Category: Common Illnesses

Rashes

2/3/2019

Most rashes need to be evaluated in the office. There are many different types and causes of rashes.

Call our office immediately if:

The rash is purple in color and does not fade away when you press on it (possibly a lifethreatening rash).
The rash looks infected (yellow pus, spreading redness, red streaks).
If your child is acting very sick.

Call our office during regular hours if:

You have other questions or concerns.

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Babies commonly grunt, push, strain, draw up their legs and become flushed in the face during passage of BMs. However, these behaviors are normal as long as their stool is soft. The painful passage of hard stools is the most reliable sign of constipation in infants and in older children. These children feel a desperate urge to have a bowel movement (BM) but are unable to pass a BM after straining and pushing for more than 10 minutes.

Some children begin to retain stool in order to avoid the pain of passing a hard BM. These children may start to soil themselves as the watery stool in the upper intestines leaks around the impaction. Constipation is often due to a diet that does not include enough fiber or fluids or due to drinking or eating too many dairy products or starchy foods. It is also caused by repeatedly waiting too long to move the bowels. If constipation begins during toilet training, too much pressure may be being placed on the child. Changes in the diet frequently relieve constipation. After your child is better, be sure to keep him on a non-constipating diet so that it doesn’t happen again.
Diet treatment for infants less than 1 year of age include:

If your baby is under 2 months of age, try 1 teaspoon of brown sugar in one ounce of water twice a day.
If over 2 months old, give 1 ounce of diluted fruit juices (such as apple or prune) twice a day.
If over 4 months old, add strained foods with a high fiber content, such as cereals, apricots, prunes, peaches, pears, plums, beans, or spinach twice daily.
If your baby is eating rice cereal, switch to oatmeal or barley.

Diet treatment for infants older than 1 year of age:

Make sure your child eats fruits or vegetables, appropriate for his/her age, at least three times a day (raw and unpeeled are best), such as prunes, raisins, pineapples, peaches, apricots, mangoes, broccoli and cabbage.
Increase the bran in her diet. Bran is an excellent natural stool softener because it has a high fiber content. Examples include bran flakes, shredded wheat, graham crackers, oatmeal, brown rice, whole wheat bread or popcorn.
Decrease consumption of constipating foods such as rice, milk, ice cream, cheese and yogurt.
Use babylax suppository if no stool for three days.

Call our office immediately if:

Your child develops severe rectal or abdominal pain.

Call our office during regular hours if:

Your child does not have a BM after 3 days on this non-constipating diet.
You have other questions or concerns.

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Vomiting

2/3/2019

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Most vomiting is caused by a viral infection of the stomach (viral gastroenteritis) or eating something that is tainted. It can occur with diarrhea or by itself. In infants, it is important to distinguish between normal amounts of spitting up and vomiting. Many normal infants may have mild reflux and may spit up small amounts of undigested milk soon after feeding. Often, the viral type is associated with diarrhea. The expected course is usually 12 to 24 hours Dietary changes usually speed recovery. If diarrhea is present, it usually continues for several days to a week.

Home care for vomiting includes special dietary changes according to age and normal diet. For bottle-fed infants less than 1 year of age, offer oral rehydration solutions (ORS), such as Infalyte or Pedialyte, for 8 hours. Offer small amounts (1 teaspoon) every 5 minutes for the first hour, then 2 teaspoons every 10 minutes, then 3 teaspoons every 15 minutes. You should aim for total of about 2 ounces per hour, After 4 hours without vomiting, increase the amount. After 6-8 hours without vomiting, return to formula. For infants more than 4 months of age, also return to cereal, bananas, etc.

A normal diet is okay in 24 to 48 hours. If your child refuses the Pedialyte, you may give Gatorade, herbal tea, chicken broth or flat sodas. Coca cola syrup is particularly effective in “settling” the stomach.” Try to avoid diet sodas and plain water since they lack any sugar and electrolytes. Once your child has managed to tolerate fluids for at least four hours, you may offer mild foods as tolerated.
For breast-fed infants, reduce the amount or feeding and feed more frequently. Your goal is to avoid filling the stomach. Nurse for 5 minutes every 1-2 hours. After 6-8 hours without vomiting, return to regular breast-feeding.

For children over 1 year of age, offer clear fluids (water, Pedialyte, or Gatorade) in small amounts for 8 hours. Give small amounts (1 tablespoon) every 10 minutes. After 4 hours without vomiting, increase the amount. For severe vomiting, rest the stomach completely for 1 hour, then start over with smaller amounts. Add bland foods after 6 hours without vomiting. Stay on bland, starchy foods (saltine crackers, white bread, rice, mashed potatoes, etc.) for 24 hours.

Call our office immediately if:

Your child has signs of dehydration (no urine in over 12 hours, very dry mouth, no tears,
etc.).
Even small amounts of fluids are not tolerated after 4-6 hours of repeated vomiting.
Any blood appears in the vomited material.
Abdominal pain develops and lasts more than 4 hours.
Your child is acting very sick.
Call our office during regular hours if:
The vomiting continues for more than 24 hours in children under age 2 or for more than
48 hours if over age 2.
You have other questions or concerns.

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Sore Throat

2/3/2019

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Most sore throats are caused by viruses and are part of a cold. However, about 30% are due to the strep bacteria.

A throat culture or rapid strep test is the only way to distinguish strep throat from viral infection.

To provide local pain relief, children over 8 years of age can gargle with warm salt water (1/4 teaspoon of salt per 6-8 oz water).

Children over 4 years of age can suck on hard candy, like butterscotch or lollipops, as often as necessary. Children over 1 year can sip on warm chicken broth.

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Cold / Upper Respiratory Infection Care

2/3/2019

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The common cold involves an array of symptoms including runny or stuffy nose, congestion, fever, sore throat, cough, hoarseness, red eyes, and swollen lymph nodes in the neck. A cold or URI is a viral infection of the nose and throat.

Cold viruses are spread from one person to another by droplets through hand contact, coughing, and sneezing, not by cold air or drafts. Since there are up to 200 different cold viruses, healthy children still commonly contract six to ten colds each year.

A typical course of cold symptoms may include a fever that lasts 3 days, nose and throat symptoms that last 1- 2 weeks, and a cough that may linger for 2 to 3 weeks. The main things to watch for are secondary bacterial infections such as ear infections, yellow drainage from the eyes, sinus pressure or pain, or difficulty breathing.
Home care remedies usually do not impact how long a cold lasts, but can relieve many of the symptoms. Examples of home treatment for associated symptoms include:

Runny nose: Nasal discharge is the nose’s way of eliminating viruses. Put a thin layer of vaseline or Aquaphor on the area under the nose to avoid irritation. You may gently use a soft rubber suction bulb to remove the secretions if necessary.
Stuffy nose and congestion: Most stuffy noses are blocked by dry mucus. Blowing the nose or suction alone cannot remove most dry secretions. Normal saline nose drops are very effective for loosening dry mucus. Place three drops of warm normal saline drops in each nostril, using a washcloth, cotton ball or syringe. Frequently, the baby will sneeze the loosened mucous out, otherwise you may use a soft cleanable rubber suction bulb to suck it out. Over use of the suction bulb may be traumatic to the nasal tissue, so try to use it only when absolutely necessary. It is especially important to clear a stuffy nose in young infants because they are obligated to breathe through the nose while they are sucking.

The older child should try to gently blow his nose after instilling the saline drops. Use nasal washes 2-4 times per day or whenever your child is having trouble breathing through his nose.
When your child sleeps you may use a cool mist humidifier in his or her room. The most effective steam room, however, is your smallest bathroom with the shower running on hot. Sit in the steamy room with your child for 20 minutes three or more times a day.

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Cough

2/3/2019

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Most are due to a viral infection and are part of a cold. Keep in mind that coughing clears the lungs and protects them.

Use cough drops for children over 4 years old and warm liquids, like chicken broth for children over 1 year of age. We generally avoid the use of cough suppressants. Dry air tends to make coughs worse. Use a cool mist humidifier in your child’s bedroom to loosen a dry cough. A steamy bathroom works well. Encourage plenty of fluid intake.
Call our office immediately if:

Breathing becomes difficult and no better after you clear the nose
Your child is drooling or having difficulty in swallowing.
Your child looks or acts very sick.
You notice wheezing.

Call our office during regular hours if:

Fever lasts more than 3 days.
To make an appointment for a throat culture if your child had had a sore throat present
for more than 24 hours.
Nasal discharge lasts more than 10 days.
Cough lasts more than 3 weeks.
Your child complains of an earache or facial (sinus) pain.
Eyes develop a yellow discharge.
You have other questions or concerns.

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Rashes

Constipation

Vomiting

Sore Throat

Cold / Upper Respiratory Infection Care

Cough

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