Breastfeeding – Answers to general and specific questions and Breastfeeding – Additional information

Colds and Cough – How should I treat my child’s cold?

Conjunctivitis (Pink eye, discharge) – What is conjunctivitis? And how do I treat it?

Conjunctivitis or “pink eye” is inflammation of the conjunctiva (the membrane covering the eye), and can be due to allergy (exposure to an irritant such a pollen, smoke or pets), infection or chemical irritation. It usually presents with a red eye and possible eye discharge. You may start treating pink eye with a cold tap water compress, avoiding irritants, and cleaning the discharge. If symptoms persist for 48 hours and heavy discharge occurs, your child should see his pediatrician to make the correct diagnosis and administer the appropriate treatment, which usually consists of eye drops or cream. Significant eye pain, swelling or severe light sensitivity require same day medical evaluation. Conjunctivitis in the newborn might suggest a blocked tear duct, which requires massaging of the tear duct and possible topical antibiotics.

Constipation – What should I do if my child is constipated?

Diarrhea and/or vomiting are usually caused by a virus infection of the intestine. This virus is contagious. The symptoms usually last about 3-5 days but sometimes may last 10-12 days. The virus may be associated with fever, decrease in appetite and abdominal cramps.

The main complication of this virus is dehydration. It is important to regularly check for dehydration signs such as:
• Sunken eye balls and no tears while crying
• Dry tongue
• Decreased urination
• Lethargy
• Depressed soft spot in infants
• Weight loss is most helpful if a recent weight measurement is available

Other warning signs include bilious (greenish) vomiting and/or bloody stools.

Most children are only mildly or moderately dehydrated and can be treated at home by drinking an oral electrolyte solution for several hours followed by a semi-restricted diet. If the child is severely dehydrated (several of the above signs are present) or getting worse on an oral regimen, the child may need to be hospitalized for intravenous fluids.

1. For the first 4-6 hours give your child an oral electrolyte solution (Pedialyte or a Pedialyte popsicle). Start with one tsp (5 ml) every 2-5 minutes and advance slowly as tolerated: One Tbsp (15 ml or ½ oz) every 10-15 minutes, then one Oz (30 ml) every 20-30 minutes, and so on. Children who are dehydrated usually do not refuse Pedialyte. The more dehydrated your child is, the more likely he/she will drink the fluid. If you are nursing, offer the oral electrolyte solution between breast feedings.

2. After the initial 4-6 hours, resume regular formula or full strength milk (depending on the age of the child) in addition to the oral electrolyte solutions. Continue to offer small but frequent portions as tolerated. Please do not force feed your child; but if your child wants to eat, provide a diet rich in rice, baked or mashed potatoes, chicken broth or soup, bread and cereals. Lean meat, yogurt, bananas, saltine crackers, pretzels, cooked carrots and applesauce are also well tolerated. Avoid fried, spicy or greasy foods. Also avoid sweetened tea, ALL juices, sodas and carbonated beverages.

Diarrhea in Infants – My baby has diarrhea, when do I call my pediatrician?

Dosage Chart Tylenol / Ibuprofen – How much should I give my child?

Ear Infection – What are the symptoms of an ear infection?

Fever – How do I treat my child’s fever and when should I be concerned?

Fever (temperature over 100.4°F or 38.0°C) is a symptom, not an illness. Most fevers are caused by a viral illness such as a “cold” or ” flu”. To measure temperature, use a digital thermometer in the rectum or under the arm or you may use an electronic ear thermometer after the age of six (6) months.

Fevers of 100°F (37.8°C) to 104°F (40°C) are not unusual and are not harmful to a child. Fevers below 106°F (41.7°C) cause no harm. 5% of children under age 5 years (usually 3 months to 3 years and with family history) may develop a febrile seizure. These are brief, and usually self-limited, lasting less than 5 minutes. Although frightening to parents, febrile seizures are rarely dangerous.

Most children tolerate fevers of up to 102°F (38.9°C) quite well. If the child can be observed, fevers in this range do not need to be treated. If the fever is over 102°F (38.9°C) or if the child is uncomfortable, you can treat with acetaminophen (Tylenol, Tempra, etc.) according to the chart. Acetaminophen wears off after 4 hours, so the same dose will need to be repeated every 4 hours if the temperature is 102°F or greater. Ibuprofen (Advil or Motrin) may also be used to treat fevers in children older than six months, every 6 hours and is available also without prescription (See chart).

When to be concerned
A child with a fever should be seen by a pediatrician if under 2 months of age, or if the child experiences any of the following; fever greater than 104°F (40°C), if neck is stiff, if fever present for over 24 – 48 hours, the child is very sick, or if the parents are very worried.

Head Injuries – When should I be concerned with a head injury?

Most head injuries are mild and can be observed at home. If your child remains alert and responsive, the injury is usually mild and tests are not needed. You may apply a cold water compress or ice pack for up to 20 minutes if there is any external swelling (e.g. goose egg). This is the result of blood from a scalp vein leaking under the skin and will most likely form a bruise. It does not necessarily mean there has been internal brain injury. The child should be observed carefully for 24 hours for vomiting, change in breathing, color, or twitching. The child should be awakened and checked every 3 to 4 hours. Call the office, or go to the emergency room immediately if your child experiences any of the following:

• Loss of consciousness of ANY length of time
• Vomiting more than 2 times
• A constant headache that is getting worse
• Slurred speech
• Difficulty walking straight or seeing straight
• Abnormal breathing or color
• Confusion or difficulty recognizing familiar people
• Difficulty waking up
• Fluid or blood coming from the ears or nose
• Continuous crying for more than 15 minutes after the injury

Head Lice – I think my child has head lice. How can I be sure and how do I treat it?

Over the counter Medications – What over the counter medications can I use to treat my child and are they safe?

Poison Control – If you suspect accidental poisoning, call Poison Control immediately 800-222-1222

Free, private, confidential, medical advice 24 hrs a day, 7 days a week
1-800-222-1222 / www.aapcc.org

Reflux / GERD (Gastroesophageal disease) – When food won’t stay down, what do parents do?

Skin Health – Frequently asked questions regarding skin health

Skin Rashes – How do I treat my child’s rash and when should I be concerned?

Skin Rashes / Skin Care / Sunscreen / Insect Bites

How should I treat my child’s rash? Eruptions of the skin have many causes and are so variable that treatment over the phone is generally not accurate. Rashes in children with fever require prompt evaluation. Any rash that appears to be blood or hemorrhages in the skin (does not blanch with pressure) require immediate evaluation. Most other acute rashes in childhood, however, will be related to contact irritants or viral illnesses. Chronic rashes are most commonly eczema (atopic dermatitis) and are best managed with skin lubricants such as Aquaphor or Cetaphil. Your pediatrician may also decide to prescribe a topical steroid cream. Additionally, if the rash seems itchy, an antihistamine (Benadryl, Zyrtec, Claritin) may be beneficial.

How should I keep my child’s skin healthy? Newborns require very little, if any, skin care products, as they tend to naturally peel and acquire stronger skin in the first few weeks of life. Older infants and children are usually bathed several times per week using a mild soap such as Dove or Cetaphil. Ideally, immediate application of moisturizer after towel drying is helpful, particularly if your child’s skin is prone to dryness.

At what age can I use a sunscreen, and which ones are recommended? Infant skin is damaged more by sunburn than older children’s skin, and any sunburn should be completely avoided. Pediatric, hypoallergenic sunscreens are recommended. In babies less than six months of age, use sunscreen conservatively. We suggest applying a “test patch” to your child’s back or upper leg, waiting 24 hours to be certain there is no reaction, prior to applying to the entire body. Effective sunscreens should protect against both UVA and UVB lights (indicated on the label) and have an SPF of at least 25. Remember to reapply often, particularly after swimming or excessive sweating.

How can I prevent and/or treat insect bites, especially tick bites? Safe insect repellants for children should have labels with “family” on them, such as Family Off and Family Cutter. The active ingredient is DEET, which is extremely effective. In younger children, use products with 10% DEET or less. Tick bites that involve tick attachment less than 18 hours are of very little risk of disease transmission, i.e., Lyme disease, but ticks should be removed as quickly as possible. Rashes that occur with tick bites, especially from ticks that have been attached for prolonged or unknown periods, should be medically evaluated in the office. Signs of Lyme disease include fever, joint pain, swelling, and stiff neck. Ticks can be removed from the skin by using tweezers close to the skin. Use firm pressure, without crushing the tick. Removed ticks should be kept because they can be examined in the lab for Lyme disease.

Sleep in Infants – How much and how should my baby sleep?

Sore Throat / Strep Throat – How can I tell when my child’s sore throat is more than a virus?

Starting Solid Foods – When is my child ready to start solid foods?

Vaccine Information and Side Effects

Vomiting – How should I treat my child’s gastroenteritis?

Vomiting – My baby vomits a lot. Is this a sign of a problem?