A virus is the most common cause of illness among children. This may cause a number of different symptoms, depending on what part of the body is affected. If the virus settles in the nose, throat, and lungs, it causes cough, congestion, and sometimes headache. If it settles in the stomach and intestinal tract, it causes vomiting and diarrhea. Sometimes it causes vague symptoms of “feeling bad all over,” with fussiness, poor appetite, poor sleeping, and lots of crying. A light rash may also appear for the first few days, then fade away.
A viral illness usually lasts 3 to 5 days, but sometimes it lasts longer, even up to 1 to 2 weeks. Home measures are all that are needed to treat a viral illness. Antibiotics don’t help. Occasionally, a more serious bacterial infection can look like a viral syndrome in the first few days of the illness.
Follow these guidelines to care for your child at home:
- Fluids. Fever increases water loss from the body. For infants under 1 year old, continue regular feedings (formula or breast). Between feedings give oral rehydration solution, which is available from groceries and drugstores without a prescription. For children older than 1 year, give plenty of fluids like water, juice, ginger ale, lemonade, fruit-based drinks, or popsicles.
- Food. If your child doesn’t want to eat solid foods, it’s OK for a few days, as long as he or she drinks lots of fluid. (If your child has been diagnosed with a kidney disease, ask your child’s doctor how much and what types of fluids your child should drink to prevent dehydration. If your child has kidney disease, drinking too much fluid can cause it build up in the body and be dangerous to your child’s health.)
- Activity. Keep children with a fever at home resting or playing quietly. Encourage frequent naps. Your child may return to day care or school when the fever is gone and he or she is eating well and feeling better.
- Sleep. Periods of sleeplessness and irritability are common. Give your child plenty of time to sleep.
- For children 1 year and older: Have your child sleep in a slightly upright position. This is to help make breathing easier. If possible, raise the head of the bed slightly. Or raise your older child’s head and upper body up with extra pillows. Talk with your healthcare provider about how far to raise your child’s head.
- For babies younger than 12 months: Never use pillows or put your baby to sleep on their stomach or side. Babies younger than 12 months should sleep on a flat, firm surface on their back. Don’t use car seats, strollers, swings, baby carriers, or baby slings for sleep. If your baby falls asleep in one of these, move them to a flat, firm surface as soon as you can.
- Cough. Coughing is a normal part of this illness. A cool mist humidifier at the bedside may be helpful. Over-the-counter (OTC) cough and cold medicine has not been proved to be any more helpful than sweet syrup with no medicine in it. But these medicines can produce serious side effects, especially in infants younger than 2 years. Don’t give OTC cough and cold medicines to children under age 6 years unless your healthcare provider has specifically advised you to do so. Also, don’t expose your child to cigarette smoke. It can make the cough worse.
- Nasal congestion. Suction the nose of infants with a rubber bulb syringe. You may put 2 to 3 drops of saltwater (saline) nose drops in each nostril before suctioning to help remove secretions. Saline nose drops are available without a prescription. You can make it by adding 1/4 teaspoon table salt in 1 cup of water.
- Fever. You may give your child acetaminophen or ibuprofen to control pain and fever, unless another medicine was prescribed for this. If your child has chronic liver or kidney disease or ever had a stomach ulcer or gastrointestinal bleeding, talk with your healthcare provider before using these medicines. Don’t give aspirin to anyone younger than 18 years who is ill with a fever. It may cause severe disease or death.
- Prevention. Wash your hands before and after touching your sick child to help prevent giving a new illness to your child and to prevent spreading this viral illness to yourself and to other children.
Follow up with your child’s healthcare provider as advised.
When to seek medical advice
Unless your child’s healthcare provider advises otherwise, call the provider right away if:
- Your child has a fever (see Fever and children, below)
- Your child is fussy or crying and cannot be soothed
- Your child has an earache, sinus pain, stiff or painful neck, or headache
- Your child has increasing abdominal pain or pain that is not getting better after 8 hours
- Your child has repeated diarrhea or vomiting
- A new rash appears
- Your child has signs of dehydration: No wet diapers for 8 hours in infants, little or no urine older children, very dark urine, sunken eyes
- Your child has burning when urinating
Call 911 if any of the following occur:
- Lips or skin that turn blue, purple, or gray
- Neck stiffness or rash with a fever
- Convulsion (seizure)
- Wheezing or trouble breathing
- Unusual fussiness or drowsiness
Fever and children
Always use a digital thermometer to check your child’s temperature. Never use a mercury thermometer.
For infants and toddlers, be sure to use a rectal thermometer correctly. A rectal thermometer may accidentally poke a hole in (perforate) the rectum. It may also pass on germs from the stool. Always follow the product maker’s directions for proper use. If you don’t feel comfortable taking a rectal temperature, use another method. When you talk to your child’s healthcare provider, tell him or her which method you used to take your child’s temperature.
Here are guidelines for fever temperature. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.
Infant under 3 months old:
- Ask your child’s healthcare provider how you should take the temperature.
- Rectal or forehead (temporal artery) temperature of 100.4°F (38°C) or higher, or as directed by the provider
- Armpit temperature of 99°F (37.2°C) or higher, or as directed by the provider
Child age 3 to 36 months:
- Rectal, forehead (temporal artery), or ear temperature of 102°F (38.9°C) or higher, or as directed by the provider
- Armpit temperature of 101°F (38.3°C) or higher, or as directed by the provider
Child of any age:
- Repeated temperature of 104°F (40°C) or higher, or as directed by the provider
- Fever that lasts more than 24 hours in a child under 2 years old. Or a fever that lasts for 3 days in a child 2 years or older.