If there are two pearls of wisdom I can impart to you about toddlers it is this: they will have many boo-boos and there will be times you will be convinced your toddler is “always sick” and you should change your address to that of your pediatrician’s office.
Toddlers are the captains of the boo-boo and “bug” brigades. While most boo-boos are minor and require nothing more than a kiss, and most “bugs” are viruses that clear before you can reach for the phone, there are times some injuries and illnesses can be serious and require more care. As with all things toddler, those times also tend to be very obvious once you know what the key factors are to focus on.
The Battle of the “Bugs”
It is tempting to just keep our kids away from other people and avoid this battle but that is just not possible – it happens on way or another, either in toddlerdom or in kindergarten! This battle is how immune systems gain experience with the world around them and how our toddler’s bodies develop the antibody troops a healthy body needs as it grows. So, while frustrating, this is as essential a part of life as learning to walk!
On average, children get 6-12 illnesses a year clustered in the winter months with infants and toddlers averaging closer to the high end of this range. Toddler illnesses range from basic colds to ear infections to stomach bugs and everything in between. Some toddlers get slugged with everything that circulates through school or daycare while others slide through relatively unscathed.
This is a common age for things like “hand foot and mouth”, which is a virus that causes cold sores in the mouth but because toddlers and infants don’t always keep their saliva in their mouths the cold sores can end up on their feet or hands. Toddlers are also a common age for fevers without any other symptoms or just rashes without any other symptoms.
What you need to keep in mind with toddlers is that just like with older kids, the majority of all illnesses they will get will be viral, meaning the cure is time and the treatment is supportive. Most viruses last 1-2 weeks – a lot longer than most people realize! And, during that time, your toddler will definitely not be his usual self. In addition to symptoms specific for whatever virus is going around, he might be grumpy. He may have no appetite. He may have much less energy than normal. In fact, he may appear like a mini-you when you are sick! But, hang in there because all these illnesses eventually end. And, if you are ever really concerned or your child appears very ill, that is when you call your pediatrician.
The Boo-Boo Brigade
Toddlers have one speed, warp, and have two left feet! While they are convinced they have eyes in the back of their heads, they don’t, which accounts for falling often as they run one direction, while looking another. They are also very skilled climbers – typically up. And, they can get themselves into amazingly small spaces. The combination of all these toddler features is a set up for multiple boo-boos, bruises, and abrasions on wandering locations on their bodies, and the need for many kisses, ice bags and band-aids.
While some injuries toddlers get can be serious because of their dare-devil nature, most are very innocent and require only very basic first aid at home (ice, ibuprofen and a kiss!). Keep in mind that toddlers are still very close to the ground so for run of the mill falls, they don’t have far to go!
Some of the common toddler injuries include:
- Twists and Sprains: typically of the lower extremity. You may only know because your toddler has a limp but otherwise seems fine. As long as she is not crying in pain and can bear weight, you can use ice and ibuprofen (Advil or Motrin) and let her toddle around as she’d like. If the limp persists for a few days, call your pediatrician for evaluation.
- Mild head bonks . Most head bonks result in small bruises or nothing but sometimes a child will get a big area of swelling we term a “goose egg.” This is actually a good thing and suggests the swelling is on the outside of the skull and not heading into the brain. But, if you have any concerns about your child’s behavior from the head bonk, call your pediatrician right away or go to the nearest ER.
- Nursemaid’s Elbow: This is a common elbow injury and is a type of dislocation called a “subluxation”. It often occurs in the setting of a child holding an adult’s hand and the child goes one way and the parent the other. The child appears normal as long as the elbow is not moved and a simple in-office manipulation gets the elbow back in to it’s regular spot.
- Toddler’s Fractures: these are small breaks in bones similar to partial breaks of young twigs and can occur without a huge trauma. Unlike simple sprains, fractures always have some degree of pain and the child will typically refuse to use that extremity. These injuries require an evaluation and x-ray to diagnose.
Triaging Your Boo and Bug Brigade
If only our kids arrived in this world with a user’s guide! Just keep in mind Dr. Gwenn’s Golden Rule of Toddlers: if your toddler can toddle and play, all is well in toddler land and you can all rest assured nothing major is lurking. And, for those other times things seem off, your pediatrician is just a phone call away.
(Originally posted February 2008; Updated December 2009)