Fever

Fever by itself is not an illness.  It is a rise in body temperature. It is a symptom or sign that a child's immune system is trying to fight off an infection. Fever is actually a healthy process. However, a fever can make a child fussy and uncomfortable.

 

Feeling your child's forehead is not a reliable way to tell if your child has a fever.  All children up to 18 months old should have their temperature taken rectally.

 

Call our office for any of the following fevers:

 

  • Birth - 3 months                 100.3 per rectum

  • 3 months - 6 months         101 per rectum

  • 6 months - 12 months      101.5 per rectum

  • Any child with a temperature of 102.5 or higher

 

Regardless of age, call if any fever persists longer than 3 days, if your child can't be comforted, is irritable, cries inconsolably, has difficulty breathing, is lethargic, not feeding well, or has a convulsion.

 

Please keep in mind if your child has had immunizations, a temperature of 101 - 102 per rectum is not uncommon at 24 - 48 hours. If you observe this, please call our office to speak with the phone nurse.

Diaper Rash

Diaper rash is an irritation of the skin from urine and bowel movements. It occurs equally with cloth and disposable diapers. Changing the diaper immediately after your child has a bowel movement and rinsing the skin with warm water are the most effective measures you can take to prevent diaper rash. With proper treatment these rashes are usually better in 3 days.

 

Home Care:

  • Change diapers frequently, make sure baby's bottom is completely dry before closing up the fresh diaper.

  • Increase air exposure. Leave baby's bottom exposed to air for 15 minutes 4 times per day, either during naps or after a bowel movement. Put a towel or diaper under your baby. When diaper is on, fasten it loosely.

  •  Rinse skin with warm water. Do not use diaper wipes  when baby has a diaper rash. If the rash is quite raw,  use warm water soaks for 15 minutes 3 times per day.

  •  If the rash is bright red or or does not respond to 3  days of warm water cleansing and air exposure,  suspect a yeast infection. Apply our Butt Cream (mix  equal parts: Lotrimin Balmex/Desitin and Neosporin)  4 times per day or after each bowel movement.
     

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

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, and 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, etc) 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.

Strep Throat

Strep throat is a throat infection caused by group A streptococcus bacteria. It is very common among children and teens. Symptoms may include: fever, red and white patches in the throat, headache, stomach ache, red and enlarged tonsils, loss of appetite, nausea and rash. If you suspect your child may have strep throat, schedule an appointment with your child’s pediatrician. It is diagnosed by performing a rapid strep test and/or throat culture. The treatment is a 10 day course of antibiotics. Usually after 24 hours on the antibiotic, your child will no longer be contagious. By the second or third day on the antibiotic, the symptoms should start improving. It is very important that your child finish the antibiotic prescription. If you stop the antibiotic too soon, bacteria can remain in the throat and the symptoms can return.

Here are some tips to prevent the spread of strep throat to others in your home:

  • Keep his/her eating utensils, dishes, and drinking glasses separate

  • Wash them in hot soapy water after each use

  • Don’t allow your child to share food, drinks, napkins or towels

  • Make sure your child covers his/her nose and mouth when sneezing or coughing

  • Good hand washing

  • Throw out toothbrush and buy a new one

 

Call Our Office:

  •  If your child’s fever persists for 3 days while on  antibiotics

  •  If your child is drooling or having difficulty swallowing

Milestones

The Click here following link to the CDC developmental milestones page. They have excellent information on developmental milestones and what to expect for your childs age. Please review the information on the website and let your doctor know of any concerns.

Diarrhea

Diarrhea is the sudden increase in the looseness and frequency of bowel movements. In most cases, diarrhea is caused by a virus. It can be mild (loose or mushy stools) to severe (constant watery stool). A green stool indicates very rapid passage of contents through the gastrointestinal tract. Diarrhea can last from several days to a week.

 

There is usually no need to stop diarrhea with medications. Children should be given such medication only under the direction of the physician. Diarrhea is often accompanied by vomiting. Diarrhea can be contagious. Make sure you wash your hands after changing diapers and that you and your child both wash hands after using the toilet.

 

The most frequent problem diarrhea causes is that your child may get dehydrated. In general, fluids should not be restricted when a child has diarrhea.

 

Signs of dehydration:

  • dry mouth

  • absence of tears

  • decrease in urine (none in 8 hours)

  • darker colored urine

 

Call our office if:

  • any signs of dehydration

  • less than one year old: more than 8 bowel movements in 8 hours

  • diarrhea is watery and child vomits clear fluid 3 or more times

  • fever lasts more than 3 days

  • mild diarrhea for more than 7 days

Constipation

Constipation happens when stools are abnormally hard and infrequent, causing pain when your child is 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

Common Cold or Upper Respiratory Infection

The Common Cold or Upper Respiratory Infection (URI) is caused by a virus.  It is easily spread from person to person by mouth, hands, coughing or sneezing.  Cold weather, cold winds, drafts, air conditioners and wet feet do not increase the chance of coming down with a cold. 

 

Most healthy children will get 6 colds a year.

Symptoms range from having a runny nose, to congestion and a cough.  Sometimes fever and sore throat may accompany it.  A cold should run its course within 4-10 days.  The main things to watch for are secondary infections such as ear infections, yellow drainage from eyes, sinus pressure or pain, or difficulty breathing.

 

There is no cure for the common cold.  Antibiotics have no effect on viruses.  So the best you can do is make your child comfortable.

 

A runny nose usually clears up in a few days without any need for medication.  For younger babies, use a rubber suction bulb, up to 4 times a day, to gently remove any secretions. 

 

Most stuffy noses are blocked by dry mucus.  If your infant is having trouble nursing because of nasal congestions, place 2 drops of saline nose drops into each nostril.  After one minute gently suction out the loosened mucus.  This can be done 3-4 times a day.  Avoid doing this too often as it can further aggravate the symptoms.

 

Most coughs are due to a viral infection of the trachea (windpipe) and bronchi (larger air passages).  Most children get this infection a couple of times a year as part of a cold.  Remember coughing clears the lungs and protects them from pneumonia.  Sometimes it becomes loose (wet sounding) for a few days.  This is usually a sign that the end of the illness is near.

 

Use a cool mist humidifier (vaporizer) in their rooms to help keep nasal secretions moist and to keep coughs down.  Don’t add medication to the water in the humidifier, because it can irritate the cough in some children.  Be sure to clean and dry the humidifier thoroughly each day to prevent bacteria or mold growth.  Hot water vaporizers are not recommended because they can cause scalds or burns.  Encourage fluids frequently to keep them well hydrated. You can also raise the head of the bed, or prop older children up on pillows to help with nasal drainage.

 

Call our office if any of the following occur: persistent cough, loss of appetite, fever, excessive irritability, nasal discharge lasting more than 10 days, if their eyes develop yellow discharge, or ear or sinus pain.

Living With Asthma During Winter

Winter is a wonderful time of year. Many people enjoy skiing, family holiday gatherings, and vacations. However, winter is also a time to take extra care if you have a child with asthma.

 

Asthma can be triggered by cold air during winter months. Winter is also a time of increased exposure to colds and viruses. The common cold or flu can aggravate airway inflammation and trigger symptoms. Viral infections are the most frequent cause of severe asthma in infants and children under the age of 10. Another trigger is smoke. Fall and winter fires can be a problem for children with asthma. Smoke has been known to contain gaseous pollutants which can be inhaled and trigger asthma. Another common trigger during the winter is exercise induced asthma. Exercise induced asthma usually presents ten minutes after the exercise has begun or following exercise.

 

Here are some important tips to help control your child’s asthma:

  • It is very important for children with asthma to receive a flu vaccination.

  • Check your heating system/fireplace, have it professionally cleaned and serviced to minimize exposure to gaseous pollutants.

  • Try to prevent the spread of colds and viruses by practicing good hand washing techniques.

  • Plan ahead! Discuss with your pediatrician how to avoid possible triggers. Discuss the use of your child’s preventative medicine to help prevent exacerbations.

  • To help minimize exercise induced asthma, keep your child’s asthma well controlled. Your child should use his or her prescribed relief medication 10 to 15 minutes before exercising. Outdoor activities can be done with proper planning.

    Hopefully by following these tips you can help your child breathe easier. Winter is a time that should be enjoyed by all.

DISCLAIMER:

The purpose of the website is to provide information of a general nature. It is intended to be used for informational purposes. The information is meant to be consistent with the standard of care at the time of publication. It is not intended to replace or substitute for the medical advice or decision making provided by one's practitioner. All the information on this website is presented as is, without any warranties of any kind, expressed or implied. North Point Pediatrics takes no responsibility for the all inclusive accuracy and content of this website or of the links from this website. Visiting this website DOES NOT establish a patient-physician relationship with any physician or practitioner associated with North Point Pediatrics. Furthermore, one should consult one's own physician for specific advice for one's personal situation.

 

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