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How to Get What You Want from the Pediatrician

What Pediatricians Really Want You to Know
There are plenty of things pediatricians would like parents to do and say while they are in the office, and we'll get to those shortly, but there are also a few key concepts they wish all parents were clear on before they called or scheduled an appointment.

Vaccinations are safe. Unbelievably, pediatricians now have to sell some parents on the benefits of vaccines! In the late 1990s a wave of suspicion about vaccines began to spread across North America and Europe, fueled by rumors that they could cause autism, attention deficit disorder, diabetes, fever seizures, polio, and even AIDS. Ignorance about the diseases themselves compounded the problem. A study done in 2001 found that 90 percent of parents of school-age children didn't know that chicken pox can have deadly complications. Half of those parents said they would rather their kids catch the disease than vaccinate them against it.

Pediatricians were aghast at these developments. Fortunately, new studies confirm the safety of most vaccines, including those protecting children from measles, mumps, rubella, hepatitis B, diphtheria, and polio. The chicken pox vaccine is relatively new so there are no long-term studies of it, but it is recommended by the American Academy of Pediatrics, and studies done thus far show the vaccine to be safe and effective for most children. If you have any doubt at all about vaccinating your child, ask your pediatrician for the most recent information.

Antibiotics don't cure everything. Doctors themselves are partly to blame for parents' love affair with antibiotics, since they are the ones who have prescribed them too often in the past, sometimes just to keep parents pacified. In a recent study, one-third of the pediatricians surveyed admitted to caving in to parents' demands for antibiotics whether or not they were called for. As a result, some strains of bacteria are becoming resistant to antibiotics – a very alarming development.

Antibiotics are only effective against bacterial infections. They cannot cure colds and flu, which are caused by viruses. However, colds and flu sometimes develop into bacterial infections, in which case antibiotics can help. It's a tough call to make, and that's what the pediatrician is there for. As a general rule, antibiotics can cure strep throat, some ear infections, some cases of chronic coughs or bronchitis, and some severe sinus infections lasting longer than two weeks. Antibiotics cannot cure most sore throats and most coughs.

Fevers are good. Pediatrician Andrew Baumel's views about fever are shared by the overwhelming majority of doctors: "Fever helps the body fight infection. Our immune system works better and quicker at a higher temperature. For a low-grade fever of 100° or 101° , you don't have to use antifever medication, depending on whether or not the child is uncomfortable."

Fever is a symptom, not an illness. A fever can get higher if an illness gets worse, but it won't rise just because you don't treat it. Brain damage can occur only if a fever reaches 107.6° F and stays there for an extended period of time. Untreated fevers usually peak at around 105° unless the child is in a hot room or overdressed.

Infants do need special handling when it comes to fevers. If they are younger than 60 days old, any fever of 100.4° or higher signals the need for a visit to the doctor. From 60 days to three years of age, call the doctor if the fever is 102° or greater. In infants and young children, low-grade fevers that have no obvious source can be a sign of serious bacterial infection. Febrile seizures (convulsions that are brought on by fever) can occur in children whose temperatures rise rapidly. The number itself doesn't matter so much as the speed at which the temperature rises. Although they are frightening for parents, febrile seizures are brief and have no lasting effect on the child.

For children older than two years, call the doctor any time a fever is 105° or greater. Call the doctor after 48 hours about a fever of less than 105° if your child seems healthy and active – an infection could be brewing. If she has cold or flu symptoms, you can wait 72 hours to call. If she is uncomfortable, vomiting, dehydrated, or having problems sleeping and the fever is less than 105°, try to lower it – but only to 100° or 101°, so that it can still fight the infection.

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From Say the Magic Words by Lynette Padwa. Copyright © 2005. Used by arrangement with Penguin Group (USA) Inc.

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