-Common Cold Advice (also known as Upper Respiratory Infection)
-Vomiting and Diarrhea (also known as Gastroenteritis)
Allergies can be miserable for your child. Sneezing, nasal congestion, a sore/scratchy throat, runny nose and dry cough are all common symptoms of allergies. There are several things you can do at home to make your child more comfortable.
1. Keep windows closed at night to prevent dust and pollen from coming in to your child's bedroom.
2. Put allergy covers on your child's mattress and pillow.
3. Limit stuffed animals to 1 or 2 of your child's favorites. Stuffed animals are covered with dust mites and the more your child has, the worse his/her symptoms will be. Run the remaining stuffed animals through the dryer once per week or place them in a plastic bag and put them in the freezer overnight once per week to kill dust mites.
4. Wash your child's sheets, pillowcases and bed spread in hot water 1x per week, also to kill dust mites.
5. Replace carpet with hardwood flooring whenever possible. This will also reduce dust mites in your child's room.
6. Try over-the-counter Loratadine (also known as Claritin) syrup or tablets to reduce sneezing, itching and runnynose. Follow the directions on the label or call during office hours for dosing.
Call the office during normal hours if:
1. Your child has a fever -- allergies do not cause fevers
2. You have tried the loratadine for a week or more with no change in symptoms
Bronchiolitis is a viral illness that may cause wheezing and a deep chest cough. It may be caused by RSV or by several other viruses and will not get better with antibiotics. It can be frustrating for parents because the cough may linger for several weeks. These are some things you can do to make your child more comfortable:
1.Do not allow ANYONE to smoke anywhere in your house or car -- smoking makes your child's wheezing and cough worse and can make it more difficult for them to recover from the illness. Smoking anywhere in the house (even in another room with the door closed) will cause your child discomfort and may lead to the development of pneumonia.
2.If you have a nebulizer, you may give your child a breathing treatment. It may help him to cough up some mucous which will help him breathe more easily.
3.Use saline (salt water) drops in her nose to help break up the congestion in the nose.
4.Do NOT use cough medicines. The cough helps your child clear mucous from the bronchial tubes and lungs. If you suppress the cough, the mucous (or "phlegm") may get stickier and plug your child's lungs.
call the doctor immediately if:
1. your child has a fever above 104.5 or is she has had a fever for more than 4 days.
2. If your child is breathing heavily or if you can see his ribs sucking in when he breathes or if the nostrils flare out when he breathes.
3. If your child is vomiting after coughing or if she is not interested in eating due to coughing so much
CALL 911 IMMEDIATELY IF YOUR CHILD IS STRUGGLING TO BREATHE OR HAS BLUENESS AROUND THE MOUTH
A cold (or Upper Respiratory Infection - URI) can be miserable for both you and your child. A cold is caused by a virus and so will not respond to an antibiotic, but there are some things you can do to make your child more comfortable while s/he recovers:
1.You may run a cool mist humidifier in your child's room at night. Be sure to clean it out 3x per week to prevent mold growth.
2. You may use salt water or "saline" spray in the nostrils before your child blows the nose or before you suction with a bulb. The saline spray helps loosen the mucous so that it can be removed more easily.
3. You may use a zinc nasal gel (like Zicam) in the nostrils 2-3 x per day. Studies show that zinc gel used at the beginning of a cold may shorten the course of a cold by 3-5 days.
Over the counter medications such as Triaminic or Pediacare may be used to relieve the symptoms, but it is important to remember that theses products do NOT make the cold go away any faster. You can expect that your child will have the cold symptoms for 10-14 days. As the cold progresses, the mucous in the nose will change from clear to yellow to green and then back to clear again. As the cold progresses, your child may develop other infections such as an ear infection or chest infections so you should call our office if:
1. The cold symptoms last longer than 14 days
2. Your child has a fever for longer than the first five days of the cold, or if your child develops fever in the middle or at the end of the illness
3. Your child begins to wheeze or have difficulty breathing
4. Your child begins to vomit mucous after coughing fits
Constipation is a very common problem throughout childhood. It has many different causes and is RARELY serious. Treatment is aimed at finding the reason for the change in stool pattern and treating the symptoms. Some of the more serious causes of constipation include thyroid disorders, Hirschsprung's disease (a narrowing of the muscles around the anal opening) and certain neurologic disorders.
Breastfed Infants
Infants have many different, but normal, stool patterns. Breastfed infants can have 8-10 stools per day, but may have as few as 1 stool every 4-5 days. Constipation is rare in breast fed infants. As long as the stools are seedy, yellow and loose, your infant is not constipated. NEVER GIVE AN INFANT HONEY TO SOFTEN THE STOOLS. Since true constipation is rare in breastfed infants, call our office in case the doctor wants to examine your infant before she gives you any advice. If the stools are hard, if your infant is vomiting and hasn't had a stool in more than 5 days or if the stool has bloody streaks in it, call immediately!
Formula fed Infants
Formula fed infants tend to have fewer (and firmer) stools than breastfed infants. A normal stool pattern for formula fed infants is anywhere from 1-2 stools per day to 1 stool every 5-7 days! As long as the stools are soft and your child isn't straining too hard to pass the stools, he is not constipated. NEVER GIVE INFANTS HONEY TO SOFTEN THE STOOLS! Honey can cause your baby to develop Infant Botulism--a severe and sometimes fatal disease caused by spores in the honey. If your child has true constipation and has not yet had a 1-2 week checkup, call our office so the doctor can examine your child first. If your baby has already had the first checkup, you may try 1/2 oz of apple juice with 1/2 oz of water twice per day. Do NOT change formulas unless you have talked to the doctor first.
Toddlers
Toddlers often develop constipation and it usually has a dietary cause. Whole or "Vitamin D" milk is high in fat and many toddlers drink too much of it. If your child is drinking more than 20 oz of whole milk per day and is over 2 years of age, you can gradually switch him/her over to 1 % milk which may help alleviate the constipation. Another reason toddlers are more prone to constipation is that they often go on food "jags" where they want the same foods over and over again. So if your toddler is a peanut butter and jelly or macaroni and cheese fanatic, try putting cheese on veggies to get her to eat them or make his sandwich with whole wheat bread instead of white bread to increase his fiber. If your toddler continues to have constipation despite these changes in diet, make an appointment to have him/her examined.
A child with an ear infection is often fussy and does not eat well because of the pain of the ear. If you have been seen in the office and given a prescription for an antibiotic, start it immediately. Even with the antibiotic, your child may continue to be fussy and run fever for two more days. If you have not yet been seen in the office, or while you are waiting for the antibiotic to work, there are several things you can do to make your child more comfortable.
1.You may warm up some olive oil or garlic oil (found in most health food stores) on a spoon and put 3 drops in the sore ear. You may do this every 3-4 hours if needed to relieve pain. To warm the oil, warm a spoon under warm (NOT hot) water. Dry the spoon and then place the oil on the spoon. you may test the temp of the oil by dropping a drop on you forearm before putting it in your child's ear.
2.If your child is over 2 months of age, you may give him acetaminophen for the pain. You may give acetaminophen every FOUR hours if needed for no more than 3 days in a row. If your child is over 6 months of age, you may use Ibuprofen for pain. Ibuprofen may be given no more than every EIGHT hours for 3-4 days.
3.You may place a warm washcloth on your child's ear as this will also help soothe the pain.
Call the office immediately if:
1. If your child urinates ("pees") fewer than 3 times in 24 hours
2. If your child acts very weak or sick even after the fever goes down
3. If your child develops a rash that looks purple or develops a rash that looks like welts
Sore throat can be caused my many things, only one of which is Strep. There are several things you can do to keep your child comfortable until going to see the doctor.
1. Give your child plenty of cool fluids to drink. Stay away from acidic things like juice or soda. Instead give cold water or tea. Salty broth like warm chicken noodle soup will also help reduce some of the pain associated with a sore throat.
2. Give your child soft foods to eat like pudding, popsicles, mashed potatoes, macaroni, etc. Soft foods won't scratch an already sore throat.
3. Acetaminophen or Ibuprofen will help reduce the pain, and if your child has a fever, it will bring the fever down as well.
Call the doctor immediately if:
1. Your child cannot swallow liquids
2. Your child has a temp above 104.5
3. Your child is vomiting and cannot keep down liquids
4. Your child has a rash that looks purple or a rash that looks like welts
5. Your child's neck hurts when s/he bends it forward
Vomiting:
1. Give your child's stomach a rest for 1 hour.
2. After resting your child's stomach, you may slowly start giving your child SMALL amounts of fluid. Start with an electrolyte solution like Pedialyte, give your child 1 teaspoon to drink every few minutes for 1 hour. If s/he is able to keep this down without vomiting, you may increase the amount to 1 oz every 15-20 minutes for another 2 hours.
3. If s/he tolerates this well, you may increase the amount to 2oz every 30 minutes for the next 4 hours. Do not attempt to give any solid foods during this time as it may start the vomiting cycle all over again.
4. Next you may increase the fluids to 4oz every hour. Since most children develop diarrhea after vomiting, do not give your child juice for 48 hours, as it will make diarrhea worse.
5. You may give your child "Gripe Water" (found at many pharmacies) as the ginger in this may help settle the stomach. Follow the instructions on the bottle for how much to give.
6. After 18 hours with no vomiting, it is safe to restart solid foods--stick with bland foods for 1-2 days after the illness has ended.
Call the doctor immediately if:
1. your child has diabetes or if you have a strong family history of diabetes
2. your child is not able to keep down the small sips of fluid
3. your child is vomiting a yellow-green colored fluid ("bile")
4. your child has severe abdominal pain or a swollen tummy
5. your child has not urinated in more than 6 hours
6. your child's neck hurts when s/he bends it forward
Diarrhea:
1. Stop all juices and sodas as the sugar content in these will make diarrhea worse.
2. give your child foods from the "BRAT" diet : Bananas, Rice, Applesauce and Toast--starchy foods will help firm up the stools
3. Yogurt is also a good food choice for children with diarrhea -- it contains lactobacillus, a good bacteria found in healthy tummies which is washed out when your child has diarrhea
4. You can also replace your child's lactobacillus with a powdered lactobacillus from the pharmacy. Ask your pharmacist for "Florastor" or a similar product. This may shorten your child's diarrhea by several days.
call the doctor immediately if:
1. your child is unusually weak or sick appearing
2. your child develops a rash that looks like tiny broken blood vessels ("petechiae")
3. your child has not urinated in more than 6 hours
4. the diarrhea has blood in it
5. your child has a fever above 104.5