Children

Children often seem to get sick one minute after the pediatrician’s office closes. At our offices, you are always able to contact the nurse or physician on call. In addition, we’ve provided some basic medical information for children’s most common ailments. While this information is intended to inform and educate you on several medical topics, it is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.

Coughing

Coughing is a normal part of many illnesses, and is usually caused by a viral infection, either in the throat (tracheitis) or the lungs (bronchitis). The infections themselves are usually not serious, and it is important to remember that, though coughing may sound serious, it is in fact a beneficial reflex that helps clear out the child’s airways and helps protect against pneumonia.

For children over 4, the most common and usually the most effective treatment is a cough drop. Cough drops help coat the irritated throat and relieve the associated discomfort. For children between 1 and 4, a teaspoon of honey can work as a homemade cough syrup to thin secretions and loosen the cough. To help relax the airway muscles and loosen the mucus, you should also give children warm liquids, such as hot herbal tea or warm juices, but only if your child is older than four months. Also, humidifiers can help loosen coughs that are irritated or worsened by dry air. Also be sure that children with bronchitis avoid physical exercise, as it may trigger coughing spasms, and that all children with cough symptoms avoid any second-hand smoke. If your child has trouble breathing when not coughing, has a cough that lasts more than three weeks, or has other severe symptoms, you should call our office immediately to schedule a consultation.

Cold

For colds, it is important to remember to aspirate the child’s nose before feedings and before bedtime. To do this, simply put two to three drops of saline solution (such as Salinex or Pediamist) into each nostril, then suck them out with a bulb syringe. When the child is in a chair or in bed, be sure also to keep the head elevated. You can also use a cool mist humidifier to keep the air humid, and offer water in addition to milk to keep the child sufficiently hydrated. If you have any questions about cold treatments, call our office.

Abdominal Pain

Most cases of stomach aches are caused by overeating, or bloating from carbonated drinks. In these cases, the pain usually subsides within one or two hours, and is best treated with rest and perhaps a warm washcloth over the stomach area.

However, if your child complains of stomach aches that are severe or constant and last for more than several hours, then it can be caused by any number of other factors. Constipation or diarrhea can lead to stomach aches, in which case simply encouraging the child to go to the bathroom and sit on the toilet may lead to some relief. If the child has a stomach flu, the aching will soon be followed by other signs such as vomiting and diarrhea. If your child has stomach aches that are mild but reoccur often, they may be from stress and worries: in fact, over ten percent of children have at some time complained of such stress-related pains.

Treatment
While your child has abdominal pains, you should avoid giving them solid foods and any medication (such as laxatives or painkillers) unless you have first talked with a medical professional. Smaller children may also refer to nausea as a stomach pain, so you should have a vomiting pan readily available. Call our office immediately if your child’s abdominal pain is:

severe and lasts more than an hour
constant and lasts more than two hours
recurrent and lasts more than 24 hours

Constipation

When bowel movements are infrequent, or are difficult or painful to pass, this is known as constipation. A constipated child may feel a need to pass a bowel movement but will be unable to while on the toilet, or may simply go several days without passing a bowel movement, even if there is no other pain or symptoms involved. With the exception of breast-fed babies, children who go three days without a bowel movement should be considered constipated.

Treatment
The main cause of constipation is insufficient amounts of fiber in the child’s diet; therefore the easiest and most effective treatment for constipation is dietary changes. For babies over two months old, add more fruit juices to the diet such as apple and pear juices. For babies six months or older, you can also add foods high in fiber such as apricots, prunes, pears, beans, peas, and barley or oatmeal cereals. For children over 4, popcorn is also an excellent choice for fiber. It is also important to remember that, even after the constipation has passed, to continue to keep your child on a healthy, fiber-rich diet for optimal digestive health.

If your child is experiencing rectal pain, you can help relieve it by giving the child a stool softener or have them soak in a warm bath to help release the anal muscles. If your child has severe pain, or continues to have constipation even after three days on the fiber-rich diet, call our office for an evaluation.

Diarrhea

Diarrhea is the medical condition in which bowel evacuations undergo a sudden unexpected increase in both frequency and looseness. The best indicator for the severity of diarrhea is the frequency of bowel movements. A few mushy bowel movements usually indicates mild diarrhea, whereas several very loose or watery bowel movements usually indicates severe diarrhea. Diarrhea is typically caused by a viral infection in the intestinal lining, known as gastroenteritis. It can also be caused by other factors, including bacteria, parasites, food allergies, dietary changes or even an excess of fruit juices. If the child’s stools are loose and watery for only one or two evacuations, it is rarely a cause for alarm and is usually attributed to something unusual the child ate or drank.

Treatment Options
Diarrhea itself cannot usually be treated directly. Instead, the main cause for concern associated with diarrhea is treated: dehydration. Dehydration can occur frequently with diarrhea if the child is evacuating significantly more bodily fluids than she is taking in, which is why it is important for children with diarrhea to be given plenty of liquids. Regardless of what you do to treat it, you should expect a case of diarrhea to last from several days to a week, and you should focus on keeping the child well hydrated during this period. The method you should choose, however, can depend on my factors, including the child’s age and diet. If you notice any signs of severe dehydration, any blood in the stool, or excessive vomiting, you should call our office immediately.

Other Considerations
Of the many myths surrounding diarrhea, the most dangerous one is the idea that the child’s intestine should be “put to rest.” Never restrict fluids, because that can lead to dehydration. Instead, offer the prescribed liquids and solids described above, and remember that the child needs not only enough hydration, but sodium and calories.

Also keep in mind that diarrhea is a very contagious condition. Always wash your hands after changing diapers or using the bathroom, and be sure that the toilet, tub, sink or changing area is clean as well. This will help prevent any other children or family members from getting diarrhea. When cleaning your baby with diarrhea, be sure to wash the area around the anus and then protect it with petroleum jelly, as diarrhea can irritate the skin.

Ear Infections

An ear infection is caused by either bacterial growth or a viral infection. Usually, the eustachian tube in the inner becomes inflamed, and fluids build up behind the eardrum, causing pain.

Ear infections are very common in children because they are more susceptible to them for a variety of reasons. Children’s eustachian tubes are much shorter, narrower and more horizontal than adults’ ear passages. Therefore fluid can more easily be trapped in children’s ears. Children’s immune systems are also not as advanced as adults’, so once they have an infection, it is harder for their bodies to fight it.

Common Symptoms of an Ear Infection
Infants and children can have many symptoms during an ear infection, including:

Ear pain (Infants will pull or tug at their ears.)
Complaints of muffled hearing/hearing loss
Cold symptoms, such as runny nose, cough, fever, etc.
Ear drainage, usually yellow or white fluid draining from the child's ear that is different than ear wax
Loss of appetite
Trouble sleeping
Resistance to lying down flat

Types of Treatment
Your child’s pediatrician or an ear, nose and throat specialist has several types of treatments. These treatments include:

Wait-and-Observe – Many doctors suggest that parents wait and observe their child for 48 – 72 hours. Many times, the child’s immune system can clear up an ear infection on its own. If the problems persist, then parents are advised to schedule an appointment for their child.
Medications – Doctors can prescribe many medications for ear infections, including:
- Medicated numbing drops – to alleviate inner ear pain
- Over-the-counter pain relievers – acetaminophen, ibuprofen, etc. to alleviate inner ear pain, reduce fever, etc.
- Antibiotics – ampicillin, amoxicillin, cefaclor, clarithromycin or the combination drug trimethoprim/sulfamethoxazole (Bactrim) to treat ear infections. These antibiotics work only if the infection is not caused by a virus.
Myringotomy Procedure – When the inner ear is severely obstructed, a small incision is made into the eardrum in order to alleviate pain and pressure and to drain the fluid. The incision usually heals within two weeks unless pressure-equalizing tubes are placed in the eardrum to keep it open. As the eardrum heals and grows, the tubes are naturally forced out. When performing this procedure, we will use strong sedation and/or general anesthesia so your child does not feel any discomfort.

Chickenpox

Chickenpox is a common illness among children, especially those under age 12. It is characterized by a red, itchy skin rash that initially begins as multiple, small red bumps, resembling pimples or insect bites. The bumps develop into thin-walled fluid filled blisters, which then crust over and scab. The rash typically develops first on the abdomen, back or face, and then extends to other areas of the body, including the mouth, nose, ears, genitals and scalp. Along with the rash, children may experience:

Fever
Headache
A dry cough
Loss of appetite
Pain in the abdomen
Discomfort and irritability

Chickenpox is caused by the varicella-zoster virus and is extremely contagious among people who are not immune to the virus. It can spread quickly; specifically in places were children are in close contact, such as in schools or daycare facilities. Chickenpox is spread through physical contact with a rash, or by droplets diffused into the air due to coughing or sneezing. Children who have had the virus or have been vaccinated are immune. Your child is at risk if they have not been vaccinated or have not had the disease.

While most cases of chickenpox are mild, the disease can affect infants and teens with weak immune systems more severely. Some children with a normal immune system can experience other complications, such as a skin infection near the blisters.

Treatment
Most cases of chickenpox require no medical treatment. Your child’s pediatrician may prescribe antibiotics if bacterial infection is present, which can commonly occur among children since they scratch and pick at the blisters. An antihistamine may also be prescribed to relieve itching. If your child is at a high risk for experiencing complications, the doctor may prescribe an antiviral drug designed to reduce the severity of the condition, permitted it is taken 24 hours after the rash appears.

Contact the doctor if your child has:

a severe headache
an area of rash that becomes warm, red, swollen or sore or leaks pus
a severe cough or difficulty breathing
a fever lasting more than four days or rises above 102° F

You should also contact your child’s physician if he or she is vomiting, and is very sick, appears confused, has trouble walking, has a stiff neck, finds it difficult to look at bright lights or is unusually sleepy and has trouble waking up.

To help alleviate fever, itching and discomfort commonly accompanied by chickenpox:

For the first few days, apply cool, wet compresses or bathe your child in cool or lukewarm water every three to four hours. Be sure to pat them to dry them off. Do not rub.
Apply calamine lotion to all itchy areas except the face, particularly near the eyes.
Since chickenpox that spreads to the mouth can make eating or drinking difficult, give your child cold, soft and bland foods. Do not give them anything that is very acidic or salty.
Ask your child’s doctor to recommend a pain-relieving cream for the genital area, and an over-the-counter medication for itching.

Do not give your child aspirin to reduce pain or fever. Aspirin can cause Reye syndrome, which can lead to liver failure and death.

Most importantly, encourage your child not to scratch. Place mittens or socks or their hands to prevent them from scratching at night. Keep their fingernails clean and trim them to prevent broken blisters and infection.