Read What to Expect the Toddler Years Online
Authors: Heidi Murkoff
What to Expect the Toddler Years (212 page)
As a last resort, if you can’t get the medicine down, talk to your toddler’s doctor about such options as suppositories and shots.
ASPIRIN OR NON-ASPIRIN?
When treating toddlers, the answer is easy: non-aspirin. Aspirin, though useful in treating many conditions in adults, is rarely recommended for children since it has a long list of possible side effects. In children with a viral illness, it has been linked to a risk of developing Reye syndrome (see page 858), a very serious illness. So do not give it to your child unless the doctor has specifically prescribed it over an aspirin-free medication.
Like aspirin, acetaminophen (brand names: Tylenol, Tempra, Panadol, as well as other generic brands) is an antipyretic (fever reducer) and a pain reliever. But unlike aspirin, it is remarkably free of side effects (though there have been occasional cases of liver damage associated with
heavy
dosing). Acetaminophen comes in liquid form for administration by dropper, measuring spoon, or cup; in chewable tablets for older toddlers; in suppository form for a toddler who can’t or won’t keep a liquid or chewable down; and in an easy-to-disguise “sprinkle” capsule for the toddler who casts a suspicious eye on any detectable form of medication.
Ibuprofen (brand names: Advil, Motrin) is as effective as acetaminophen at reducing fever and relieving pain and also has an anti-inflammatory effect. Like aspirin, it can upset the stomach, but its use in children has not been linked to Reye syndrome. Your child’s doctor may find it the drug of choice under certain circumstances (it’s presently available for children only by prescription).
It takes about half an hour for an antipyretic to reduce fever; the effects last anywhere from 4 to 6 hours with acetaminophen and 6 to 8 hours with ibuprofen. Response to the medication tends to be faster in children under two than in older children.
Since all these medications can be dangerous in larger-than-recommended quantities, never give more than the doctor has ordered (see dosage chart, page 586); and, between doses, keep them (like all medications) safely out of the reach of children.
HE MOST COMMON TODDLER HEALTH PROBLEMS
C
OMMON COLD (UPPER RESPIRATORY INFECTION, OR URI)
Symptoms:
Runny nose (discharge is watery at first, then thickens and becomes opaque and sometimes yellowish or even greenish); nasal congestion, or stuffiness; sneezing; often fever, especially in toddlers; sometimes, sore or scratchy throat, dry cough (which may worsen at night), fatigue, loss of appetite. Most of these, incidentally, are not true “symptoms.” They are part of the immune response, the body’s way of defending against illness—in this case, the cold virus.
Season.
A cold can strike anytime, but they occur most often fall through spring.
Cause.
Almost always a virus. More than two hundred viruses are known to cause colds (including the rhinovirus, the parainfluenza virus, and the respiratory syncytial virus) and it’s suspected that there may be as many as 1,500 cold viruses or virus combinations. Because toddlers have had few opportunities to build immunity to any of these viruses through previous infections, they are extremely susceptible to colds. Contrary to popular belief, going bare-headed in the winter, getting the feet wet, exposure to cold drafts, and so on, do
not
cause colds.
Method of transmission.
Most commonly, it is believed, via hand-to-hand contact (the child with a cold wipes her nose with her hand then holds hands with a playmate at play group; the playmate rubs his eye with his hand and the infection is passed on). Also via droplet transmission from sneezes or coughs, and via contact with an object (such as a toy) contaminated by an infected person—but only as long as the moisture surrounding these droplets remains. Incubation period is usually 1 to 4 days. Colds are often passed along a day or two before symptoms appear; once the runny nose dries up, a cold is less contagious.
Duration.
Usually 7 to 10 days (with day 3 the worst for most sufferers); a residual nighttime cough may linger longer, however.
Treatment.
No known cure, but symptoms can be treated, as necessary, with:
Time off. It’s a good idea to keep a child home for the first day or two of a cold, when possible (see page 588). It’s not necessary, however, to restrict activity; in fact, exercise stimulates production of adrenaline, which is a natural decongestant.
Saline nose drops to soften dried mucus (use those sold over-the-counter in pharmacies rather than making your own solution, but avoid drops containing alcohol, which can burn tender mucous membranes). You can also give warm (not hot) tap-water nose drops (3 drops in each nostril two or three times, until the nose seems clear). Drops may be most useful before your child eats or sleeps. Warm commercial saline drops to body temperature before administering them by tucking them into your pocket or inside your shirt for 15 minutes.
Humidification to help clear nasal passages (see page 838).
Petroleum jelly (Vaseline) or a similar ointment, spread lightly on the rims of the nostrils and under the nose to help prevent chapping and soreness. But be careful not to get the ointment inside the nostrils, where it could block breathing passages.
Elevation of the head of the crib or bed (by placing pillows or books
under
the head of the mattress) to make breathing easier.
Warm slippers or slipper socks; when the feet are cold, the redistribution of blood flow can lead to a stuffy nose.
Decongestants, but only if prescribed by the doctor; they tend to be ineffective in young children.
Don’t give your child over-the-counter cough medicine, since it’s not safe for children under the age of two.