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Illnesses - Da-Gz

[Dental Cavities]   [Diaper Rash]   [Diarrhea]   [Ear Infections]   [Eczema or Atopic Dermatitis]   [Emergency Calls]   [Fever]  

DENTAL CAVITIES
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General Information:

Cavities cause toothaches, lost teeth, bite and jaw problems(malocclusion), and costly visits to your dentist. Most tooth decay is preventable.

Fluoride added to your drinking water or through vitamin supplements dramatically lowers the number of cavities your children may have. Most communities across the nation have appropriate amounts of fluoride added to the water, but check with a local dentist. Fluoride supplements normally need to be added only if your family uses well water or bottled water. Too much fluoride (causing staining of the teeth) may occur when fluoride vitamins are taken while a child is also drinking fluoridated water, or if the child ingests toothpaste frequently.

Your child should stop bottle feeding by about 12 months of age. Babies older than 1 year who carry a bottle with them, expose their teeth to sugar for much of their day. This increases the bacteria and acid on their teeth, causing tooth decay. These babies usually have multiple cavities which may require expensive dental procedures on many teeth. The type of food your child eats and the hardness of his teeth are the most important factors determining whether he has a tendency toward frequent cavities.

Brushing his teeth is less important. He needs to eat less candy and other sugar-containing sweets because bacteria in his mouth digest sugar residue on his teeth producing acid which weakens his tooth enamel. Brushing her teeth should begin at about 1 year of age and is best done within 30 minutes of eating. If she is not in a place where she can brush, have her rinse out her mouth with water several times. Most children and adults use too much toothpaste on their brush; a drop the size of a pea is all that is needed.

Flossing is an even better way to reduce loss of teeth because it removes plaque and reduces gum disease. This becomes more important when his permanent teeth come in since these teeth need to last a lifetime. Dental sealants are especially effective for the biting surfaces of his molars because they protect pits and fissures that brushing and flossing do not clean very well.

Prevention:

  1. Stop giving her the bottle completely by 12 to 15 months of age.
  2. Give him sugary drinks and foods only occasionally.
  3. Never let your child carry a sippy cup or bottle around with anything but water in it, and certainly don't let them take either one to bed!
  4. Brush her teeth or rinse her mouth with water after every meal.
  5. School age children and adults should floss their teeth every day.
  6. He should see a dentist every 6-12 months starting at 6 months of age.

Talk to your dentist about using a sealant when she is a few years old.

 

DIAPER RASH
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General Information:

Diaper rashes are very common in young infants and occur most often because your baby's tender bottom is being exposed to irritants in the urine and stool. Other types of diaper rashes can be more serious or require your baby to be seen by your physician. These would include yeast infections, impetigo (a bacterial infection of the skin), and abscesses or boils of the skin.

Treatment:

  1. Change your baby's diaper as soon as your baby wets or has a bowel movement.
  2. Do not use diaper wipes while her bottom is irritated because they might make matters worse.
  3. Use baby soap and a soft cloth to clean his bottom and all skin folds as well.
  4. Rinse her skin well and pat dry; Turn her over to her tummy on a clean diaper and let her bottom air dry for a time while she is playing.
  5. You may use a soothing ointment or cream on his bottom, but do not use diaper powder which gets in the air and can cause lung irritation.
  6. Plastic pants and disposable diapers might make the rash worse. Using cloth diapers while the rash is healing may help.
  7. If his wet diaper has a strong smell of ammonia, give your baby more water to drink between feedings.
  8. If his stools are runny, reduce the amount of juice you are giving her.

Call Your Doctor If:

Call Your Doctor 1. Your baby is not improving with this care.
2. Your baby develops a fever or seems extra fussy.
3. Your baby's rash is spreading beyond the diaper region.

 

DIARRHEA
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General Information:

Diarrhea is a very common symptom in children and occasionally can be dangerous. Most diarrhea is caused by viruses but parasites and bacteria can also cause diarrhea.  Some medicines (especially antibiotics) may cause loose stools.  Anxiety can cause somewhat loose stools in older children. Teething is thought by some pediatricians to cause loose stools, but if it does, the diarrhea should not be very bad. Chronic diarrhea is unusual in children.

Parasitic diarrhea is fairly common in warm climates like the southern U.S. and Mexico. Parasites do not cause fever and seldom cause vomiting. They are more common in day care centers. Diagnosis of a parasite usually occurs when your child has had diarrhea for longer than 14 days or has been exposed to someone with the parasite.  A stool test is necessary to see the parasite under the microscope.  Drugs to kill the parasite may then be prescribed. Bacterial diarrheas are uncommon.  However, your child's symptoms would be dramatic with fever, vomiting, and severe diarrhea often with blood and mucous in her stool.  The chances of dehydration and hospitalization are much higher when she has a bacterial diarrhea.  Bacterial diarrhea is quite contagious to all family members. Viruses are the most common cause of diarrhea in your child. He may have only mild symptoms with just a little abdominal pain and loose stools or he may have high fever, vomiting, and explosive diarrhea.  No medicine will eliminate his virus but changes in his diet may help.  The diarrhea will last longer the younger he is so that infants often will have symptoms for 2 to 3 weeks.  Toddlers will usually have diarrhea for 1 week but still may continue with abdominal cramping for another week.

Treatment:

  1. Medicines will vary depending on the cause, but since most are viral there will be no specific medicine given.
  2. If the diarrhea is severe, dietary changes will help her to rest her bowel:

For bottle-fed infants (0-12 months):

  1. Give 12-24 hours of rehydration solution (Pedialyte or kaolectrolyte) which is sugar water with salt, potassium. chloride, etc. This is easy to digest, difficult to vomit, and replaces lost fluids.
  2. Then begin 1/2 strength lactose free formula (Lactofree, Prosobee, or Isomil) for the next 24 hours.
  3. Give full-strength lactose free formula for 1-2 weeks.  Restart solids in 1-2 more days.

For breast fed infants (0-12 months):

  1. Give 12-24 hours of Pedialyte.  Pump milk from your breasts to keep your milk flowing.
  2. Begin nursing again, but try to nurse more frequently during the day so that he will have smaller, more frequent meals.  Restart solids in 2-3 more days.

For older children (older than 12 months):

  1. Give Gatorade, or other clear fluids for 12-24 hours.  Hold all other foods.
  2. Then begin a bland diet such as the BRAT diet (bananas, rice, applesauce, and toast) for 1-2 days depending on the severity of your child's diarrhea.
  3. Slowly expand the diet to include other foods, but stay away form excessively greasy foods.
  4. Rectal suppositories do not work very well to prevent vomiting on the first day.
  5. Paragoric, Lomotil, or other narcotic, anti-diarrheal agents do not work well in children.  They tend to cause your child's symptoms to last longer since they do not allow his bowel to flush out the infection.
  6. It is fine to give acetaminophen (Tylenol, Panadol, Tempra, or generic) for pain relief.  Sometimes an antispasmotic such as Donnatal will be prescribed for your child.

Call Your Doctor If:

Call Your Doctor 1. She is urinating less often than every 8 hours with a very dry mouth and very little tear production.
2. He is getting progressively weaker.
3. She's been vomiting and having diarrhea for more than 48 hrs if she is an older child or 24 hrs if she is an infant.

 

EAR INFECTIONS
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General Information:

Middle ear infections are common childhood illnesses that cause ear pain, fever (in young children), and restless nights. They occur frequently during colds, sinusitis, or allergies. Ear infections are also associated with feeding your baby a bottle while he is lying flat on his back, smoking around your baby, and when he is placed in a day care center. He may have more ear infections in the winter because he is more likely to have colds at that time of the year. Parents who had many ear infections when they were young tend to have children with more ear infections.

Your child may have ear infections because she has poor drainage of fluid from behind her ear drum due to poor eustachian tube function. This tube serves to equalize air pressure on both sides of her ear drum and to drain fluid from her middle ear. It becomes obstructed during her colds which leads to fluid build-up which then often becomes infected with bacteria.  Young babies have poor drainage of fluid through the eustachian tube. As they age, drainage improves so that many babies outgrow their ear infections. Cold air, swimming, and getting water in her ears do not increase ear infections.

Treatment:

Before seeing the doctor

  1. Give him a good dose of pain medicine such as acetaminophen (Tempra, Tylenol, Panadol, or generic) every 4 hours. Children older than 6 months can take ibuprofen (Nuprin, Advil, Motrin, etc.) as an alternative or may take it 2 hours after taking the acetaminophen.
  2. Lying down increases pressure on her tender ear drum, causing painful ears in the middle of the night. Keeping your child up for 20-30 minutes after she wakes up with ear pain may decrease her pain. Propping her head up with 2 or 3 pillows may help her also.
  3. Antibiotics will not relieve his pain at night. Do not give old antibiotics you may have at home.
  4. Other forms of pain relief include placing a warm cloth over her ear or using pain drops like Auralgan.

After seeing the doctor,  if your child has an ear infection:

  1. An oral antibiotic will be prescribed for him. It is important to follow the directions  closely and to give him all the medicine prescribed even if he feels better quickly. 
  2. Additional pain medicine such as ear drops or oral codeine may be prescribed for your child. These are only given when she needs them, usually just the first or second night.
  3. A follow-up appointment is usually required to make sure his ear infection has been cured to avoid repeat ear infections or permanent hearing problems.
  4. Medicines for cough or cold symptoms may be suggested for her comfort, but they do not help her cure the ear infection itself.

Call Your Doctor If:

Call Your Doctor 1. His ear pain has not improved after 3-4 days of antibiotics.
2. She has a high fever for 3 days or longer.
3. He has repeated vomiting and a decreased ability to move his neck.
4. She develops rashes, abdominal pain, or severe diarrhea that may be the result of her antibiotics.
5. He seems to be sicker in any way compared to the time that he was seen by the doctor.

 

ECZEMA OR ATOPIC DERMATITIS
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General Information:
Eczema is a mild, recurrent, noncontagious skin rash that can occur at any age.  It tends to occur in families that have problems with allergies or asthma.  Eczema can occasionally be severe and lead to scarring, but it is usually more of a nuisance causing dry, itchy skin.

In a baby, eczema tends to involve her face and abdomen, but can occur all over.  She may have eczema for a few weeks and never have it again or she might develop more of an adult-type eczema as she gets older.  Her adult-type rash will tend to be in the folds of her elbows and knees, or her hands, and behind her ears. Although eczema is thought to be related to allergies, it is very difficult to decide what is actually causing your child to have an allergic reaction. If he is a baby then placing him on a soy formula may help.  Otherwise, your child should avoid anything that makes him have a runny nose and wheezing such as animal dander, dust, molds, and certain foods.

Circumstances that will make her eczema worse are cold weather (the air is drier), irritants on the skin, frequent washing with harsh soaps, perfumes, or makeup. Some families find that eliminating allergens from the diet helps, as does switching to no perfume soaps and detergents, or avoiding artificial additives in food and products for the skin.  It is pretty much trial and error to see if any of these changes helps.

Treatment:

  1. Use an unscented moisturizer such as Eucerine cream or unscented Lubriderm on your child 3 times a day.
  2. Switch to mild soaps and try to minimize his bathing to every other day if his rash is persistent. Your child may use a cloth to wash under his arms and in his genital area on his off days.
  3. For facial rash on your child, use 1% hydrocortisone cream 3 to 4 times a day.  This can also be used on other places on her body especially if she is a young baby.
  4. Stronger creams such as fluorinated cortisone (Triamcinolone, etc.) or other anti-inflammatory medications (Elidel, etc.) may be used in your older children anywhere except on his face, neck, and genital regions where his skin is thin.
  5. If both moisturizer and cream are being used, place the cream on your child first so that her medicine comes in direct contact with her rash.
  6. Continue the moisturizer on your child even after his cortisone cream has been discontinued.
  7. If your child has a lot of itching, Benadryl liquid may be given to her especially before bed.

Call Your Doctor If:

Call Your Doctor 1. Your child's rash is not improving despite the medication being tried.
2. Your child is developing reddened areas on the skin which might be due to a skin infection.
3. The area of the rash seems to be spreading rapidly or if the skin seems to be quite tender.

 

EMERGENCY CALLS
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Parents are often unsure as to when they should call their doctor after office hours. The following are common physical complaints and guidelines to help you know when to call. These are only guidelines and should your child ever appear severely ill do not hesitate to call at any time.

Fever is one of the most common signs that your child is sick. Fortunately, it is also one symptom that is easily treated by the parents with acetaminophen (Tempra, Panadol, Tylenol, etc.) or after 6 months of age with ibuprofen (Advil, Nuprin, etc.).  No prescription medicine will cause the fever to drop any faster than these medicines. Even fever as high as 105 degrees is not harmful if the cause of the fever is a virus or a mild bacterial infection such as an ear infection. Fever in a child who otherwise is fairly active is not an emergency unless the child is less than 6 weeks of age. Treat the fever first, then evaluate how sick the older child appears before calling.

Dosage (every 4 hours) - Refer to instructions from Doctor and packaging instructions.

Respiratory symptoms such as a cough, runny nose, "rattling" in the chest occur in all children at times. Cough usually worries parents because it can sound so bad. However, no matter how bad the cough sounds, if your child has no fever, the chances of a serious pneumonia are very small. Wheezing in children is common due to asthma and viruses. Wheezing is not an emergency unless your child is having difficulty breathing also. Respiratory symptoms are an emergency only if your child is having severe respiratory difficulty (turning blue in the face, ribs are showing, lots of effort in breathing, or panicky).

Rashes although often impressive, are almost never emergencies unless your child also has a high fever. If your child is on a new medicine or food, stop giving the medicine or food to him and call in the morning. If your child complains of itching, an antihistamine such as Benadryl and a cool bath will reduce the itching.

Gastrointestinal symptoms such as vomiting and diarrhea are common in children and are usually caused by viral infections. Serious dehydration, the main concern, almost never occurs in children older than 1 year. Even babies seldom become dehydrated unless both diarrhea and vomiting are occurring at the same time. If your child is urinating at least once every 8 hours, is acting alert and occasionally playful, or has a moist mouth, then you do not need to call until morning. Simply stop all foods and give Pedialyte (in babies) or Gatorade (older than 12 months) frequently, but only in small amounts. Acetaminophen may be given for fever or abdominal pain.

Refills on medicine, questions on behavior, or need to schedule an appointment should wait for regular office hours.

 

FEVER
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General Information:

Fever is a helpful response of your body to infection, as it acts to prevent the infecting bacteria or virus from multiplying. Fever may tell us that a possibly harmful infection is present, but fever itself is rarely harmful. Fever virtually never causes brain damage, and a normal child's temperature generally does not rise above 105-106 degrees Fahrenheit even during the most severe infections.

You may take your child's temperature in his mouth, rectum, or armpit with regular thermometers and in his ear with ear thermometers. At home, the rectal temperature is the most accurate for babies and young children, because his oral temperature can be affected by food and drink and his armpit temperature varies depending on thermometer position, clothing, and how long the temperature is taken. It is about one degree lower than the rectal temperature. Forehead strips are not accurate. While the ear thermometers are very accurate in the hospital, the ones sold to the general public are less accurate. Fever is defined as any temperature greater than 100 degrees Fahrenheit rectally.  Usually, temperatures less than 102 degrees Fahrenheit do not need to be treated (although the infectious cause of her fever may need treatment). When her fever rises above 102 degrees, you may want to bring her fever down to make her feel more comfortable, increase her appetite, and improve her attitude. In an uncommon event, a seizure may occur in young children with a high fever.  Although frightening to the parents, this type of seizure is not dangerous to her.

Treatment:

  1. Notify your doctor if your baby of less than 3 months has any fever, your baby between 3 and 6 months has fever greater than 101, or your child of more than 6 months has a fever greater than 103. Any fever associated with decreased appetite, sleeplessness, or irritability should be reported to us.
  2. The fastest way to reduce his fever if he is less than 1 year is in a lukewarm bath for 30-60 minutes (most parents make this bath too brief).  Don't use an alcohol bath; it lowers his fever too fast.
  3. Acetaminophen (Tylenol, Tempra, Panadol, etc.) in the appropriate dose every 4 hours is the safest medicine for her fever control.  Do not give her aspirin since it causes Reye Syndrome.
  4. After 6 months of age ibuprofen (Advil, Motrin, Nuprin, etc.), a newer medication, may be given him to reduce high fevers when acetaminophen is not effective. It may be given in a maximum dose every 6 hours or in a lesser dose every 4 hours (in the latter case, alternated with acetaminophen, also given every 4 hours, so that 1 of the 2 medications is given every 2 hours).
  5. Dress your child lightly. If you overdress her, the extra warmth will be held in.
  6. Encourage him to take plenty of fluids.  He can have milk as long as he is not vomiting.

Dosage (every 4 hours) - Refer to instructions from Doctor and packaging instructions.

 

 

The information contained within this website is no substitution for timely medical care.

Feel free to copy the information on this web site and give to friends and family. Contact Dr. Glenn Wood at
Carousel Pediatrics (512) 744-6000 We are located at 7112 Ed Bluestein Blvd., #100 - Austin, TX 78723

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