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I'm a Pediatrician and Here Are the Top 5 Questions I Always Get Asked

Providing emergency care for kids has been my gig for over 20 years, and I’ve seen and treated a wide spectrum of urgent situations–everything from spiking fevers to broken bones, appendicitis, burns…you name it. But even as an emergency pediatric physician, the most common questions I receive pertain to conditions that nearly all babies and children experience at one point or another.

From fevers to ear infections, stomach pains to gas, here are the top five questions I get asked most regularly: 

1. At what temperature should I be concerned about a fever?

This depends on the age of the child. Any infant less than 28 days old with a fever of 100.4F (38C) should be evaluated right away. Between one and six months old, a temperature of 100.7 or higher should be discussed with the child’s healthcare professional. Meanwhile, for older, fully immunized children, a temperature of 102.2 and above indicates it’s time to call the doctor.

But even if your kid’s fever is below that threshold, there are plenty of measures you can take at home to remedy the situation–a cool compress on their head, bathing them in lukewarm water and making sure they’re getting plenty of liquids, as well as fever reducers such as acetaminophen and ibuprofen.

In general, for children older than about 2 years old, we often follow the practice of “treat the child, not the number.” I’ve seen plenty of kids acting playful and smiling with a temperature of 102 and an equal number feeling crummy at 100. As always, if you have any concern about how your child is acting regardless of temperature, check in with your healthcare professional.

2. My kid never eats! Is this a problem?

If you notice considerable weight loss or consistent (meaning, daily) problems going to the bathroom, it’s time to call your doctor. But if your child is growing normally, not getting sick with any sort of regularity and is going to the bathroom normally/not complaining about constipation, there is really no need to be worried. Yes, I understand it can be frustrating. (I experienced this with my own child when he was younger, so trust me, I get it!) Just do your best to sneak in healthy foods whenever you can, and try to think about the spectrum of foods your child eats in a week, rather than a day or at a specific meal. I’m also a fan of seizing the moment when a child actually seems hungry, acknowledging that these instances may be more or less often depending on growth periods.

3. My baby is really gassy. Should I switch formula?

I always encourage parents to discuss potential formula changes with their child’s pediatrician, as many times it’s not the answer to the underlying issue, whether that’s gas or spitting up or something else entirely. Indeed, many babies are “gassy” and perfectly healthy, so the remedy is more learning to manage it (with more frequent burping or positioning) rather than expecting a cure via formula change. That said, there are conditions of intolerance, difficulties with nutrient absorption and true allergic reactions, where a formula switch can be beneficial. Ongoing large-volume vomiting, bloody stools or diarrhea, skin rashes or persistent fussiness are reasons for an infant to be evaluated. And while a formula change may be the resulting management, other causes should be investigated as well.

4. My child gets so many ear infections. When should we consider ear tubes?

Due to the intricacies of kids’ middle ear anatomy, germs that migrate from the outside through the nose and mouth often accumulate in the ear and cause infection. Toddlers ages one to three are particularly susceptible, which can make for a frustrating and painful situation for both child and caregiver. Ear infections are caused by viruses or bacteria in the ear which can happen alongside another illness, such as the common cold.

For children who get recurrent infections, ear tubes to help fluid drainage can be a lifesaver. (A small, soft tube is placed through the ear drum so that fluid can’t build up in the middle ear space.) There are, however, specific criteria that must be met. Namely, it’s time to discuss ear tubes with a pediatrician if your child has had three or more ear infections within a six-month period or has ongoing fluid build-up in the ears between ear infections that affects hearing.

5. How long is this cold going to last?

For many families, it seems like their child, especially toddlers and young school-age kids, ALWAYS have a cold. No one is sleeping and everyone is uncomfortable. The good news? It’s not just you. During the toddler years, children have an average of eight to ten colds, mostly concentrated during the typical cold and flu season in fall and winter. Symptoms often last seven to ten days, but can sometimes linger for up to two weeks. (Which…if you have multiple kids can mean months of illness.) These upper respiratory infections are usually caused by various viruses, so antibiotics won’t work to cure them; it simply takes time. Support your kids as best you can, by clearing secretions from babies’ noses to open up their airways and making sure older kids are hydrated, rested and properly fueled with nutrient-dense foods.

Dr. Christina Johns is a pediatrician + Senior Medical Advisor at PM Pediatric Care, the largest pediatric urgent care group in the U.S.  

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