What's Up Doc - December 2007

Got questions? We've got answers - or at least our health care professionals do. Send us those health-related parenting questions that always seem to stump you, and we'll find an answer from the Mid-South's great pediatricians and clinicians. This month, we tackle scary fevers in infants, orthodontic trouble for thumb/pacifier suckers and how to get yourself and your teenager ready for college.

Q: I get nervous when my baby's body temperature starts rising, and I am even more confused about when I should treat a fever. At what temperature should I treat a fever, and what are some recommended treatment methods? Furthermore, when should I call my doctor or go to the Emergency Room?

A: It can be difficult to tell a child's temperature by skin contact alone, so always have a thermometer at home and confirm temperatures with a thermometer. Fevers are usually only an emergency in newborn infants. If your child is 2 months old or younger you should call your doctor or go to the emergency room for fevers higher than 100.2 degrees Fahrenheit. In infants and children older than 2 months, a fever is usually not an emergency unless your child is lethargic, not urinating well or having difficulty breathing.  Always call your doctor if your child is having these symptoms.

If your child is active, alert and keeping liquids down, it is safe to give your child Tylenol/Acetaminophen or Motrin/Ibuprofen for fevers once you take their temperature. This will make your child feel more comfortable. You can even alternate the two medicines if fevers stay high. Check the bottle or talk with your doctor to determine the correct dose to give. If fevers continue for several days you may want to see your doctor even if your child is acting well. It's always safe to check with your doctor's office if you have concerns or questions about fevers in your child and if you need to be seen in the office.

Dr. Bradley Carter, MD
Christ Community Health Services

Q: My preschooler still sucks his thumb. At what age should I worry that the habit will mess up his permanent teeth in the future? Also, do pacifiers pose the same problem for preschoolers?

A: A thumb sucking habit is one of the most devastating influences on a child's developing dentition and facial growth and should be discouraged as early as possible.  One must also be aware that a thumb habit may be the result of insecurities for that child.  It is important to encourage the child to overcome the habit and not scold him for the problem.

Behavior modification techniques are helpful in treating young children. Parents can allow the child to place a funny sticker on a humorous calendar for each day the thumb is not sucked. If the child can earn two weeks of stickers, then reward the child with a special treat. Fun band aides may be placed on the thumb during the day to deter the habit. At night, place a sock on the hand and pin it to the pajama sleeve (be sure the sock is clean!). If these techniques are unsuccessful then a thumb-habit appliance may be placed by a dentist. This appliance is attached to the upper molars and may be used on children as young as 3 or 4 years old. This therapy will usually correct the habit within six months.

Pacifiers may also contribute to dental problems if used too much. They should only be used at bedtime and eliminated by age 2. Parents can resolve any conflict by allowing the child to turn over all pacifiers to their pediatrician at the annual check-up visit. Tell the child that many boys and girls can't afford pacifiers and they are helping them. This approach worked great with my daughter!

Dr. William G. Parris, DDS, MS

Q: My teenager is six months away from graduating high school and going off to college. He's already started showing his independence by breaking curfew. I feel like he's out of control and wonder if this is normal. How do I cope now while preparing him for his next stage of life?

A: It is normal for teenagers to start to want more independence, especially when it is so close to the time that they will have complete independence when going off to college.  The most difficult thing in life is letting our children grow up. At some point we have to do that.

Trusting that your child will use good judgment and remember the things you have taught them about safety and rules is hard to do. Rather than making it a source of conflict, let them know you trust them and they can count on you whenever they need you. Let them know they can always call you if they need you. Make a verbal contract letting them know that you will be there for them without being judgmental and that you will provide them support and unconditional love no matter what the problem may be. By doing this, they will know that they can rely on you to help when they make decisions on their own.  By allowing some independence now rather than using the old adage "while under my roof you'll follow my rules," you can help him gradually move toward independence in a more responsible way.

Dr. Vickie Brewer, Ph.D
Center for Pediatric Neuropsychology, CEO