Call our office:

• If the rash looks infected (yellow pus, pimples, blisters, spreading redness or open sores)

• If the rash is red or bleeding

• If the rash doesn't improve in 3 days

Constipation:
Constipation happens when stools are abnormally hard and infrequent causing pain when having a bowel movement.  Large or hard bowel movements unaccompanied by pain are normal.  Babies less than 6 months of age commonly grunt, push, strain, draw up their legs and become flushed in the face during passage of bowel movements.  However, they shouldn't cry.  You can help your straining baby by holding the knees against the chest to give them something to push against.  Between 4 and 7 weeks of age, your baby will go through a normal bowel pattern change.  They might change from having a bowel movement 4 times a day to one bowel movement every 4 days.  This too is normal as long as the stool stays soft.

Constipation is usually relieved with dietary changes.  If your child is eating solid foods, increase foods high in fiber.  This includes fruits and vegetables like prunes, apricots, raisins, plums, peas, celery, broccoli and beans.  Increase bran and whole grains like bran flakes, bran muffins, shredded wheat, graham crackers, oatmeal, brown rice and whole wheat bread.  Limit bananas, cheese, white bread and potatoes.

If your child is under 1 year of age give daily, one ounce of water per month of age up to a total of 6 ounces each day.  Give 2 ounces of a 50/50 blend of water and fruit juice (apple, white grape and pear) each day.  If your child is older, increase their water consumption to 4-5 glasses per day.  Also you may give apple and/or prune juice twice a day.

To relieve constipation in your infant, you can stimulate the urge to push by inserting a rectal thermometer or a Q-tip coated in Vaseline or K-Y jelly.  Gently insert into rectum 1/4 of an inch and run it around the ring of the rectum in a circular motion for up to 5 minutes.

Call Our Office:

• If your child gets cramps or pain that lasts over 2 hours

• If your child doesn't have a bowel movement in 3 days after a change in diet

• If your child has blood in the stool

• If your child begins to vomit or run a fever

• Before you give any laxatives, enemas, or suppositories

Vomiting:
Vomiting is the forceful ejection of a large portion of the stomach's contents. By contrast, regurgitation is the effortless spitting up of one or two mouthfuls of stomach contents that is commonly seen in babies under 1 year of age.  Most infants will spit up small amounts of formula usually within the first hours after being fed. It will occur less often if a child is burped frequently, held upright for 20-30 minutes after feedings and if active play is limited, right after meals. This spitting up tends to decrease as the baby becomes older but may persist in a mild form until 10-12 months of age. Spitting up is not serious and doesn't interfere with normal weight gain.

Most vomiting is caused by a viral infection or eating something that disagrees with the child. Vomiting usually stops in 12-24 hours. Changing your child's diet generally speeds recovery. Occasionally regurgitation may occur during the first few months of life. It it appears repeatedly or is forceful (projectile) after every feeding, call our office as soon as possible.

If your child is vomiting and is less than 1 year old offer 1 teaspoon of Pedialyte every 10 minutes. Slowly increase the number of teaspoons every hour until the child has gone 8 hours without vomiting. (For example, 2 teaspoons every 10 minutes for 2 hours, 3 teaspooons every 10 minutes for 3 hours.) They can then return to formula and if older than 4 months they can also return to cereal, bananas and applesauce. A normal diet is okay in 24-48 hours.

For breastfed infants provide breast milk in small amounts. Do not fill up their stomach. If your baby vomits twice, nurse on only one side every 1-2 hours. If the child vomits more than twice, nurse for 4-5 minutes every 30-60 minutes. After 8 hours without vomiting, return to regular breast feeding.

For older children offer clear fluids in small amounts for 8 hours. Offer an electrolyte solution (Gatorade, Pedialyte), Jello, ice pops, chicken broth. Give 1 tablespoon every 10 minutes. Increase the number of tablespoons every hour until the child has gone 8 hours without vomiting. (See example above.) If vomiting occurs, give the stomach a 1 hour rest and start again. After 8 hours of no vomiting, start a bland diet for the next 24 hours, (saltines, rice, mashed potatoes...) A normal diet is OK in 24-48 hours.

Discontinue all over the counter medications. If the child is on a prescription medication call our office.

Call our office for any of these symptoms:

• blood or bile (green colored) vomitus

• severe abdominal pain

• strenuous repeated vomiting

• swollen abdomen

• lethargy or severe irritability

• signs of dehydration including dry mouth, absent tears, depression of the soft spot, or decreased urination.

• inability to drink adequate amounts of fluid

• vomiting more than 24 hours or more than  12 hours in a child 6 months or less

• fever develops

• no urine output in 6 hours

• if diarrhea develops

If you suspect poisoning from a plant, bad food, medicine or chemical, call poison control at 404 616-9000.