URGENT CARE, SICK VISITS, AND COMMON COMPLAINTS
On this page you can review general information on common pediatric complaints. However, please be aware that every child is different, and you should always listen to specific instructions given by your provider. Below you can read about antibiotics, asthma, bedwetting, colds, colic, constipation, croup, ear infections, eczema, fever, overweight children, spitting up/reflux, and vomiting and diarrhea. Please remember that our providers are available 24 hours a day by phone to answer your questions.
Antibiotics are medications used to treat bacterial infections. There are many types of bacterial infections, and these are sometimes hard to distinguish from viral infections. Viral infections ARE NOT treated with antibiotics. Schedule an appointment so your provider can see if your child's illness requires an antibiotic. Please be aware that antibiotics are not routinely prescribed over the phone.
Asthma accounts for over 3,500 deaths each year, and over 150,000 children will be admitted to hospitals across the country. With careful management and frequent follow up with a provider, the vast majority of these could have been prevented. Even when your child feels well, it is important to continue taking the medication in the way it was prescribed. Asthma management consists of a medication called albuterol that is given for you to use when you are having problems. Often, a second medication is given for you to use everyday, even when feeling well. It is important to use this daily inhaler to decrease underlying inflammation in the lungs. You often cannot tell this inflammation is present. If this inflammation goes untreated, it increases the chances of death, hospitalizations, and long term consequences like COPD and reliance on supplemental oxygen. It is important to always use your spacer when using your inhalers, regardless of your age. It is also important to rinse out your mouth after using the daily inhaler to prevent fungal infections. To view the proper way to use your inhaler, watch an instructional video here.
Many children will continue to wet the bed even after the have become potty trained during the day. Most of the time, this will resolve by the time your child is 6 years old. If it is still present at 6 years old, then an appointment is warranted. The majority of these children have a parent that also had issues with bedwetting. Other medical problems causing bedwetting are rare and your provider will decide if further investigation is warranted. However, please be aware that this is not your child's fault. No amount of punishment or negative reinforcement will help with your child's bedwetting. In fact, these strategies may make problems worse. Virtually all children will outgrow this problem if just given time. Although, there are a variety of treatment options available to help with special circumstances like sleepovers.
Colds are a very common pediatric complaint and make up the majority of sick visits, especially during the winter months. Your child may cough, sneeze, wheeze, have fever, or be fussier than normal. Many different viruses cause colds, including RSV. Often other people in the household will have similar symptoms. Antibiotics do not treat colds. For young children, the mainstay of treatment is suctioning with saline. There are not many medication options for young children. Saline drops are sold in virtually every pharmacy as are devices used for suctioning. Suctioning is most important just before feeding and before going to sleep. Using a humidifier can also help clear congestion from your baby's nose. For detailed instructions on how to suction your baby's nose, click here.
Colic is described as inconsolable crying in infants typically less than four months old. Many people believe that colic is related to cramping abdominal pain or gas. The truth is, gas pain is probably only one of many different reasons for colic. For this reason, colic remains a complex and difficult to treat condition. Currently, colic is treated symptomatically with soothing techniques. This includes swaddling snugly, offering pacifiers for sucking, swaying back and forth while holding your child, and offering your child a calming environment. Sometimes, probiotics and gas drops are used to treat colic. This has some success with some children but does not improve every child's symptoms. However, they do remain a safe treatment option. All children will eventually outgrow colic. If your infant has just recently started crying or exhibiting new or worsening behaviors, an appointment is warranted to evaluate your child for other conditions. Colic can be stressful for parents. If your child is diagnosed with colic, it is important that you have help. Take turns with other caregivers dealing with your infant. Sometimes no other caregiver is available. If you find yourself getting frustrated, place your infant in a safe place, like their crib or pack-n-play, and leave the room for a few minutes. This will give you time to breathe for a moment before returning to care for your child.
There is a wide range of what is normal when it comes to infant bowel movements. Some infants will have a bowel movement with every feeding, others may go several days without a bowel movement. The most important thing is that the bowel movement is soft. Hard balls are concerning for constipation. Parents often get distressed because it seems like their infant is having trouble stooling. It is very normal for infants to turn red, grunt, strain, and get mildly fussy while having a bowel movement. To help your infant, you may bicycle their legs. If your child has white or red stools, you need to seek medical attention.
In older children, the goal is to have a soft bowel movement every 1-2 days. If your child is passing hard stools, please speak to your provider.
Croup is a specific type of viral illness that results in upper airway swelling and often a "barky" cough. Your child may also have other symptoms of a viral illness like a snotty nose. Sometimes the upper airway swelling worsens, and your child will develop "stridor". Stridor is a sound that is made while your child inhales. If you think your child has stridor, there are two things you can try at home to improve it. The first is very warm humidified air. This is often accomplished by sitting in the bathroom with the door shut and a very hot shower running. Steam will fill the room and can help improve your child's breathing. Another option is cold dry air. If it is winter time, you can take your child outside to breathe the cold air. If it is not cold outside, you may hold your child in front of the freezer door and allow them to breathe in the cold air. Please make sure your child is dressed appropriately so they stay warm. If neither of those options work, please seek medical care.
Ear infections are very common in early childhood, although, they can happen in older children and adolescence as well. Ear infections are commonly treated with antibiotics. However, some ear infections will resolve on their own without need for antibiotics. You can discuss with your doctor if antibiotics are right for you during your visit. If your child has recurrent ear infections, they may be referred to a specialist for tube placement. It is helpful to let your provider know if your child has been seen at another office and treated for an ear infection in the past.
Eczema is a life long condition but can be managed with daily skin care. The best way to prevent eczema flare-ups is to use daily moisturizers. When it comes to moisturizing your skin, thicker is better. The gold standard is 100% petroleum ointment. However, we know the thickness of this ointment can be very messy and difficult to use consistently. For this reason, there are many other great products that remain available including, Aquaphor and Eucerin. Scented lotions should be avoided, as this can make eczema worse. Washing any clothes, sheets, towels, or blankets in scent free laundry detergent without fabric softeners or other scented products is also recommended. These types of laundry detergents are often labeled as "free and clear". Using mild soap, such as Dove, can also help moisturize skin. Your provider may also prescribe a topical steroid to use when you are having an eczema flare-up. If your eczema is very severe, you may be referred to a specialist to discuss other medication options.
Fever is defined as any temperature 100.4 degrees Fahrenheit or higher. Fever itself is not an illness but a sign of illness. Fever is your body's response to several types of illnesses and actually helps your body deal with illness more effectively. At your visit, your provider will examine your child to find the reason for their fever. Most of the time, your child's fever is caused by a virus and needs no specific treatment other than fever reducers. There is not a specific temperature that increases your child's risk for complications. The two most important things when addressing fever are finding the cause and treating the fever to help your child feel better. If needed, acetaminophen (Tylenol) and ibuprofen (Motrin) are two medications used to decrease fever. In addition to these medicines, you need to make sure your child is drinking plenty of fluids to stay hydrated. For appropriate dosing of medications, click here.
Children are considered overweight if they are between the 85th and 94th percentile for BMI and obese if they are above the 95th percentile for BMI. We know this can be a difficult topic to discuss with your provider, especially for our adolescent patients. We also know that your child's worth is not defined by their place on a growth curve. However, this remains one of the biggest predictors of long term health in patients. What used to be considered "adult only" problems, like Type 2 diabetes and high blood pressure, are becoming more and more common in children every year. Our job is to help you and your child build habits that will make them healthy now and for many years to come. Ultimately, our job as pediatric providers is to help children have a solid foundation of health before becoming an adult. Please be assured that any discussions we have in the exam room remain confidential and protected by federal law. You can refer to our well child page to find handouts that give recommendations on diet and exercise. You can also find more information on healthy eating here.
Almost every infant will spit up to some extent during infancy. This is a very common problem and happens for a variety of reasons related to your child's normal development. Almost all children will eventually outgrow this problem given time. Most of the time, the severity of spitting up can be reduced by frequent burping, keeping children upright for 30 minutes after feeds, and making sure to not overfeed your child. Feeding guidelines can be found in the routine guidance section of our well child page. The most important thing regarding reflux is that your child is growing appropriately. If your child is gaining weight appropriately, not choking and turning blue, and not irritable every time they spit up, then reflux is more aggravating than it is dangerous. If you feel that your child is spitting up in an abnormal way, please speak to your provider to discuss treatment options.
VOMITING AND DIARRHEA
Vomiting and diarrhea often occur during the course of a single illness, although your child may experience one without the other. While there are medical conditions that cause vomiting and diarrhea that require a specific treatment, most of the time this will resolve if just given time. Your child may be in danger of dehydration during this illness. It is important to encourage your child to drink plenty of water or pedialyte. In general, we try to avoid juice because the amount of sugar it contains can make your child's diarrhea worse. We also prefer to avoid orange or red drinks to avoid any confusion of whether or not there is blood present. If your child prefers orange or red colored beverages and you are having trouble getting them to drink plenty of water, then the obvious need for keeping your child hydrated outweighs any potential confusion. If your child has been vomiting or having diarrhea for more than 48 hours an appointment is needed. Obviously, some children may need appointments sooner if illness is severe.