The purpose of this article is to provide information and offer suggestions to au pairs with regard to caring for children who are ill. It is intended that au pairs discuss this information with their host parents as they might want to modify or expand on what is presented here.
When a child has less energy than usual, is unusually cranky, has less of an appetite, or just doesn’t seem him/herself, chances are the child is sick. Fever is a sign a child is fighting an illness or infection. Fevers are usually not serious and can be cared for at home. It is typical for younger children to run higher fevers than older children. Fevers are also often higher in the evening than in the morning. Be alert for rash, earache, stomachache or sore throat, as these may indicate more serious problems.
A child’s temperature can be taken orally, under the armpit, or with special thermometers only in the ear. Au pairs and host families should discuss the preferred method for that family. A child has a fever if the temperature is 99.4’F (37.4’C) when taken by mouth or under the arm. Be sure the thermometer is shaken down first, and left in place for 3 minutes in the mouth or 6-8 minutes in the armpit. Talk or read to the child while you are taking his/her temperature. Never leave a child alone with a thermometer.
When a child has a fever, he or she needs more rest than usual and should not be awakened. Quiet play is fine, but too much activity can aggravate a fever. Children should be dressed in light layered clothing. Liquids are very important – offer water, juice, fruit drinks, tea, popsicles, Jello or soup. Some children might enjoy stirring their tea with a lollipop, or having soda as a special treat. Host families and au pairs should discuss appropriate medication and desired dosage. Do not offer children aspirin; consider instead acetaminophen or ibuprofen, but only with the approval of a host parent. If a child’s fever is over 103’F, a lukewarm bath might be comforting. If a child vomits, offer small amounts of liquids, but no dairy products. Within the first 24 hours the diet should be limited to clear liquids, bananas, plain white rice, applesauce and plain toast.
When children are sick they will need an extra dose of patience, attention, affection and comfort even more than they need medicine or special diets. Although basic rules and discipline should not change, a child may be more dependent on adults when he or she is ill. Extra imagination and creativity is needed to keep a sick child entertained with quiet pastimes. Children will welcome novelties – use a baking sheet as a tray to assemble a puzzle in bed or to keep crayons from rolling away; create a story with stuffed animals and a flashlight under a blanket.
Warning signs – It is time to ask for more help if a child :
• has a fever higher than 104’F (40’C)
• is very cranky, sluggish or doesn’t awaken easily
• has trouble breathing
• is confused, or vomits repeatedly
• is unable to swallow or is drooling
• has a convulsion or seizure
• has dry lips, sunken eyes, little or no urine or dark yellow urine

Thanks to Etta Rosen for this article.