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This area of the web site provides concise answers to frequently asked questions. As with all written advice, use it as a general guideline and reference. Do not make significant medical decisions on your own. For pediatric advice on a wider range of subjects we recommend the web site “The Pediatric Advisor”.

Common Illnesses (11)


  • Pain or discomfort around the ear.
  • Child reporting ear pain.
  • Child acting like previously with ear infection (crying, fussy).


  • Give acetaminophen or ibuprofen (if older than 6 months)
  • Raise the head of the bed 30 – 45.
  • Apply warm compress to ear – if older than 1 year.
  • Try a few drops of warm Oragel to affected ear. DO NOT USE IF EAR IS DRAINING.
  • If earache persists to the morning and child has a fever, call for an appointment.

Remember: Earaches do not always indicate an infection.


  • Elevation of the normal body temperature.
  • Fever is a friend – it helps the body fight infection.
  • Fever is not dangerous and will never go high enough to cause harm (even when over 104 F).
  • Fever is often higher in the evening and lower in the morning.
  • Fever should only last 2-3 days.


  • If temperature is below 101 F – no treatment necessary.
  • Increase daily fluid intake.
  • Keep child lightly dressed with clothes that will breathe.
  • Give acetaminophen or ibuprofen for comfort.
  • For temperatures above 103 F – bathe child in lukewarm bath 20-30 minutes (water temperature should be around 98 F).
  • Call immediately if child is under 2 months of age and has a temperature above 100.5 F, child is difficult to arouse or does not interact with you, child is complaining of stiff neck or not able to move neck.
  • Call during regular office hours if the fever last longer than 3 days.


  • Runny or stuffy nose (drainage may be clear, cloudy, yellow or green).
  • Associated symptoms: fever, sore throat, cough, red eyes.
  • The average child will have as many as 8 colds per year. Children in day care setting may get a cold every 2-3 weeks during the winter season.
  • Antibiotics and cold medication will not cure a cold.


There is no cure for a cold but offer comfort support including:

  • Give acetaminophen for fever or discomfort.
  • Increase daily fluid intake.
  • Use a cool mist humidifier to moisturize secretions (remember to change water daily).
  • Raise the head of the bed 30- 45 (Infant may sleep in car seat).
  • Nasal saline drops or spray and nasal suctioning as needed.
  • Children over 1 year of age may use oral decongestants (pseudoephedrine) as needed to decrease congestion for a few hours.

Cough is one of the body’s own way of getting rid of mucus, so unless it is painful or keeping the child awake, do not give cough suppressants.


  • Pain or discomfort in the throat, worsens with swallowing.
  • Child under 2 years of age doesn’t know how to complain of a sore throat, but may refuse previously enjoyed foods or cry with feedings.


  • Gargle with warm salt water (1 tsp. per 8 oz glass of water)
  • Give acetaminophen or ibuprofen for comfort.
  • Encourage cold fluids or foods.
  • Soft bland diet – avoiding spicy, acidic or rough textured foods.
  • Call during regular office hours if sore throat lasts longer than 24 hours, it is accompanied by fever, the child has recent contact or exposure to strep throat, it is accompanied by abdominal pain, vomiting or headache, if a rash develops.
  • Call immediately if there is drooling, difficulty breathing, or swallowing.


  • Strike or blow of the head, may not always include loss of consciousness.
  • If loss of consciousness call office immediately.
  • If child remains unconscious or looks critically ill – call 911.

Treatment (if no loss of consciousness):

  • Clean any scrapes or cuts with soap and water.
  • Apply direct pressure to cuts for 10 minutes to control bleeding (Caution: head injuries tend to bleed heavily).
  • Apply cool compress or ice pack to affected area to decrease swelling.
  • Give acetaminophen for headache.
  • If child is sleepy allow them to sleep, but stay nearby and arouse every two hours during the day or four hours during the night.

Observe child and notify your doctor if any of the following are noticed:

  • Child has a deep cut in the scalp that may need suturing.
  • Child becomes disoriented, confused or dizzy.
  • Child begins vomiting more than twice ( is not uncommon for child to vomit right after injury occurs if upset).
  • Child is having difficulty speaking or blurred vision.
  • Child is having blood or watery fluid from nose or ears.
  • Child cannot remember how injury occurred.
  • Child is unusually sleepy.


  • Tight, low pitched barky cough (seal like bark).
  • Voice or cry hoarse sounding.
  • Child may have stridor – crowing like noise when child breathes in as croup becomes worse.
  • Symptoms tend to increase in the evening and last for 5 -6 days.
  • Associated symptoms include fever or nasal congestion.


Croup without stridor:

  • Cool mist vaporizer at night.
  • Increase daily fluid intake. Use warm fluids if having cough spasms to relax airways.
  • Ibuprogen if older than 6 months. Cold medications or antibiotics do not cure the illness.

Croup with stridor:

  • Take child outside for 5 -10 minutes into cold night air or have the child breathe in air from an open freezer.
  • Foggy bathroom -turn on the hot water in the shower and close the bathroom door. Bring the child into the foggy room to breathe the warm moist air for 10-15 minutes.
  • If these measures are unsuccessful call the office immediately.


  • Hard, dry stools that come infrequently.
  • Sometimes cause pain and bleeding during BM.
  • No BM longer than 4 days (exception – exclusively breast fed infants may go longer periods up to 7 days).


Infant (0 – 2 months)

  • Try using a well lubricated thermometer or Q-tip to stimulate the rectum.
  • Give 1/2 – 1 oz prune juice mixed with an equal amount of water once daily as needed.
  • If these steps do not work, call for further consultation during regular office hours.

2 months – 1 year

  • Above treatments.
  • Limit binding foods such as bananas, rice cereal, and applesauce.
  • Increase high fiber content foods (fresh fruits and veggies).
  • Add fruit juices to diet (no more than 8-10 oz per day).
  • A warm bath may decrease abdominal cramps and encourage a BM.
  • If these steps do not work, call for further consultation during regular office hours.

Over 1 year

  • Above treatments.
  • Limiting binding foods above plus excessive dairy products (milk >16-20 oz a day, cheese, yogurt).
  • Increase high fiber foods including bran, whole grains, oatmeal, (popcorn if over 3 years of age).
  • May try pediatric glycerin suppository once or twice.
  • If these steps do not work, call for further consultation during regular office hours.

Most vomiting in infants and children is caused by a viral infection of the stomach (viral gastroenteritis). Occasionally, it may be caused by eating something that is spoiled (food poisoning). Vomiting usually lasts less than 24 hours. Treatment is directed towards preventing dehydration. Diarrhea frequently accompanies vomiting. It, too, is usually caused by a virus although it may occasionally be caused by bacteria (for example Salmonella). Diarrhea can last a lot longer than vomiting (a few days to a week). Again, treatment is directed towards preventing dehydration.

While the child is still vomiting intermittently, you should try to rehydrate with small frequent feeds of clear fluids, preferably electrolyte-containing solutions (Pedialyte, Gatorade). Large volumes can induce vomiting.

Infants (Bottle-fed)
For young children, Pedialyte is a good fluid. However it should not be used for more than 24 hours without consulting a physician. Give small amounts (1-2 oz at a time). If this is unsuccessful, try 1-2 teaspoons every 10-15 minutes. After 4 hours without vomiting, slowly increase the amount. After 8 hours without vomiting, you may return to giving formula. Reintroduce a normal diet in 24 hours. With severe diarrhea your doctor may recommend giving a lactose-free formula for several days or until the diarrhea subsides.

Infants (Breast-fed)
Provide breast milk in smaller amounts. Your goal is to avoid completely filling the stomach. If your child vomits frequently, try nursing on only one side every 1-2 hours. If vomiting persists, nurse for five minutes every 30-60 minutes. After 8 hours without vomiting, return to routine breast feeding. If the vomiting is persistent you may also try giving Pedialyte 1-2 teaspoons every 10-15 minutes (and pumping your breasts) for several hours. Breast feeding may be resumed if the baby has tolerated the Pedialyte feeds for 2-3 hours without vomiting.

Older Children
For older children Gatorade, diluted to 1/2 strength with water, is better than either soda or juice. Pedialyte ice pops also work very well. Initially, do not attempt to feed the child solid foods while the child is still vomiting. The key is encouraging small amounts of clear liquids every 10-15 minutes. If your child continues to vomit, hold liquids for 1-2 hours than reintroduce slowly. Feeding of solids can be reintroduced once vomiting has ceased for 8 hours. Start with bland, starchy foods at first. For persistent diarrhea foods such as shredded wheat and peanut butter can slow gastrointestinal transit time and help bulk up the stools.

When to call the Physician:

  • If vomiting persists for greater than 24 hours
  • If your child does not urinate for greater than 8 hours
  • If you notice blood in the stools
  • If your child develops severe abdominal pain
  • If you child looks very ill

Conjunctivitis, commonly known as “pink eye”, is an inflammation of the membrane (conjunctiva) that covers the white part of the eye and lines the inner surface of the eyelid. There are three main causes of conjunctivitis. One cause involves the introduction of either bacteria or viruses into the eye. These germs may be transmitted to the eye by contaminated hands, washcloths, towels, or cosmetics (particularly eye makeup). Mild cases of conjunctivitis many times will occur with a cold or viral infection. Although bacterial and some of the viral infections (particularly herpes) are not very common, they are potentially serious. Both types of infection are contagious. Irritants are another cause of conjunctivitis. Offenders of this type include air pollutants, smoke, soap, hairspray, makeup, chlorine, cleaning fluids, etc. Lastly, some individuals acquire conjunctivitis due to a seasonal allergic response to grass and other pollens.

Various combinations of the following symptoms may be present: itching, redness, sensitivity to light, swelling of the lids and/or discharge from the eyes. The consistency of possible discharge may range from watery to purulent (pus-like), depending on the specific cause of the conjunctivitis.

It usually takes from a few days to 2 weeks for most types of conjunctivitis to clear. Conjunctivitis due to an allergy may continue as long as the offending pollen is present. With such conditions, symptoms are likely to recur each year.

Treatment varies depending on the cause. Medications in the form of ointments, drops or pills may be recommended to help kill a bacteria infecting the eye, relieve allergic symptoms and/or decrease discomfort. In the case of conjunctivitis due to a viruses your pediatrician may recommend that you be patient and let it run its course.

Other measures that should be followed:

  • Apply cool compresses to the infected eye(s) 3-4 times per day for 10-15 minutes using a clean washcloth each time. This should help reduce itching and swelling and provide some comfort.
  • Wash your hands frequently and keep them away from your eyes.
  • Avoid rubbing your eyes to decrease irritation of the area.
  • Wear sunglasses if your eyes are sensitive to the light.
  • Avoid exposure to the irritants which may be causing the conjunctivitis.
  • Dispose of old eye makeup if the culture for bacteria is positive.
  • Use a clean pillowcase each night.
  • Avoid wearing contact lenses while you are using medications or if your eyes are uncomfortable.

Although many kinds of conjunctivitis are hard to prevent, there are measures that can be taken to decrease your risk of reacquiring or spreading it to someone else. These are listed below:

  • Do not share eye makeup or cosmetics of any kind with someone else.
  • Avoid sharing washcloths or towels.
  • Wash hands frequently and keep away from the eyes.

When to call the doctor:
If any of the following problems should occur, notify your clinician:

  • Visual changes
  • Severe eye pain
  • Pain when moving eyes
  • No improvement with medication within 48-72 hours
  • Drainage continues after you have completed full course of medication
  • Eyes become very sensitive to light

Diaper rashes are common in infants and young children. Diaper rashes can vary from a mild redness (the most common kind) to painful open sores in the area of the abdomen, buttocks, genitals, and within the folds of the thighs. The causes are many, as are the prescriptions and non-prescription creams, ointments and powders that parents use to manage these rashes. Excessive wetness, diarrhea, diaper sensitivities, food sensitivities and antibiotic use are just some of the precipitating factors. Avoidance of commercially available wipes (even the scent-free, alcohol-free ones) may help prevent diaper rash in the first weeks of life. Cotton balls, gauze and soft cloths (cloth diapers as wash cloths) with some warm Dove-soapy water may be used, particularly when not on the go.

Many parents find Vaseline useful as a protector before re-diapering. If an irritative rash is noticed, change diapers frequently and keep the area as dry as possible. Creams and ointments, such as zinc oxide, A&D, Balmex and Desitin may be used for simple irritative diaper rashes. Some parents prefer powders such as cornstarch or Caldescene, applied carefully and limited to the diaper area. Yeast rashes or blistering rashes may be more stubborn. If a diaper rash is persistent, a call or visit to the office may be necessary.

Nose bleeds (Epistaxis) are rare in infancy, but become common in childhood. Their frequency decreases in puberty. Common causes include digital trauma, foreign objects in the nose, dry air, and inflammation. In addition, they may be caused by upper respiratory infections, sinusitis, and nasal allergies. In children with nasal lesions, bleeding may occur after exercise. In many children, there is a family history of childhood epistaxis. When bleeding occurs, the blood may be swallowed. If this causes an upset stomach, your child may vomit up red blood. If the blood passes through the intestine, it may turn the stools dark or black.

When your child has a nose bleed:

  1. Have your child sit up straight with the head tilted slightly forward.
  2. If the child is old enough, have him/her gently blow out any clot that is sitting in the nose.
  3. Squeeze the TIP of the nose closed using thumb and fingers. A gauze pad or some tissues will keep the fingers of the nose-holder clean. Do not hold the nose over the bridge or sides. It has to be the tip.
  4. Hold for 10 minutes without letting go of the tip. Hold firmly, then gently let go. All of the bleeding should be stopped. If it is not, resume holding.
  5. If holding a second time does not work, call our office.
  6. If nose bleeds are common, try putting antibiotic ointment on a Q-TipTM swab and coating the inside of the nose. Be especially sure to cover the septum, which is the divider between the two sides of the nose. BacitracinTM, NeosporinTM and Triple Antibiotic Ointment are all available over the counter. Apply one of them twice daily for several weeks.
  7. In winter, when the air inside your home is very dry, a vaporizer in your child’s room at night may help reduce bleeding episodes. Be sure to dry out the vaporizer each day, or it may grow mold.
  8. If nose bleeds are very common or very hard to stop, and these measures do not work, contact our office.

Medical Questions (14)

In general, between 4-6 months.Earlier than 3 months can lead to allergy problem and by 6 months the babies need the extra iron in cereals.

There’s no sure way unless you see bloody or pussy drainage from the ear. Many ear infections follow head congestion from colds or allergies. Some come with fever or difficulty sleeping and as they get older the children can tell you it hurts.

Many things affect baby’s sleep including congestion and other illnesses, hunger and loneliness. Children also vary in their need for sleep and in how deeply they sleep. If they wake during the night and aren’t used to falling asleep alone, they will wake Mommy for help.

Make sure bedtime is appropriate time and that they’re tired; then work toward some relaxing routine for bedtime. Once they’re in bed, be firm and consistent about them staying there.

Start by increasing fluids such as water and juices, humidify the bedroom and elevate their head with a pillow or blanket under the mattress. Medications for stuffy heads are widely available and worth trying but are not always effective. Saline nasal spray also helps moisten the nasal passages and loosen congestion for all ages. Mucus can be very thick and even greenish or yellow with a cold. If it lasts more than 5-7 days, a visit may be in order.

Introduce a bottle of pumped breast milk or formula in place of one feeding a day and increase the number of feedings by bottle every few days. Usually first morning or good night feedings are the last to be given up.

Use a cup more and more. Limit bottles to bedtime or illness and watch for opportunity to remove completely. Bottles can be quite harmful after many teeth are in because milk or juice at bedtime can lead to cavities if not followed by rinsing or brushing.

Generally around age 3, sooner if problems arise or later if afraid, shy or uncooperative.

When they know the words to tell you the need and are able to maneuver pants up and down, they are physically ready. Girls tend to be earlier, usually l8 months – 2 years while boys a little later, usually 2- 2 l/2 years.

Not necessarily, but we take that into account when deciding which antibiotics to prescribe.

After children have been on three antibiotic courses in a period less than 4-6 months or show signs of trouble hearing.

First step is to request testing at school to determine ability and performance. Then a meeting with that information and the doctor can be arranged to discuss the results. We may treat here or send on for other testing.

If they are under 6 and are always wet, there is not much to do but wait for their body to mature. If they have been dry and are now wetting again, there are many considerations and the child should have a urine test and probably a visit to discuss.

Yellow/green drainage is normal the first 2-3 days of a cold. If drainage persists past 5-7 days, then child would need to be seen for possible sinus infection.

DISCLAIMER: The medical information provided in this site is for educational purposes only, it is not intended nor implied to be a substitute for professional medical advice. Always consult your physician or healthcare provider prior to starting any new treatment or with any questions you may have regarding a medical condition