How high is “too high” a fever?

How do I wean my baby from the bottle?

Why won’t my child sleep through the night?

When it comes to child rearing, there are no simple questions. But there are common ones.

That’s why pediatricians from The University of Texas Medical School at Houston compiled the top seven questions parents ask (and their answers.)

1. Is my child’s weight normal?

With children’s waistlines expanding and Type 2 diabetes cases rising, parents are asking this question all the time, says Dr. Lynnette Mazur, professor of pediatrics at the UT Medical School.

She says the way a pediatrician calculates your child’s normal weight range is by using age-appropriate growth curves to graph your child’s height and weight at each visit.  When a pediatrician gives the parent a figure for their child’s weight percentile, it is based on the chart the doctor is using.  If they tell you your child falls in the 50th percentile for weight that means they are average when compared to other children their age. 

Your pediatrician may also compare that number to your child’s Body Mass Index, or BMI. “Many pediatricians are starting to look at both the percentile curves and body mass index to compare them to determine whether a child is under or overweight,” says Mazur.

2. When should I introduce solid food?

Dr. Johnnie P. Frazier, associate professor of pediatrics at the UT Medical School, says solids usually are first introduced to an infant between 4 and 6 months of age.  “Usually at this age infants will have achieved adequate developmental skills to move pureed foods to the back of their mouths to swallow. They also have good head and neck control and can sit with support to successfully eat solids.” The American Academy of Pediatrics (AAP) Committee on Nutrition recommends that single ingredient foods be introduced one at a time at least a week apart.  This allows parents time to observe if their infant has a reaction to the food, and may be allergic to it. Frazier recommends that parents introduce rice cereal first, followed by vegetables then fruits. Meats are usually introduced at 9 months of age.

3. How can I wean my child off the bottle?

Frazier says you can begin by introducing your infant to a cup when the baby is 6 months old. “Try giving them breast milk or formula in the cup at least two times a day as part of their regular feedings and the remainder in the bottle,” says Frazier. This signals to the infant that formula/breast milk from the cup is acceptable. Over time (usually by 9 months) you may gradually increase the number of cup feedings after meals and between while eliminating the bottle feedings. “The parent has to be consistent and willing to supervise cup feedings because this does require more time and patience.” The AAP recommends that toddlers be completely weaned from the bottle by 15 months old. “Delayed bottle feeding can cause negative health implications such as obesity, cavities, ear infections and anemia,” says Frazier.

4. How Do I Get My Baby To Sleep Through The Night?

Exceptions come to every rule—and every baby—but most will sleep about six hours straight a night, once they weigh about 10 pounds. Pediatrician Dr. Stuart Cohan says the old standby advice is still good: a full stomach and a clean diaper go a long way to ensure a good night’s rest.  “Babies who awaken, having been fully fed and are dry, need to be encouraged to go back to sleep, not fed a little.” A little patting on their back and a soothing voice can sometimes be all a baby needs to fall back to sleep. 

For older babies who won’t go to sleep, or who wake and stay awake, or have been sleeping with Mom and Dad, Cohan says these techniques seem to work best: 

• For several days put the baby in the crib, sit next to the crib and pat or sing until the baby falls asleep. 
• Do not, if at all possible, take the baby out of the crib. 
• Once that seems to work, spend the next several nights sitting across the room, near the door, talking softly. 
• Cohan says for a few more nights, an occasional reassurance from the hall, should complete the “cure.”

5. Does My Child Have ADHD?

Cohan says ADHD is a complex issue with no easy answer for parents. “Most children under the age of 5 seem to have some attention span problems; they also are usually very active so they appear to have signs of ADHD. However, once they reach 5 years old and are in kindergarten, most will be mature enough to sit still for a while, pay attention and follow instructions.”

Cohan suggests that if your 5-year-old cannot stay still for a story, speaks out of turn, and frequently seems disruptive and even aggressive, you should address your concerns to your pediatrician.  He says to keep in mind that all children with these behavioral traits DO NOT fall into the category of ADHD, but a health professional should be included in an assessment.

6. How high is “too high” a fever?

“Any fever in a child is a concern and usually more problematic when it’s present in the very young and associated with other symptoms,” says Dr. Frazier.

She says anything between 100.4 and 103.9 degrees F is considered “running a fever.”  A high fever is 104 degrees F and higher. She says most pediatricians do not consider 98.6 to 100.3 degrees F to be a fever of concern or fever at all. However, if you the parent are concerned, it’s always best to call the pediatrician. 

Thermometers come in all varieties these days and each version—ear, forehead strips, rectal or underarm—have their particular set of directions. Make sure you follow the directions associated with that device to get the most accurate temperature reading.

7. How do I know when a sore throat is strep throat?

 “A sore throat that has a low grade fever, a runny nose, cough, conjunctivitis, mouth ulcers, diarrhea, or symptoms lasting longer than a few days is probably viral,”  explains Dr. Mazur.  

Kids with strep usually have a sudden onset of high fever, sore throat, headache, pain on swallowing, abdominal pain, nausea and vomiting, no runny nose, and “classmates out with strep during the winter strep season.”

Mazur also says that if the parent sees pus on the tonsils, a very red and white “strawberry” tongue, plus swollen and tender lymph nodes and possibly a body rash, strep definitely is a suspect.  

Kids younger than 3 years are less likely to have strep.

 

UPDATED: 8-16-2006

Editorial Board | Legal Disclaimer | Privacy & Security | Contact Us

©2000-2006 Office of Institutional Advancement, UT-Houston