Comprehensive care of Infants, Children and Adolescents

F.A.Q.

Disclaimer: The information provided is for general use only and is not intended to provide personal medical advice or substitute the advice of your care provider.

Common Cold/Cough
Earache
Fever
Insect Bites
Poisoning and Accidents
Sprains and Strains
Vomiting and Diarrhea
Well Child Check-Ups

Common Cold/Cough

Common colds are caused by a virus and because of this antibiotics will not help. Most often you will notice stuffy or runny nose, which is clear in color, cough, fussiness, loss of appetite and, at times, a low fever (less than 102 F). Vomiting of mucus following a coughing spell is not uncommon. Breathing may be noisier than usual but not usually difficult.

Taking care of my child:

1. Use a cold water humidifier near your child in the child's bedroom to increase humidity. This will keep the secretions moist and more easily cleared from the nose. Avoid using medicines in the humidifier (i.e. Vicks Vapor Rub) which may irritate the respiratory passages.
2. Saline (salt water) nose drops can be prepared by dissolving ¼ teaspoon of table salt in 4 ounce (8 tablespoons) room temperature tap water. Two to four drops (or more) can be placed into each side of the nose as often as needed. The nose is partially cleared by the child sneezing or sniffing, or by using the bulb syringe if child is an infant. Decongestant nose drops should not be used unless directed by the doctor.
3. Thick mucus can be removed by gentle suction with a one ounce bulb syringe which can be purchased at the drug store.
4. Encourage extra juice and water.
5. Baths may be given as long as the room is warm.
6. Fever medication (see fever) may be beneficial in controlling fever and relieving fussiness. Use only as directed and only when temperature is over 102 F.
7. Over-the-counter cough syrup or decongestants may provide limited relief for older children. Dextromethorphan has been shown to be an effective medication usually found in some over-the-counter cough syrups. We do not believe stopping the coughing completely is beneficial, as it serves a protective purpose by preventing secretions from building up in the lungs and causing the risk of worse infections.

Earache

Most children will have at least one ear infection during childhood, and some children will have many. If your child has an earache and fever, or is an infant who is pulling at their ear(s) with fever, or anyone who has drainage coming from the ear(s) should be seen in the clinic. An antibiotic may be prescribed for your child. If an antibiotic is prescribed, it is important that they finish the antibiotic as prescribed.

Taking Care of my child:

1. Elevate the child's head.
2. Give acetaminophen (Tylenol) or ibuprofen (Advil.) to help relieve the pain of the earache or fever of over 102 F.
3. Warm compress to the outer ear.
4. Lukewarm oil may be placed in the ear canal, but DO NOT put any oil in an ear that has drainage.

Fever

Fever is any temperature over 102 F taken rectally or orally. Fever itself is not dangerous until it is over 107 F. Children generally run higher fevers than adults. It is usually a sign that the body is fighting an infection. MORE IMPORTANT THAN FEVER IS HOW YOUR CHILD IS ACTING, DRINKING, BREATHING, ETC. Fever greater than 104 F in children less than 2 years is of greater concern because of a higher rate of associated bacterial infection.

Before using fever medicines, remember that fever by itself rarely causes injury to children. Some studies suggest that fever may help the body to defend itself against illness. The use of fever reducers is intended only to relieve discomfort associated with high temperatures.

There are two different kinds of medications, namely aspirin and acetaminophen, which are commonly used to control fever. Because of the association, between aspirin usage and a rare illness called Reyes Syndrome, the F.D.A. has recommended not using aspirin for viral illness in children. In light of this, we do not recommend aspirin usage unless prescribed by your physician.

Points to remember:

1. Don't abuse these drugs. They should not be used unless temperature is over 102 F.
2. They are a frequent cause of poisoning in children and should be stored in safe places and out of reach of children.
3. Do not overdress or wrap a feverish baby or infant. This retards normal heat loss and only enhances the fever.
4. Dont force a young child to swallow a pill. Tablets can be crushed or dissolved in water if needed.
5. Push fluids to prevent dehydration.

Insect Bites

Use of insect repellant is recommended to prevent insect bites and West Nile Virus. The liquid or stick form such as Cutter is easiest to use and prevents accidental spraying insect repellant in the child's eyes.

Poisoning and Accidents

These are the leading causes of death in the pediatric age group. Unfortunately, most cases could be prevented. An ounce of prevention is worth a pound of treatment and is the only true cure.
Medications (including aspirin and vitamins), prescription drugs, and household cleaning agents (lye, drain cleaner, furniture polish, detergents, bleaches, etc.) should be stored in locked cabinets located out of reach of a child. They should not be stored under the sink unless you can lock them up. Gasoline, turpentine, or other petroleum distillates should never be stored in bottles or containers which normally contain liquids which are drank (such as soda bottles). These too should be stored in a secure place.

NATIONAL POISON CONTROL 1-800-222-1222

Sprains and Strains

If your child suffers a minor sprained or strained joint (most commonly from turned ankle or jammed finger) and you do not feel that a visit to the doctor is necessary, there are certain measures which you can take at home that will reduce swelling and promote healing. Depending on severity, some or all of these measures may be necessary.

Taking care of my child:

1. Apply ice pack to injury as soon as possible for first 24 hours. Never use hot soaks for the fiest 24 hours.
2. Elevate arm or leg (above level of the heart) for the first 48-72 hours as much as possible if swelling is obvious.
3. After 24 hours, apply heat (heating pad, hot towels or warm water soaks) to the injured area at least 20 minutes four times a day. Be careful not to burn the skin.
4. Acetaminophen or ibuprofen may be used for pain as directed on label.
5. If there is a persistent pain or continued loss of use after several days, it is advisable to make an appointment to have the injury checked.
6. It is not unusual for some discoloration around the joint to occur on the second or third day and if all is going well and things are pretty much back to normal, this should not cause concern.

Vomiting and Diarrhea

Vomiting and diarrhea may occur by itself or may occur together. The most frequent cause is a virus.

Taking care of my child:

1. If the child with vomiting and diarrhea is breastfeeding, continue to breastfeed, but stop all other solid foods and milk (formula). In addition give your baby a clear fluid drink like Pedialyte, in small amounts (1-2 ounces) every 10 to 20 minutes. This liquid will help to give your child minerals that they loose while vomiting or having diarrhea.
2. For babies over one year of age or older children give only clear liquids in small amounts, frequently, for the first 12 to 24 hours. Water, ice chips, Pedialyte, or flat lemon lime soda mixed with water is best.
3. After your infant has stopped vomiting for 12 hours, add half strength formula (double the amount of water added to formula) for the next 12 hours.
4. After your child has stopped vomiting for 6 to 8 hours, the child may have bland foods. Babies may have applesauce, strained bananas and rice cereal. Older children may have food such as crackers, pretzels, bland soups, mashed potatoes, bananas, toast with jelly, and rice.
5. If the child is still improved after 72 hours go back to the child's regular diet slowly.

Call the doctor if:

1. Your child has not improved in 72 hours.
2. Your child seems worse.
3. Your child has not urinated (pee) in 8 hours, has a very dry mouth, or has no tears when he cries.
4. For any reason you feel the doctor should see your child. Do not hesitate to call if you are worried or concerned.

Well Child Check-Ups

Well child check-ups are done at fairly regular intervals for the first two years of life and less often thereafter. These appointments provide parents the opportunity to ask questions about growth and development. The care provider will monitor growth and development, diet, behavior, social skills and administer immunizations.

Well child check-ups and immunizations are recommended at:

Birth-NBS #1, Hep B#1
3 Days - Newborn Check
2 wks. - NBS #2
2 mos. - DtaP #1, Hib #1, Prevnar #1, Hep B #2
4 mos.- DtaP #2, Hib #2, Prevnar #2, IPV #1
6 mos. - DtaP #3, Hib #3, Prevnar #3, IPV #2
9 mos. - Hep B#3, IPV #3, HH
12 mos. - Hib #4, Prevnar #4
15 mos. - MMR #1, Varivax
18 mos.- DtaP#4
2 yr. - Hep A #1 (Booster 6 mos. later.)
4-5 yr. - DtaP #5, IPV #4, MMR #2
11-18 yr Td Booster, Meningoccal

Hep A is recommended, for age 2 yr. & up. Not required by schools at this time (04).