My Child is Sick

Autism spectrum disorders (ASDs) are a group of developmental disorders that can cause difficulties with socializing, communicating or behavior. Symptoms of autistic disorder are usually recognized between two and three years of age, although they may be present much earlier.

An autistic child may lack the ability to speak or understand and may show little interest in communicating – even by nonverbal means such as making eye contact, gesturing, pointing or miming. Some children with autism engage in repetitive behaviors such as hand or finger flapping or twisting, rocking or swaying. Many children with autism spectrum disorder perceive sounds, tastes, or touch differently.

It is not clear how or why autism develops. Autism has been attributed to vaccine exposure (particularly measles vaccine and thimerosal, a mercury preservative used in vaccines). However, the overwhelming majority of scientific studies do not support an association between immunizations and autism.

Our doctors routinely screen for autism as part of all baby and small child check-ups. If you have concerns that your child may be demonstrating signs of autism spectrum disorder, please come in and discuss them with us.

Upper respiratory infections (URIs) are very common in children due to the contagious nature of the viruses that cause them. It is normal for a child to have 6 to 10 colds in a year. Symptoms include a cough, runny nose and sometimes fevers. They are caused by viruses, and typically last between 7 and 10 days.

Unfortunately, there is little that can be done for the common cold except to just wait it out. Have your child drink plenty of fluids and consider using a humidifier, nasal saline drops or sprays, and/ or a bulb suction to help get the phlegm out of a baby or young child’s nose.

If your child is coughing a lot, you may want to also look at our “Cough” section for more detailed information on cough specifically.

Tylenol or Ibuprofen can help relieve discomfort from fevers or a sore throat. Please reference our dosing chart for how much of each medication to give your child based on his or her weight. Since URIs are caused by viruses, and antibiotics only kill bacteria, antibiotics do not help.

Children with colds can still attend school unless they have a fever (greater than 100.4F) or they just aren’t feeling well enough to participate. URIs can be associated with wheezing or ear infections, or may even result in a sinus infection later on. If you suspect any of these conditions, or if a fever is persisting more than 4 days, please come in and see us!

Coughs are extremely common in childhood. Although they can be frustrating and sound awful, coughs that are associated with a cold are usually not a sign of a serious condition. In fact, coughing helps protect the airways and is a healthy and important reflex.

We, in agreement with the American Academy of Pediatrics (AAP), do not recommend the use of cough and cold medications for your child, especially for children under the age of 2. There is no indication that these products are effective and the ingredients in these medications can cause harmful side effects. Instead, have your child drink plenty of fluids and consider using a humidifier. Good old honey might also help your child’s cough. You can give a teaspoon of honey to your child every few hours. Do not give honey to children under 1 year of age.

Coughs may last up to several weeks and this can be normal. However, if you notice the cough getting increasingly worse over several days, or if it is accompanied by a fever or noisy breathing, please call us to schedule an appointment.

Colic is generally defined as unexplained crying in an infant. Typically, it peaks between 3 weeks and 3 months of age, is worse in the evening hours, and can last for hours at a time.

Do what you can to try to make your baby comfortable. Make sure your baby is not hungry, overheated, has a wet or dirty diaper or a fever. Walking or rocking your baby, swaddling, stroller rides, car rides, providing a pacifier, giving a bath and playing soft music are all great methods to try to soothe your baby.

Many colicky babies will cry, scream, draw up their legs to their chests, turn bright red and/ or pass gas. Many parents mistake these symptoms for constipation or formula intolerance. However, most of the time, switching formula will not help.

Colic can be very frustrating and exhausting as a parent. When you need a break, it is fine to allow your baby to cry in his or her crib for short periods. This helps babies learn to soothe themselves to sleep and might help you feel less overwhelmed when dealing with a crying baby on little to no sleep yourself. Do your best to take care of yourself, too, during this newborn period – it will really benefit you and your baby!

Please call us immediately if your baby has been crying without stopping for more than 2 hours, has a fever, is acting sick, turns blue or if you are so frustrated that you fear you may hurt your baby.

Most of all- trust us- it will get easier!

A diaper rash is very common in infants. It is most commonly linked to wet diapers or diarrhea. If your baby has a diaper rash, we recommend you change your child’s diaper frequently – at least every 3 hours – or immediately after a bowel movement.

Several diaper creams on the market can help keep urine and stool from touching your baby’s skin. Simply apply a thick layer of the cream onto your child’s clean skin. Increasing air exposure to the diaper area by allowing your baby to go diaper-free on a towel or pad for several hours might also help as well as taking a break from using chemically-treated baby wipes. Instead, consider using warm water alone to rinse the diaper area, and then pat the area dry with a soft towel.

If you have tried the methods above and the diaper rash does not improve or continues to get worse after several days, please call our office to schedule an appointment.

Eczema (atopic dermatitis) is a dry, itchy inflammation of the skin, which can be associated with allergies and asthma. Like allergies, it is often a chronic condition, but will come and go depending on many factors, like the weather, exposure to irritants and the level of moisture on your child’s skin. It is most often seen in infants and children but can continue into adulthood. Eczema tends to run in families, but the frequency of the condition has been increasing in recent years, even in families with no other affected members.

The main problem for children with eczema is an abnormal skin barrier. Treatment therefore focuses on hydrating and protecting the skin. Start with daily moisturizing lotions that are fragrance-free. Eucerin and Aveeno are good examples. The best time to apply these lotions is right after a bath or shower. Petroleum jelly, Aquaphor or Vaseline can then be applied on top of the moisturizer, to seal the moisture in and protect the skin. In some cases, a steroid cream might need to be applied first. We can guide you in these cases.

Make sure all of your child’s products (including diapers, wipes, soaps, lotions and laundry detergents) are fragrance-free and dye-free. In some cases, eliminating certain foods might also help improve your child’s skin. Talk to one of us if you feel your child’s eczema worsens after eating a particular food. The most common offenders are milk, wheat, nuts, soy and fish.

Skin with eczema can easily become infected with bacteria. Please call us for an appointment if you notice red, yellow-crusted or weeping lesions on your child’s skin.

An ear infection (acute otitis media) is most often a bacterial or viral infection that affects the middle ear, the air-filled space behind the eardrum that contains the tiny vibrating bones of the ear. Children are more likely than adults to get ear infections.

If your child has an ear infection, he or she may have a fever and/ or ear pain. Ear infections are often painful because of inflammation and buildup of fluids behind the eardrum. Babies and small children might pull on or touch their ears, and cry a lot. Upper respiratory infections, or colds, can predispose your child to ear infections.

If you suspect an ear infection, please call us to schedule an appointment or come to our morning walk-in hours. It is not necessary to go to the emergency room unless you have other concerns. If it is the middle of the night, since ear infections can be very painful, we recommend controlling your child’s pain with Tylenol (Acetaminophen) or Motrin (Ibuprofen) until he or she can be seen in our office in the morning. Please reference our dosing chart for how much of each medication to give your child, based on weight.

Fever is defined as a temperature of 100.4 F or greater. Don’t be alarmed just because your child has a fever. It is usually just the body’s normal way of fighting off an infection. Fever itself has not been shown to be harmful to children.

Most fevers are caused by common viruses and last 1-4 days. Medications such as Tylenol (Acetaminophen) or Motrin (Ibuprofen) can help treat the symptoms of a fever but will not resolve the underlying infection. Tylenol can be used once your child is older than 2 months, Motrin after your child is 6 months. Please reference our dosing chart for how much of each medication to give your child, based on weight.

We do not recommend that you over-bundle your child or give your child a cold bath. Do offer your child more fluids to avoid dehydration.

If your child is less than 2 months old and has a fever or if your older child has a fever for more than 4 days or any other concerning symptoms, please call us.

Pink eye (conjunctivitis) is commonly caused by bacteria, viruses or allergies. Symptoms include red, itchy, uncomfortable and swollen eyes and discharge. Though the inflammation of pink eye can be irritating, it rarely affects vision.

With bacterial pink eye, the discharge is significant and continuous, thick, and yellow to green in color. A child with bacterial conjunctivitis might wake up with his or her eyes crusted shut. Bacterial forms of pink eye can be treated with antibiotic ointments or eye drops. In viral or allergic pink eye, the discharge is often more watery.

Pink eye is very contagious so an affected child might have to miss school or childcare.

If you suspect that your child has pink eye, early diagnosis and treatment is best to help limit its spread. Please call us during regular office hours so that we can see your child in our office. In the meantime, make sure your family’s hands are all being washed often, as well as your child’s towels and pillow cases.

Gastroenteritis, or the stomach bug, is usually caused by a common virus. Symptoms include vomiting, diarrhea, stomachache and sometimes fever. Stomach bugs often begin with vomiting and end with diarrhea. The diarrhea can last for up to 7-10 days. As long as your child is well hydrated, this is not worrisome.

Stomach bugs are very contagious so make sure your child’s hands are being washed frequently. Children should not be in school or daycare if they are vomiting, have a fever (greater than 100.4F), have loose bowel movements that cannot be contained in a diaper or cannot keep up with regular activities.

Medications cannot cure most stomach bugs. The most important course of action is to make sure your child stays hydrated. To monitor for dehydration, keep a close watch on how often your child is urinating. Ideally, we would like your child to have at least 3-4 wet diapers in a 24-hour period. If your child is becoming dehydrated, one of the first signs is very dark urine, followed by scant urine.

Encourage fluid intake by offering small sips very frequently, sometimes every 5-10 minutes. For babies who are breast-feeding, continue breastmilk, as it has immune cells that help fight infection. Other good options are Pedialyte or Liquidlytes. For older babies and children, water is another option but do not give water to babies under 6 months of age, as their bodies’ natural chemicals might get diluted out and cause seizures. Older children might feel better with small sips of carbonated beverages such as ginger ale. Milk and sugar juices might not be absorbed well during a stomach bug but they are much better than nothing if your child will drink them.

Once your child is keeping fluids down for several hours, it is okay to give solid food again. Stick to bland foods, such as bananas, plain toast, crackers or plain rice.

If there is blood in the stool, worsening abdominal pain, your child also has a fever and a rash, if the diarrhea lasts for more than 7 to 10 days, or you are worried that your child is becoming dehydrated, please give us a call.