Sick Day Guidelines for Children

• Mitochondrial disorders make it harder for the body to fight infection. This means your child may get sick more often than other children.
• Your child’s body may have more severe symptoms and take longer to get better when they are sick because of their mitochondrial disorder.
• In addition, your child may get sicker than other children. Their body cells may not have energy needed to fight infection, so they might build up harmful toxins.
• These toxins can make your child’s body work very hard and require a longer time to get better. If your child’s body doesn’t have enough water (becomes dehydrated), it can make the illness more involved and require more treatment.

• Sick day guidelines can help you manage your child’s symptoms so you can take them to the hospital early if needed.
• At the hospital, doctors may give your child medicine, including IV (intravenous) fluids for hydration. The medicine can help prevent them from getting sicker.

When you first notice that your child is getting sick, offer your child:

• Sugary drinks such as Gatorade or Pedialyte (do not give them zero calorie or diet versions)
• Small, frequent snacks that are high in carbohydrates, such as crackers

Treat your child’s fever. Check with your child’s specialist to ensure these over-the-counter medicines are safe for your child’s specific diagnosis.

• Acetaminophen (Tylenol) - Do not exceed the recommended dose. Avoid chronic use (no more than 3 days in a row). If your child still has a fever after 3 days, call their doctor.
• Ibuprofen (Advil/Motrin) – Avoid using if your child shows signs of not getting enough water (dehydration).
• Some cough and cold medicines contain alcohol. Do not use these.

Watch them for things that can cause dehydration:

• Fever over 100.4° F (38 ° C)
• Throwing up (vomiting)
• Diarrhea

Signs of dehydration include:

• Peeing less than normal
• Dark yellow or amber pee (urine)
• Dry mouth
• Crying with few tears
• Acting cranky or irritable

Signs that your child may be very sick include:

• Confusion or inability to interact normally
• Difficult to wake up
• Crying a lot
• Not eating (loss of appetite)
• Fast breathing
• Belly (abdominal) pain
• Looking very sick (such as unusual skin coloring or facial expression)

Children with mitochondrial diseases have very different responses to being sick. Because of this, management at home is different for every child.

Over time, experience will make it easier for you to recognize your child’s symptoms early to decide on a plan of action. If you need recommendations, please call the Neurology Clinic.

Monday through Friday, 8 a.m. – 4:30 p.m.: Call the Neurology nurse line 206-987-2078 option 4.

Evenings, weekends and holidays: Call 206-987-2000 and ask the operator to page the on-call neurologist. If you have not heard back within 30 minutes, call the operator again.

We will also give you a High Priority Care Plan. This plan gives medical recommendations for emergency department providers in case your child is treated there. If your child’s High Priority Care Plan is more than 1 year old, call Neurology at 206-987-2078 option 4, or send a MyChart message to ask for an updated Plan.

If you take your child to an emergency department, bring your child’s High Priority Care Plan.