Frequently Asked Questions

Much of the text below is courtesy of and is credited to kidshealth.org.

KidsHealth is the largest and most-visited site on the Web providing doctor-approved health information about children from before birth through adolescence. Created by The Nemours Foundation’s Center for Children’s Health Media, the award-winning KidsHealth provides families with accurate, up-to-date, and jargon-free health information they can use. KidsHealth has been on the Web since 1995 – and has been accessed by about half a billion visitors. On a typical weekday, more than 500,000 visitors access KidsHealth’s reliable information.
1My child has a fever. At what temperature should I bring him in to be seen, and when do I need to go to the emergency room?
In healthy kids, fevers usually don’t indicate anything serious. Fever itself below 106-107 degrees almost never causes harm, and can actually be a good thing-it’s the body’s way of fighting off infections. In most cases, a fever should be treated only if it is causing discomfort. A fever higher than 104.5 may be a sign of a more serious illness, so if your child experiences a fever higher than 104.5, please call the office for evaluation. However, if your child is less than 2 months of age and has a fever of 100.3 or higher measured rectally, please call the office right away as infants that young need immediate evaluation for potentially serious infections. Tylenol or Motrin can be used to help your child feel more comfortable (see the dosing guide available at this website). Cool baths (no ice-cold or alcohol baths), dressing loosely, and drinking plenty of fluids can help him feel better. Never give a child Aspirin as it can cause Reye Syndrome, a rare but potentially fatal condition.
For more information, see http://www.kidshealth.org/parent/infections/common/cold.html
2My baby spits up all the time. When should I be worried that this is something more than just normal reflux?
All babies reflux, or spitup, at times. It is a normal occurrence because the valve that connects the esophagus to the stomach does not close completely in most babies. It is an inconvenience but usually no more than that. We get concerned about reflux, or gastro esophageal reflux, when babies have difficulty gaining weight, become dehydrated (no wet diapers in 8 hours or more), are very fussy, arching their backs and crying as if in pain, or have times when they stop breathing or turn blue. If your child has any of these symptoms, please call the office right away. If your child is growing well and doesn’t seem unduly uncomfortable, spitting up is nothing to be concerned about. Pay attention to her signals; perhaps you are feeding her more than she wants (does she push away the bottle or breast or thrust her tongue out?), or perhaps she needs to slow down her eating and get burped more often. It also may help to hold her upright for 30 minutes after feedings. Changing formulas is usually not necessary; talk to your pediatrician if you are considering switching formulas.
3My child has a cold and can’t sleep. Is there anything I can do to help her get some rest?
As cliché as it sounds, time is the only cure for colds. Medicine can’t cure the common cold, but it can be used to relieve such symptoms as muscle aches, headache, and fever. Although you may be tempted to give your child over-the-counter (OTC) decongestants and antihistamines to try to ease the cold symptoms, there’s little or no evidence to support that they actually work. In fact, decongestants can cause hallucinations, irritability, and irregular heartbeats in infants and shouldn’t be used in children younger than 2 without first consulting a doctor. You can give your child acetaminophen or ibuprofen based on the package recommendations for age or weight. Some other ways you can help ease cold discomfort include:
  • saltwater drops in the nostrils to relieve nasal congestion (you can buy these – also called saline nose drops – at any pharmacy)
  • a cool-mist humidifier to increase air moisture
  • petroleum jelly on the skin under the nose to soothe rawness
  • hard candy or cough drops to relieve sore throat (for kids older than 3 years)
  • a warm bath or heating pad to soothe aches and pains
  • steam from a hot shower to help your child breathe more easily
  • drink lots of fluids
Call the office if your child has any of these symptoms:
  • shortness of breath, breathing faster or harder
  • unusual lethargy/tiredness
  • inability to keep food or liquids down or poor fluid intake
  • increasing headache or facial or throat pain
  • severely painful sore throat that interferes with swallowing
  • fever of 103 degrees Fahrenheit (39.3 degrees Celsius) or higher
  • chest or stomach pain
  • earache

For more information, see http://www.kidshealth.org/parent/infections/common/cold.html
4There is so much on the news about vaccines, but I know a lot of it isn’t true. Where should I look for reliable information about giving my child shots?
Since the start of widespread vaccinations in the United States, the number of cases of formerly common childhood illnesses like measles and diphtheria has declined dramatically. Immunizations have protected millions of kids from potentially deadly diseases and saved thousands of lives. Vaccinations play a crucial role in keeping kids healthy. Unfortunately, misinformation about vaccines could make some parents decide not to immunize their children, putting them and others at a greater risk for illness. To better understand the benefits and risks of vaccines, some helpful websites are listed below. If you would like printed materials or have any questions, please call the office or discuss it with the pediatrician at your child’s next well visit.
Overview of immunizations and the illnesses they help prevent: http://www.kidshealth.org/parent/general/body/vaccine.html.
A review of myths and facts about immunizations: http://www.kidshealth.org/parent/general/body/fact_myth_immunizations.html.
American Academy of Pediatrics: http://ww w.cispimmunize.org/.
A recently released information sheet regarding vaccines and autism can be found here:  http://www.aap.org/advocacy/releases/autismfactsforparents.pdf.
Center for Disease Control: http://www.cdc.gov/vaccines/spec-grps/parents.htm.
5My child’s ear pain is making her miserable. What can I do until she is seen in the office in the morning?
In most cases ear pain, though extremely uncomfortable, can be managed at home until you come in to the office during regular hours. Ear pain does not automatically mean she has an ear infection; we would need to take a look in her ear before we would prescribe any antibiotic medications or other treatment. Until then, Motrin or Tylenol is the treatment of choice. Also, kids often find a warm compress placed over the ear to be soothing. If you have tried these measures and your child is still extremely uncomfortable, has a fever higher than 104.5 or any other concerning symptoms, please call our office for further advice.
6What do I do about my child’s vomiting and diarrhea?
Most of the time, vomiting and diarrhea in children are caused by gastroenteritis, usually due to a virus infecting the gastrointestinal tract. These infections often don’t last long and are more disruptive than dangerous to your child. However, if kids (especially infants) are unable to take fluids adequately they could quickly become dehydrated. Offering plenty of reassurance to your child and preventing dehydration are essential for a quick recovery. In general, no medicine should be given to stop vomiting or diarrhea as they could potentially prolong the illness. Signs that vomiting could be something more serious include fever greater than 104.5, severe abdominal pain, vomiting up blood or black specks that look like coffee grounds, or vomiting a deep green colored fluid (bile). If your child is having any of those signs or has bloody or black colored diarrhea, or is becoming dehydrated, call the office. To get your child to take fluids even if he is vomiting can be a challenge. In an infant under one year of age, water should not be given unless you are specifically instructed otherwise. Instead, give Pedialyte or other electrolyte-balanced fluid meant for rehydrating infants (avoid Gatorade and the like with infants; they have too much sugar and not enough salt). If your infant prefers his formula or breast milk, that is fine to give as well. Children can drink water, pedialyte, or any other clear fluid that they will accept (though juices can worsen diarrhea). There is no reason to limit food if your child is interested in eating as long as they are drinking, though it is normal for kids to lose their appetites when they are sick. Offer your child frequent small amounts (one tablespoon every few minutes by bottle or oral syringe, for example). Monitor for signs of dehydration, including dry mouth, soft spot that is sunken in, lethargy or difficulty arousing, or no urination in 8 hours. If you see any of these or have other concerns despite your best efforts, call the office.
7My child hasn’t had a bowel movement in more than 24 hours. Should I be worried?
It is normal for children to have bowel movements as often as a few times a day to as infrequent as once a week. A child is considered constipated when the stools are hard, dry, or large; or when it’s hard for the child to have a bowel movement. If your child has not had any other problems with stooling and does not complain of abdominal pain, it is unlikely to be anything serious. The first step in helping a child who is constipated is increasing their fluid and fiber intake. Regular exercise and sitting in the bathroom at the same time every day (especially after dinner) can also be helpful. If your child has not had a bowel movement in a week, is complaining of abdominal pain, has a fever, is throwing up more than once or twice, or you see any blood in the toilet or on the toilet paper, call the office to schedule an appointment as these may be signs of a more serious condition.
For more information, please see http://www.kidshealth.org/parent/food/general/constipation.html
8My toddler just hit his head on the coffee table; what do I do?
Call the office or go to an emergency room right away if your child is an infant; has lost consciousness, even momentarily; or if he has any of the following:
  • won’t stop crying
  • becomes difficult to console
  • isn’t walking normally
  • abnormal breathing
  • obvious serious wound or fracture
  • bleeding or clear fluid from the nose, ear, or mouth
  • disturbance of speech or vision
  • pupils of unequal size
  • weakness or paralysis
  • dizziness
  • neck pain or stiffness
  • seizure
  • vomiting more than two to three times
  • loss of bladder or bowel control
If your child is not an infant, has not lost consciousness, and is alert and behaving normally after the fall or blow, apply an ice pack or instant cold pack to the injured area for 20 minutes. If you use ice, always wrap it in a washcloth or sock; ice applied directly to bare skin can cause frostbite. Observe your child carefully for the next 24 hours. If the incident occurred close to bedtime or naptime and your child falls asleep soon afterward, check in every few hours to look for twitching limbs or disturbances in color or breathing. There’s no need to keep a child awake after a head injury. If color and breathing are normal, and you observe or sense no other abnormalities, let your child sleep (unless the doctor has advised otherwise). If color and/or breathing are abnormal, or if you aren’t comfortable with your child’s appearance (trust your instincts), arouse your child partially by sitting him or her up. If your child can’t be awakened or shows any signs of internal injury, call the office or an ambulance. For more information, see http://www.kidshealth.org/parent/fitness/problems/head_injury.html.
9Why can’t you call in an antibiotic prescription without seeing my child?
Most infections in children are caused by viruses, tiny particles that do not grow and reproduce on their own. Unfortunately, viruses do not respond to antibiotics. Some viruses may be fought off by the body’s own immune system before they cause illness, but others (colds, flu, and chickenpox, for example) must simply run their course. Antibiotics are only effective against bacteria (living single-celled organisms) because they kill these organisms by stopping their growth and reproduction. Without seeing your child it is not possible to determine if antibiotics would be an effective treatment. Taking antibiotics for colds and other viral illnesses not only won’t work, but it also has a dangerous side effect: over time, this practice helps create bacteria that are more difficult to kill. Frequent and inappropriate use of antibiotics selects for strains of bacteria that can resist treatment, such as MRSA (methicillin-resistant staph aureus), now a widespread problem in our community.
For more information, please see  http://www.kidshealth.org/parent/general/sick/antibiotic_overuse.html
10What do I do if I am concerned about my child’s illness and your office(s) are closed?
We are on-call 24 hours a day for emergencies. Our after-hours answering service is always available to forward your message to our on-call provider who will get back to you as quickly as possible.

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