Michael Bishop, M.D.

Jean Bryant, M.D.

Mary McDavitt, M.D.

Vyju Ram, M.D.

Philip Zeve, M.D.

Amanda Nguyen, C.P.N.P.

Member
AAP
American Academy of Pediatrics

Care Tips

While not meant to replace a visit to our office, the following information is for your reference when your child is ill. We've included helpful information on common illnesses.

Please call our office if you are concerned about your child. We can answer non-emergency questions and concerns during office hours. After hours, our 24-hour answering service will arrange to have your call returned within a short time.

To go directly to a specific topic, simply click on the name below:

Bird Flu l Congestion l Constipation l Cough (Croup) l Cough (Whooping) l Diarrhea/Vomiting l Earache l Fever l Head Injuries l Sore Throat l Summer Stuff: Bug Bites/Poison Ivy/Sunburn

We also provide answers to frequently asked questions about everything from bed wetting to allergies to dental care in our FAQs section.

l Bird Flu

On May 9, 2006, ABC aired a made-for-TV movie, "Fatal Contact: Bird Flu in America." To find out what the American Academy of Pediatrics and the Center for Disease Control say about this subject, please visit: www.aap.org/new/influenza-birdflu.htm or www.pandemicflu.gov/news/birdfluinamerica.html#QA 

l Congestion

Symptoms

• Runny or stuffy nose (drainage may be clear, cloudy, yellow or green).
• Associated symptoms: fever, sore throat, cough, red eyes.
• The average child will have as many as 6-12 colds per year. Children in a daycare setting may get a cold every 2-3 weeks during the winter season.
• Antibiotics and cold medications will not cure a cold.

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Treatment

There is no cure for a cold, but offer comfort and support, including:

• Give acetaminophen for fever or discomfort (click here for medication dosing schedule).
• Increase fluid intake.
• Raise the head of the bed 30-45° (infants may sleep in car seat).
• Nasal saline drops or spray and nasal suctioning as needed.
• Children over 1 year of age may use oral decongestants (pseudoephedrine) as needed to decrease congestion for a few hours.

Cough is one of the body's own ways of getting rid of mucus, so unless it is painful or keeping the child awake, do not give cough suppressants.

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l Constipation

Symptoms

• Hard, dry stools that come infrequently.
• Sometimes cause pain and bleeding while stooling.

Treatment

Infant (0-2 months)

• Try using a well-lubricated thermometer or Q-tip to stimulate the rectum. (Vaseline works well as a lubricant.)
• Give 1/2 - 1 oz. prune juice mixed with an equal amount of water daily as needed.
• A glycerine suppository (available over the counter) may also be tried.
• If these steps do not work, call for further consultation during regular office hours.

2 months - 1 year

• Above treatments.
• Increase high-fiber foods (fresh fruits and veggies).
• Add fruit juices to the diet (no more than 8-10 oz. per day).
• A warm bath may decrease abdominal cramps and encourage a bowel movement.
• If these steps do not work, call for further consultation during regular office hours.

Over 1 year

• Above treatments.
• Limit excessive dairy products (no more than 16-20 oz. of milk a day, cheese, yogurt).
• Increase high-fiber foods including bran, whole grains and oatmeal (popcorn if over 3 years of age).
• If these steps do not work, call for further consultation during regular office hours.

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l Cough: Croup/Barky Cough

Symptoms

• Tight, low-pitched barky cough (sounds like a seal).
• Hoarse voice/cry.
• Child may have stridor (a crowing-like noise heard when child breathes in) as croup becomes worse.
• Symptoms tend to increase in the evening and last for 5-6 days, with a loose cough in the last 7-14 days after the barking cough has resolved.
• Associated symptoms include fever or nasal congestion.

Treatment

Croup ("bark") without stridor:

• Cold air (stand in front of a refrigerator or take a walk on a cool night).
• Cool mist vaporizer at night.
• Increase daily fluid intake. Use warm fluids if having cough spasms to relax airways.
• Ibuprofen if older than 6 months (click here for medication dosing schedule). Cold medications or antibiotics do not cure the illness.
• Keep your child calm - try to keep them from crying, since crying often increases the barking cough of croup.

Croup ("bark") with stridor:

• Take child outside for 5-10 minutes into cold night air or have the child breathe in air from an open freezer. You may need to repeat this several times during the night.
• If these measures are unsuccessful, call the office immediately.

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l Cough: Whooping Cough (Pertussis)

Symptoms

• "Whooping" sound when child tries to breathe in during or after a severe coughing spell.
• Coughs usually produce a thick, productive mucus.
• Vomiting may occur.
• Lips and nails may turn blue due to lack of oxygen.
• Patient is left exhausted after a coughing spell.
• Cough lasts longer than two weeks.
• Can affect a person of any age, but infants and the elderly seem to suffer the most when they get this illness.

Treatment

• Whooping cough is highly contagious and requires prescription medication. Call our office immediately for treatment options.
• Avoid contact with anyone, particularly infants and young children.

To see and hear an example of the "whooping cough" caused by pertussis, and for more detailed information, visit www.pertussis.com.

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l Diarrhea/Vomiting

Definition

Most vomiting and diarrhea is caused by viral infections. This is a common illness and rarely dangerous. If vomiting doesn't stop within 12-14 hours, please call your doctor. Diarrhea is a watery stool that occurs more than four times per day and can last for several days.

Treatment for Vomiting

• Rest the stomach for 2-3 hours by giving nothing by mouth.
• Then give 1 tablespoon of liquids such as Pedialyte, juices or soda every 20 minutes for 3 hours. If breasfeeding, continue, but nurse for shorter intervals more frequently.
• If the liquids are tolerated, increase the liquids by small amounts until child is retaining 2-4 oz. at a time. If vomiting occurs, the process must be restarted. Pedialyte should not be continued for more than 24 hours.
• Gradually (over 2 days) return to regular diet.
• Monitor for signs and symptoms of dehydration, which include dry mouth, no tears, and decreased urine output (no urine for more than 8 hours).
• Medicines such as Emetrol, Phenergan and Tigan are not recommended for acute infectious vomiting, and may hide a more serious illness such as appendicitis or kidney infection. We do not routinely prescribe such medications.

Treatment for Diarrhea

• If vomiting is also occurring, follow the above directions.
• If there is no vomiting, adequate fluid intake is essential to prevent dehydration. It is important to provide more fluid than the child loses through diarrhea. Signs of adequate hydration include a normal or near normal urine output, a moist mouth, and an alert child who is reasonable active.
• If breastfeeding: Continue to breastfeed at more frequent intervals. Supplement with Pedialyte by bottle or dropper if urine output decreases. Call our office if there are no wet diapers after 8 hours.
• If formula feeding: increase the amount of formula or supplement with Pedialyte to make up for additional fluid losses.
• Provide a regular diet with a few simple changes. Avoid grape, pear or prune juices, which can loosen stools. Try to give your child their normal diet.
• Monitor for signs and symptoms of dehydration, which include dry mouth, no tears, and decreased urine output (no urine for more than 24 hours).
• Despite the above steps, diarrhea may last days after the illness seems over. If the child seems well, there is nothing to worry about unless the diarrhea lasts longer than 10-12 days.
• You child may return to school/daycare when they feel well, are without fever for at least 24 hours, and have stools that remain in the diaper or, for school age, occur less than 4 times per day.

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l Earache

Symptoms

• Pain or discomfort around the ear.
• Child reporting ear pain.
• Child acting like they acted when they has a previous ear infection (crying, fussy).

Treatment

• Give acetaminophen or ibuprofen (click here for medication dosing schedule).
• Raise the head of the bed 30-45°.
• Apply warm compresses to ear, if older than 1 year.
• If earache persists to the morning, or your child has a fever, call our office for an appointment.

Please keep in mind that earaches do not always indicate an infection.

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l Fever

Symptoms

• Elevation of the normal body temperature.
• Fever is a friend - it helps the body fight infection.
• Fever itself is not dangerous, and will not go high enough to cause harm (even when over 104° F).
• Fever is often higher in the evening and lower in the morning.
• Fever usually lasts only 2-3 days.

Treatment

• If temperature is below 101° F, no treatment is necessary.
• Increase daily fluid intake.
• Keep child lightly dressed with clothes that will breathe.
• Give acetaminophen or ibuprofen for comfort (click here for medication dosing schedule).
• For temperatures above 103° F, bathe child in lukewarm bath 20-30 minutes (water temperature should be around 98° F), and give ibuprofen and Tylenol (click here for medication dosing schedule).
• Call immediately if your child is under 3 months of age and rectal temperature is above 100.4° F, they are difficult to arouse or they do not interact with you, or they complain of a stiff neck or are unable to move neck.
• Call during regular office hours if the fever lasts longer than 3 days.

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l Head Injuries

Symptoms

• Strike or blow to the head, which may or may not include loss of consciousness.
• If loss of consciousness occurs, call the office immediately.
• If your child remains unconscious or looks critically ill, call 911.

Treatment (if no loss of consciousness)

• Clean any scrapes or cuts with soap and water.
• Apply direct pressure to cuts for 10 minutes to control bleeding (caution: head injuries end to bleed heavily).
• Apply cool compress or ice pack to affected area to decrease swelling.
• Give acetaminophen for headache. Do NOT give ibuprofen! (Click here for medication dosing schedule.)
• If child is sleepy, allow them to sleep, but stay nearby and arouse them every two hours during the day or four hours during the night.

    Observe child and notify doctor if any of the following are noticed:

• Pupils of the eyes don't get immediately smaller after a flashlight is used.
• Child has a deep cut in the scalp that may need suturing.
• Child becomes disoriented, confused or dizzy.
• Child begins vomiting more than twice (it's not uncommon for a child to vomit right after an injury occurs, if they are upset).
• Child is having difficulty speaking or has blurred vision.
• Child is having blood or watery fluid from nose or ears.
• Child cannot remember how the injury occurred.
• Child is unusually sleepy or is very irritable.

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l Sore Throat

Symptoms

• Pain or discomfort in the throat, worsens with swallowing.
• Child under 2 years of age doesn't know how to complain of a sore throat, but may refuse previously enjoyed foods or cry with feedings.

Treatment

• Gargle with warm salt water (1 tsp. per 8 oz. glass of water)
• Give acetaminophen or ibuprofen for comfort (click here for medication dosing schedule).
• Encourage cold fluids or foods.
• Soft bland diet - avoid spicy, acidic or rough textured foods.
• Call during regular office hours if the sort throat lasts 24 hours, there is recent exposure to strep, or if there is abdominal pain, vomiting, headaches, or rash.
• Call immediately if there is drooling or difficulty breathing.

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l Summer Stuff: Insect Bites/Poison Ivy/Sunburn

Insect Bites

Prevent bites by using insect repellent containing less than 30% DEET if your child is more than two months old. For infants under two months of age, use a mosquito net to prevent insect bites. Be sure to avoid the eyes and mouth when using insect repellent.

Unless your child is allergic to a particular sting or bite, local treatment with soap and water, cold compresses, topical anti-itch medications (Itch-X, Rhuli-gel, Aveeno Anti-Itch) and Benadryl can be given to decrease swelling. (Click here for medication dosing schedule.)

Contact our office if there is fainting/passing out, difficulty breathing, or the bit area seems to be showing signs of infection.

Poison Ivy

Prevention is the key. Wear long-sleeved shirts and long-legged pants instead of shorts if possible. Remove these clothes as soon as you get home, and take a shower (not a bath, which will allow plant resins to stay in the bathwater and potentially irritate other bodily areas). Apply cool compresses, take an antihistamine such as Benadryl, Claritin or Zyrtec (click here for medication dosing schedule) and apply 1% hydrocortisone such as Cortisone 10 or Cortaid three times daily as needed to affected areas.

Wash all contaminated clothing and bed linens to remove plant resins. Be sure to wash your hands immediately after handling your child’s affected clothing to avoid getting a rash yourself.

Contact our office if swelling in the eyes occurs, if the affected area seems to be showing signs of infection, or if there is no response to antihistamines/hydrocortisone after five to seven days of treatment.

Sunburn

Prevention is the key. Always use sunglasses containing both UVA and UVB protection. Sunscreen can be used at any age. Use sunscreen containing SPF 30. (Be sure to avoid contact with the eyes and mucous membranes. If contact with eyes occur, rinse with cool water.) Apply at least 30 minutes before exposure, and reapply every 80-90 minutes. If sunburn occurs, apply cool compresses and a lotion containing aloe. Since sunburn can be associated with dehydration, be sure to offer plenty of fluids.

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