundation in medical fact. Anyone who is ill, fever or no, needs a nutritious diet (in line with any recommendations for the particular illness); if there is fever, extra calories are also important to compensate for the additional calories burned with each increase in body temperature. For most toddler illnesses, you should:

Stress fluids.
If your toddler has a fever, a respiratory infection (such as a cold, influenza, or bronchitis), or a gastrointestinal illness with diarrhea and/or vomiting, clear fluids and foods with high water content (juices, juicy fruits, soups, fruit-juice-based gelatins, and frozen-juice desserts—but not sugar-sweetened sodas, juices, or punches) will help prevent dehydration. (Sometimes, particularly with diarrhea, an oral rehydration solution may be necessary.) Offer fluids frequently throughout the day, even if your toddler takes no more than a sip at a time. If your toddler’s appetite is sluggish, fluids should take precedence over solids.

Emphasize quality.
When your toddler’s appetite is dampened by illness, the temptation to put good nutrition aside and allow non-nutritious foods that are ordinarily taboo may be great. Resist it. Since anyone—adult or child—who is sick needs a plentiful supply of nutrients (particularly protein, vitamins, and minerals) to help the immune system fight back, be sure that what little your toddler eats goes a long way nutritionally. And continue to offer a vitamin supplement to your child (unless the doctor advises otherwise or your child has been vomiting it up).

Think small.
Since appetites may be tender during illness, it’s best to feed small amounts of food frequently during the day. Avoid heavy, fatty foods that are difficult to digest.

Don’t force.
Even if your toddler hasn’t taken a bite in 24 hours, don’t force-feed. Do make sure, however, that your toddler gets enough fluids—you may wish to keep a record of the amounts. Be sure to report inadequate fluid intake and/or serious loss of appetite to the doctor.

Play favorites.
Skip new foods and foods you know your toddler doesn’t love. Instead focus on nutritious favorites. Concern yourself less about balance than about total food intake—six bowls of cereal, milk, and bananas in a day is fine, if that’s what your sick toddler craves. If nothing seems to spark the appetite, try tempting your toddler with some of the tasty tricks on page 522. A nutritious shake or juice “smoothie” (made with milk or juice, bananas, berries, or other fruit, fortified with yogurt or a teaspoon or two of wheat germ) may be appealing—and go down more easily than solids.

TLC.
The best medicine for anyone who isn’t well, especially a child, is tender loving care. Dose your toddler with it regularly.

Being around unfamiliar people in unfamiliar surroundings; being poked and jabbed and dosed with medicine; being crib-bound (and sometimes, when mobility has to be rigidly restricted, even physically bound to a crib). When a toddler must be hospitalized—whether for an overnight procedure, a week of testing and observation, or long-term treatment that spans a month or more—no one and nothing can make the experience completely painless or anxiety-free, for the toddler or the toddler’s parents. But a positive attitude and the right preparation can make things go more smoothly.

If your toddler must be hospitalized, start preparing as soon as possible (assuming you have the luxury of advance notice) by taking the following steps:

Be sure that a hospital stay is absolutely necessary. Ask if the planned procedure could be performed on an outpatient basis—either in the doctor’s office or the hospital—so that your toddler can return home to familiar surroundings the same day.

Check out the hospital before your toddler checks in. If you have a choice of hospitals (this may be restricted by urgency, local availability, finances, or insurance stipulations), investigate the options. A respected pediatric hospital is usually the best choice, with a tertiary hospital (a major medical center) that has a large pediatric department next best. If your toddler requires surgery or another procedure that isn’t routine, look for a hospital that has a good track record for that particular procedure (ask the doctor who is to provide the care about his or her experience and results). Sometimes the right hospital for your toddler may end up being far from home, but getting the best care possible, when it’s possible, is almost always worth the trip.

Also look for a hospital that has rooming-in arrangements for one or both parents (the doctor may be able to write an order for this if it isn’t routinely offered), a play room, a child-friendly atmosphere, and an empathetic staff (stop in and chat for a few minutes, if the hospital is local). Also be sure that you’ll be allowed to bring some of the comforts of your toddler’s home along to make the hospital accommodations more cozy.

Arrange for some time off. If it’s at all possible, at least one parent should be with your toddler around the clock during the hospital stay—not only to provide reassurance and comfort as needed and to serve as his or her advocate, but to afford a sense of security and continuity in the often-unpredictable hospital environment. Most working parents are legally allowed to take time off from their jobs to care for sick children (though, unfortunately, they are not always guaranteed pay for the days they miss). If there are two working parents, alternating bedside shifts can minimize total missed work time for each, and be less physically and emotionally wearing. If you’re a single parent, try to find a friend or relative to help relieve you when you need a break, a shower, or some fresh air.

Arrange for child care. If you have other children at home, the logistics of spending time at the hospital become even more complex. Arranging school or day care drop-offs, pick-ups, and hospital visits, as well as daytime and/ or nighttime care, will require some advance planning. Depend as much as possible on the kindness of friends and family (most people are happy to help), supplementing as needed with paid help, if necessary and feasible. Be meticulous in your scheduling so that slipups will be less likely; keeping a daily calendar will help. When possible, reconfirm the next day’s schedule the night before with those who will be transporting and caring for your family. Some hospitals offer a support program for siblings of young patients; ask if one is available.

Prep yourself. Learn everything you can about your child’s condition (ask the doctor to recommend reading material) and about what you can expect at the hospital. If there will be surgery, will your child receive general anesthesia? Can you be present while it is administered? What kind of after-effects can you expect? Will he or she have to be immobile for a while? Will food be limited? Will intravenous lines be connected? Will pain medication be available? If you’re still breastfeeding, will you be able to nurse?

Prep your toddler. Though older children may benefit from a very thorough hospital briefing, toddlers generally have no preconceived notions about hospitals. Your most important task will be to avoid passing on to your toddler the burden of any negative baggage you’re carrying. Make the preparations as upbeat as possible and gear them to your toddler’s level of understanding. Include, as possible:

Reassurance.
Be sure that you don’t give your toddler the impression that you’re sending him or her “away” to the hospital; make it clear from the very start that you are going there
together
and you (and/or your spouse or other close family member or friend) are going to be there all the time.

An explanation.
Explain that a hospital is a place where children go when they are sick (or have “boo-boos”), and that there are doctors and nurses there to help make them better. A brief overview, with a few details, is fine. Avoid potentially frightening terms and explanations. If surgery or another invasive procedure is scheduled, don’t say, for example, that “the doctor is going to cut your tummy”; instead, explain that the doctor is going to “fix the boo-boo in your tummy.” If your toddler has questions, answer them honestly, but don’t provide more information, or more detail, than he or she requests.