| Fevers |
 A fever can be a good thing. That statement may seem strange to many but it is true. When a child gets an infection part of the body's immune reaction is to cause a fever. Raising the body temperature allows white blood cells to function more effectively and decreases the abilities of bacteria and viruses to spread. A fever will help a child recover from an illness more quickly and does not necessarily need to be treated.
You should treat a fever if a child is very uncomfortable, refusing to eat or drink or is in pain. If a child has a high fever (> 100.4 in an infant less than 4 months old or >102 in an older child) or a low grade fever that last more than 2-3 days please let me know and I will set up a time to examine him.
When a fever does need to be treated, either acetaminophen (Tylenol) or ibuprofen (Motrin) can be used. Tylenol is the best choice in children less than 2 because it has been tested more in infants than Motrin has. Motrin does tend to last longer than Tylenol and is a good choice for older children. Many parents have been advised to alternate the medication (giving one dose of Tylenol followed a few hours later by Motrin). These are different medications and can theoretically be used together safely, but you must take caution not to overdose on either medication. If you do chose to alternate medications you should wait 4 hours between doses to make sure you do not accidentally overdose your child.
Tylenol and Motrin are best dosed by your child's weight. The Tylenol dose is 6 mg per pound (multiply your child's weight in pounds by 6 and that is how many mg of Tylenol she can get), and for Motrin the dose is 4 mg per pound. After determining how many milligrams your child should get you should look at the bottle and under active ingredients it will tell you the concentration (for example: infant Tylenol is 80mg per 0.8 milliliter but children's Tylenol is 120mg per 5 milliliters) and from there you can calculate how much medicine to give. When in doubt, give me a call.
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| Infant Feeding |
| Two of the most common questions I get during well child exams are: How much should my baby weigh and how much should she be eating? The answer to both questions, of course, depends on the child, but I will give some general guidelines here.
Infants less than 4 months old should not be fed any solids or cereals. All your baby needs is breastmilk and/or formula; infants should not be drinking whole cow's milk until they are a year old. Between birth and 6 months, baby's need between 2-2.5 ounces of formula per pound per day (i.e. a ten pound baby needs 20-25 ounces per day). In general:
- Newborns take 1-2 ounces per feeding
- 1 to 2 month olds take 3-4 ounces per feeding
- 2 to 6 month olds will eat 4-6 ounces per feeding
- Babies older than 6 months can take up to 8 ounces per feeding
Remember: Your baby's stomach is about the size of his fist and if you put too much milk in it, it is likely to come back out on you.
You can expand your baby's diet to include cereals when she is between 4 and 6 months old. Studies have shown that starting babies on cereals younger than this increase the risk for food allergies. Start by offering simple iron fortified cereals (rice cereal usually works best). Mix the cereal with formula or breastmilk (about 1 teaspoon of cereal with 4-5 teaspoons of formula or breastmilk works best but you can make it thicker or thinner depending on the babies eating skills). When your baby has mastered rice cereal you can start to offer other foods, remember not to add more than one new food every 2-3 days so if he has a reaction to something you know what it is. If your baby is doing well with the rice cereal at 6-8 months you can add other cereals, fruits and vegetables. From 7-10 months of age think about offering strained or mashed fruits and vegetables, and finely chopped table foods like egg, meat and poultry. By 9-12 months you can offer yogurt, cheese and soft combination foods like macaroni and cheese, spaghetti and casseroles.
The first time you offer an infant a new food they are likely to make faces or act like they do not like it. He might just need a chance to get used to it, so try again with the same foods several times before you give up on it. Have fun feeding your baby, and remember to keep a wash cloth nearby because your baby is sure to get more food on him than in him! |
Sincerely,