Editor’s Note:  Dr. Psota will write for Her View From Home once a month. If you have a question you would like her to answer, simply leave a comment on this post or send an e-mail to [email protected] and we’ll make sure she answers your question!

These questions come from a previous post on Her View From Home:

1. When to start solids and in what order?

The American Academy of Pediatrics recommends breast feeding or formula exclusively till somewhere between 4 and 6 months of age. If there are no prior feeding or formula problems, we start the solids in the following order: cereal–vegetables–fruits–and finally meats. We recommend going thru all 4 food groups of baby foods before starting table foods.

If the child has any feeding problems requiring a special formula or concerns regarding the need for increased calories, they should discuss this with their physician at the 4 month health care visit.

2. When to take the child to the doctor?

This is very age dependent, as the younger child is more worrisome than an older child and gets sicker faster than an older child.

0 to 2 months of age:  Any temperature rectally greater than 100.5, needs to be seen day or night. Also if not feeding well or not having wet or dirty diapers.

2 to 12 months of age and has had 1st set of immunizations:  If temperature greater than 101, the child should be seen within 12-24 hours. Also if difficulty breathing or wheezing, greater than 8-10 stools per day, blood in stools, or no wet diaper in past 8-12 hours, the child should be seen that day.

12 to 24 months:  If temperature above 101 and not associated with any other symptoms, or the child doesn’t act normal when the temperature has returned to normal with fever reducers. If you can’t get the temperature down with appropriate doses of fever reducer, difficulty breathing or wheezing, persistent vomiting beyond 12-24 hours, child not alert and responsive to family and unable to get the child to drink–these children need to be seen.

24 months of older:  Temperature lasting longer than 48-72 hrs. or doesn’t return to normal with adequate doses of fever reducer. Also if severe abdominal pain, vomiting longer than 24 hours, altered mental state, difficulty breathing and wheezing, bloody diarrhea, rash that is purplish and doesn’t appear to be bug bites, ear ache or sore throat or the child that is not improving in 24 to 48 hours.

The parents should always call their pediatrician or family physician’s office if they are unsure if they need to be seen or not.

3. What is sepsis?

Sepsis is a clinical spectrum that begins with a systemic infection, caused by a bacteria, a fungus, or a virus. The infection can be the result of spread from a localized infection of the lungs, kidney, skin, meninges, or the gastrointestinal tract. The infection or sepsis can progress to severe sepsis (this includes organ dysfunction along with the infection), then to septic shock which means low blood pressure and poor tissue perfusion of the organs, and ultimately death.

Children at risk for sepsis include infants, those with serious injuries, those on chronic antibiotics, malnourished children, and those with chronic medical conditions. Also those who are immune suppressed are at an increased risk for infection, therefore increased chance of sepsis and septic shock.

It is important to distinguish between the infection and the host response to the infection, or the inflammatory response. If the host’s immune response produces an inflammatory cascade of toxic substances, and this cascade is uncontrolled, it leads to a systemic inflammatory response syndrome (SIRS). This leads to cellular and organ dysfunction and eventual death.

Initial signs and symptoms of sepsis include temperature instability (either high or low), tachycardia (fast heart rate), and tachypnea (fast respiratory rate). The child usually appears very ill and becomes sick quickly. Vital signs, physical examination and laboratory results are used to make the diagnosis. 

Treatment includes intravenous antibiotics, admission to an intensive care unit with continuous close monitoring. Despite early diagnosis and treatment, severe sepsis has a mortality rate of approximately 10%. 

The best means of prevention include: obtaining all the recommended immunizations, cleaning all cuts and wounds adequately and observing for signs of infection and close monitoring when child is ill.
feature image site

So God Made a Mother book by Leslie Means

If you liked this, you'll love our book, SO GOD MADE A MOTHER available now!

Order Now

You should also check out our new Keepsake Companion Journal that pairs with our So God Made a Mother book!

Order Now
So God Made a Mother's Story Keepsake Journal

Dr. Psota

DeAnn K. Psota, M.D. Dr. Psota received her undergraduate education at Kearney State College, and her Medical Degree from the University of Nebraska College of Medicine. Her residency in Pediatrics was completed at the University of Nebraska Medical Center. She began her medical career at Kearney Clinic in 1992. Dr. Psota is Board Certified by the American Academy of Pediatrics. She and her husband, Kent, have two children, Karman and Lauren.

I Had to Learn to Say “I’m Sorry” to My Kids

In: Kids, Motherhood, Teen, Tween
Mom hugs tween daughter

My two oldest kiddos are at the front end of their teen years. I remember that time in my own life. I was loud, somewhat dramatic, I let my hormones control me, and I never—ever—apologized. This last part was because no one ever really taught me the value of apology or relationship repair. Now, I could do some parent blaming here but let’s be real, if you were a kid whose formative years were scattered between the late ’80s and early ’90s, did you get apologies from your parents? If so, count that blessing! Most parents were still living with...

Keep Reading

5 Things Your Child’s Kindergarten Teacher Wants You To Know

In: Kids, Motherhood
Child raising hand in kindergarten class

I am a teacher. I have committed my life to teaching children. Of course, before I began this career, I had visions of standing in front of a group of eager-eyed children and elaborating on history, science, and math lessons. I couldn’t wait to see the “lightbulb” moments when students finally understood a reading passage or wrote their first paper. And then I had my first day. Children are not cut out of a textbook (shocking, I know) but as a young 23-year-old, it knocked me right off my feet. I was thrown into the lion’s den, better known as...

Keep Reading

To the Extended Family That Shows Up: We Couldn’t Do This Without You

In: Kids, Living, Motherhood
Family visiting new baby in a hospital room

This picture—my heart all but bursts every time I see it.  It was taken five years ago on the day our daughter was born. In it, my husband is giving her her very first bath while our proud extended family looks on. It was a sweet moment on a hugely special day, but gosh–what was captured in this photo is so much more than that. This photo represents everything I could have ever hoped for my kids: That they would have an extended family who shows up in their lives and loves them so deeply.  That they would have grandparents,...

Keep Reading

You’re Almost Grown, But You’re Always Welcome Back Home

In: Kids, Motherhood
Teen in room studying with computer and smartphone

Dear child, In the days before you could walk or talk, there were times when you would wail—when my rocking and shushing and bouncing were seemingly futile—but it didn’t matter. Each day and night, multiple times, I always picked you up and welcomed you back into my arms. As a toddler and a preschooler, you had some pretty epic meltdowns. There were times when you would thrash and scream, and all I could do was stand by and wait for the storm to blow over. Eventually, you would run to me, and I would welcome you back with a warm embrace....

Keep Reading

No One Warned Me About the Last Baby

In: Baby, Kids, Motherhood
Mother holding newborn baby, black-and-white photo

No one warned me about the last baby. When I had my first, my second, and my third, those first years were blurry from sleep deprivation and chaos from juggling multiple itty-bitties. But the last baby? There’s a desperation in that newborn fog to soak it up because there won’t be another. No one warned me about the last baby. Selling the baby swing and donating old toys because we wouldn’t need them crushed me. I cried selling our double jogger and thought my heart would split in two when I dropped off newborn clothes. Throwing out pacifiers and bottles...

Keep Reading

Parents Are Terrible Salespeople for Parenting

In: Kids, Motherhood
Tired mother with coffee cup on table, child sitting next to her

As the years of fertility start to wane, many of my childless peers are confronted with the question, “Should I have kids?” With hesitation, they turn to us parents who, frankly, seem overwhelmingly unhappy. They ask sheepishly, “Is it worth it?” We lift our heads up, bedraggled, bags under our eyes, covered in boogers and sweat and spit up, we mutter, “Of course! It’s so fulfilling!” It’s like asking a hostage if they like their captor. Sure, it’s great. We love them. But our eyes are begging for liberation. Save me, please. I haven’t slept through the night in years....

Keep Reading

Soak in the Moments because Babies Don’t Keep

In: Kids, Motherhood, Tween
Roller coaster photo, color photo

I love marking the moments, the ones that count—making a note and storing them for memory. But I often miss out on them when it comes to our oldest. ⁣ ⁣The day he wanted to be baptized, I was at home with another kiddo who was sick. He called me from church excitedly, emphasizing he was ready and didn’t want to wait. I couldn’t argue with that, so I watched him go underwater through videos my husband and sweet friends in the congregation took. ⁣ ⁣On the day of his fifth-grade graduation, we found ourselves at the pediatrician’s office. Instead...

Keep Reading

Sometimes a Kid Just Needs a Sick Day

In: Kids, Motherhood
Little boy outside, color photo

My middle son stayed home from school today. He said he was sick. I’m not sure that is the truth. I was lucky enough to have a mom who was an amazing caretaker, especially when you were sick. She pulled out all the stops. A cozy clean space to be, a thermos with ice cold juice by your side, Mrs. Grass’s soup, and Days of Our Lives on the screen while she tidied up the house. It was the best feeling in the world to be home and cozy with my mom when I was sick. It felt cozy and...

Keep Reading

Sometimes We Need Someone to Just Sit With Us in Our Struggle

In: Kids, Motherhood
Sad woman sits on floor, black and white image

Early this morning, I told (yelled is more accurate) my sons to get up with the same furious ferocity I use every morning when I realize they should be ready to go, but are still unconsciously snoozing away. One son lazily said, “I’m up, Mom” (even though he was very much not up). The other son, who typically has no problems getting up, had overslept and immediately freaked out, thinking he would be late to school. He proceeded to have a mini-meltdown from the dark recesses of his bedroom. That overflowed into the hallway where I found him lying face-down,...

Keep Reading

Daughter of Mine, Do Not Let the World Extinguish Your Fire

In: Kids, Motherhood
Mother and young daughter, color photo

Daughter of mine, I see the fire behind your eyes. Do not let it die. Daughter of mine who runs wildly and loves freely and whose anger is always whipping silently just under the surface like a pilot light, ready to ignite with one tiny spark. Do not let it die. RELATED: There is Wild Beauty in This Spirited Child of Mine Daughter of mine, one day you will become a woman, and the world will try to steal you and mold you and tell you who to become. Do not let it. It will try to fit you in...

Keep Reading