Signs and Symptoms
Whenever your child is ill, your observations of what’s going on are very important. When you are assessing your child’s illness, you’re really looking at two different things-signs and symptoms. These terms have specific meanings to your doctor.
A symptom is something a patient complains about. A sign is something the doctor [or you] can see, measure, hear, taste or smell. So, if your child complains of her ear hurting, that’s a symptom; if she’s pulling on her ear, that’s a sign.
Signs and symptoms are indications of illness, but they are not illnesses themselves. When your doctor treats your child, he or she may treat the signs and symptoms of the illness, the illness itself, or both. For example, aspirin or acetaminophen is frequently given to a child with a fever, either may reduce the fever, but neither affects the underlying illness causing the fever. However, an antibiotic given to your child when he has an ear infection, actually helps the body to fight off the infection and, so, is treating the illness. The earache [a symptom] and the fever [a sign] will go away because the infection [the illness] is being treated.
Most of the medicines you can buy in the drugstore without a prescription treat symptoms but doesn’t treat the illness itself. So the “cold” medicine you may buy for your child doesn’t make the cold go away any more quickly, but they may make your child feel a little better.
There’s an ongoing debate about treating signs and symptoms of common illnesses. Some doctors believe that unless the signs and symptoms are severe, you’re better off not treating them. Some of the symptoms of an illness may actually be beneficial and speed recovery. Every medicine has side effects, and sometimes these can be worse than the illness itself.
Your doctor’s well-baby examination consists of many different parts, each designed to help her find certain information. You may have to watch closely to see her do each part of the exam because she probably has developed her own tricks and techniques. Some doctors like to have the baby on the examination table; others prefer that the parents hold the baby. Sometimes the doctor will be talking to you while examining your baby.
As your baby grows, he will not need to be seen routinely as often as when he was an infant. Instead of every three months, most doctors see children once every six months. These visits are for the same reasons as the earlier ones-to make sure your child is growing and developing as he should and to provide you with an opportunity to ask questions. New topics will become important, although many of the old ones such as behavior and eating may need to be discussed again.
From your discussions with your doctor, you will know how she wants to deal with emergencies and after hour’s calls. Keep her guidelines in mind when you think about calling her. However, if you are very concerned about your child, then call. Most childhood illnesses can be handled over the phone, and the child won’t have to be seen by the doctor until morning.
Over the years, a commonly accepted immunization schedule has evolved. Most doctors follow it, although there are some acceptable variations. The schedule is designed to give your child the maximum protection available as soon as possible. The reason some shots are not given earlier is that the child’s own defense system hasn’t matured enough to develop immunity. For example, a number of years ago, the measles, mumps, and rubella vaccine were given to infants at twelve months. It was discovered that many of these infants didn’t develop protection against these illnesses because their own defense systems weren’t able to react to the vaccine correctly. The date was changed, and now the vaccine is much more effective.
It’s often helpful to know your child’s temperature. It is sometimes an indicator of the seriousness if the illness, although this isn’t always true. A normal oral temperature is 98.6 degrees Fahrenheit. A rectal temperature is one degree higher; an axillary [armpit] is one degree lower. “Normal” means average-some people run a slightly higher or lower temperature, and that is “normal” for them. Temperature varies throughout the day; a person’s temperature is usually a little higher in the afternoon and evening.
There’s nothing scarier for a new parent than a sick baby. Your infant is fussy, not eating well, and has a fever. Should you take her to the hospital? Should you call your doctor? Or are you overreacting? As a well-informed parent, you want to know what you should do-when to be concerned and when not to worry. You want to know when to call the doctor and what to tell him. That’s what this section is all about.
An important part of most baby visits is immunizations. They are designed to lessen the chance that your baby comes down with certain diseases. There was a time, not too long ago that many babies died of infections. Now we can prevent many of these killers with immunizations. It’s rare to see a child with polio, diphtheria, pertussis [whooping cough] these days, although there’s been more whooping cough recently since fewer parents are protecting their children. The number of people, both children and adults, who get rubella [German measles], has declined drastically since immunization became common.
Fever in a child strikes fear in the hearts of many parents. They wonder if their child will have a seizure and develop epilepsy, or if the temperature will go high enough to “cook” their child’s brain and cause permanent damage. You may be concerned about the proper way to treat your child’s fever and when you should call your doctor. Fever is perhaps the most misunderstood sign in all of medicine. It’s the body’s normal response to infection.
Doctors like to see infants at regular intervals to monitor their growth, development, and health. These visits are important because if any health problem is developing, it’s best to find it early and treat it appropriately. Although your doctor may have a slightly different schedule of visits, most infants are seen when they are two, four, six, nine, twelve, fifteen, eighteen, twenty-four, thirty, and thirty-six months old.
During your baby’s first three years of life, she will see the doctor a number of times. These visits are important to make sure she is growing and developing appropriately. Your doctor will ask you a number of questions to see how things are going, and he will examine your baby, checking for normal growth and looking for problems. Routine and regular checkups are particularly important for you r baby during her first three years of life. Problems at this age, if not treated early, may have serious implications for her later in life.
Two relatively new health care practitioners are seeing more and more children. These are nurse practitioners and physician’s assistants-often collectively referred to as physician extenders. Nurse practitioners are registered nurses who take one or two tears of further training in physical examination, diagnosis, and prescribing medicines. Many work with physicians, although a number of them practice by themselves. Physician’s assistants graduate from a two year program in which they learn the same things as the nurse practitioner.
When you go for the “get acquainted visit” before your baby is born, you should bring with you a list of questions. The doctor’s answers to your questions are important and you should make notes. Follow up on any answers you don’t understand. Be aware of the doctor’s style and how he answers the questions.
There are two different specialists that take of babies-family practitioners and pediatricians. Both have completed a residency [extra training after graduating from medical school]. A family practitioner’s training covers all areas of medicine including adult medicine, pediatrics, obstetrics, and surgery. A pediatrician’s residency is focused primarily on pediatrics. He has spent more time dealing with ill children and children with special problems. A family practitioner will take care of your entire family-from the very young to the very old. Most family practitioners encourage this. They find it easier to treat an individual if they know the whole family. Family practitioners frequently are better able to deal with emotional or family problems that affect everyone in the household… A pediatrician takes care of children exclusively. Usually they stop seeing a child when he is in his mid teens.
One of the most important decisions you’ll make about your baby’s health is selecting his doctor. Finding the right doctor isn’t easy. There are many questions that must be asked and answered before you make the selection. It’s important to find a doctor you feel comfortable with-someone whom you can talk to and who’ll answer your questions to your satisfaction. The doctor’s style must be right for you!