COMMON COMPLAINTS AND ILLNESSES

The following section is devoted to the most common illnesses and symptoms that parents ask us about. The purpose of this section is to provide you with a resource to use when your child is ill before you call the office for advice.  The problems are listed alphabetically for easy reference.

  Chicken Pox: Although we are seeing less of this as more children are immunized, chicken pox is still a common problem among children. Chicken pox is caused by a virus and is very easily spread among children who are not immune. If your child is exposed to chicken pox, the rash will appear 10-21 days after the exposure. Chicken pox usually begins with 2-3 days of cold-like symptoms and fever, followed by the rash. The rash may appear anywhere and quickly spreads (within hours) to involve the entire body. The spots look like small blisters filled with clear fluid. Your child is contagious until all of the spots are scabbed over, usually about 5-7 days. The treatment for chicken pox is supportive. Tylenol will help relieve any fever. Benadryl (liquid or tablets) or Calamine cream can be used to relieve itching. Oatmeal baths are also sometimes helpful. Encourage your child to drink plenty of liquids.

Occasionally the pox get infected and turn into impetigo. If you think this is happening, call us.

If your child develops a fever more than five days after the rash appears, please call us.

Please do not bring your child into our waiting room if he or she has chicken pox. We do not want to expose the other children. Knock at the back door and one of our staff will assist you.

  Colds: Viral upper respiratory infections (common colds) are the most common infections among children and adults. The symptoms generally last 7-10 days and include nasal congestion, cough, and runny nose. There may be fever as well. Children generally sleep more and eat less when they have a cold. Colds need to run their course. There is nothing you can do to make the cold go away more quickly. Only rarely does a cold turn into sinusitis in children (see "Sinusitis"). Here are some suggestions for helping your child feel more comfortable when he or she has a cold:

Congestion: See "Colds".

  Conjunctivitis: Conjunctivitis, or pink eye, is an infection of the lining over the eyeball and eyelids. Conjunctivitis sometimes occurs during the course of a cold, or may happen by itself. The eye looks red and puffy and there is a thick yellow or green discharge. The eyelids may become matted shut, especially in the morning after sleep. Treatment usually requires an antibiotic eye drop. You can help the discharge by patting the eye with a warm, moist washcloth.

  Constipation: Constipation is the passing of HARD STOOL. It has nothing to do with the frequency of stooling. Children commonly get constipated for short periods because of diet changes or mild illnesses. It is rarely something to worry about. If your child gets constipated, decrease the amount of dairy products in the diet for a few days and encourage juices, especially prune or pear juices. Infants commonly get constipated when foods are introduced. Two ounces of pear juice each day usually keeps the stools soft.

Cough: There are many reasons why children cough. The most common one is the common cold. For suggestions on dealing with this type of cough, please refer to "Colds". Pneumonia, croup, asthma, and allergies are other causes of cough in children. If your child coughs without other cold symptoms, only coughs at night, or has had a lingering cough for more than two weeks, schedule an appointment with us.

  Diarrhea: Diarrhea in children is usually caused by a stomach flu virus. There may or may not be vomiting and fever as well. A stomach virus usually lasts about 6-7 days. During this time, your child will have frequent (6-12 per day) watery stools. After about a week, the diarrhea will slowly resolve, with stools returning to normal after a total of about 14 days. If diarrhea is the only symptom your child has, there is no need to alter his or her diet. However, if you notice that your child has worse diarrhea right after eating, you may want to restrict intake to clear liquids for a day or two to reduce the diarrhea. The greatest danger from diarrhea is dehydration. This can be prevented by encouraging your child to drink a lot of liquids. Signs of dehydration that we consider concerning are:

If these signs appear, call us.

Diarrhea can often present a problem for children in day care settings, as many centers will not allow attendance by children with watery stools. If your child is less than 18 months old and you find yourself in this situation, we suggest that you try feeding him or her Isomil DF. This is Isomil with added fiber that bulks up the stools and reduces diarrhea. Frequently, children can then go to day care while their diarrhea resolves. Give this formula for about 5-7 days and then resume a normal diet.

  Ear Infections/Ear Pain: Ear infections are one of the most common illnesses among children under 3 years old. However, not all ear pain is due to an infection. Teething, the common cold, allergies, and earwax can all make kids pull at their ears and complain of pain. Most, though not all, true ear infections are accompanied by fever and frequently develop after several days of cold symptoms (i.e. runny nose and cough). Children with cold symptoms but no fever frequently pull at their ears because they are "plugged up" and this sensation is uncomfortable.

If your child seems to be having ear pain but no fever, try some Tylenol and watch her for several hours to see what happens. Remember, ear infections are painful but not dangerous to your child. Frequently, by using Tylenol or Ibuprofen as well as a numbing eardrop, you can keep your child comfortable until we can see them at the office.

Fever: Temperature is best measured rectally (in the bottom) in infants and under the tongue in older children. If you are uncomfortable taking a rectal temperature, a temperature can be taken under the child’s arm, although this is less accurate. As a rule, ear thermometers are inaccurate, especially in infants. If you have trouble reading a mercury thermometer, try one with a digital readout.

Fever can be especially concerning in infants less than two months of age, because serious illnesses can sometimes present with no symptoms except fever. If an infant this age has a temperature more than 100 degrees, call us right away.

Fevers, while they make children irritable, are NOT dangerous. In fact, there is growing evidence that fever is the body’s way of fighting off infection and may actually be beneficial. Parents should not be frightened by fever. While in a small number of children, fever can cause a seizure, these seizures are brief and are not associated with brain damage or a future risk of epilepsy. If your child has a febrile seizure, call us right away.

Fevers are not necessarily a sign of a serious infection. Common colds are often accompanied by fevers to 103 degrees and the flu frequently gives children temperatures of 104-105 degrees. Your best clue as to what is going is going on with your child is not fever, but activity level and disposition.

Both Tylenol and Ibuprofen (Advil, Motrin) reduce fever temporarily, but the fever will continue to come back until your child is over his or her illness. Simply continue the medicine until the fevers do not come back. If the fevers last more than three days, call us. Tylenol and Ibuprofen are equally effective at reducing fever. The difference is that Tylenol lasts about four hours while Ibuprofen lasts about six. The potential downside of Ibuprofen is that it can cause stomach irritation. The Tylenol or Ibuprofen should be given according to the directions on the package. Sometimes Tylenol or Ibuprofen alone does not keep fever under control. If this is the case, these medicines can be given together, alternating every three hours (for example: 9:00 Tyl., 12:00 Ibu., 3:00 Tyl., 6:00 Ibu.).

A bath in tepid water can also reduce fever. Please do NOT bathe your child in alcohol. This is a dangerous practice that can lower temperature too quickly.

Fevers are, of course, associated with ear infections and pneumonias as well as with colds and the flu. If you are concerned about your child’s illness, call us or schedule an appointment.

  Head Injury: Children frequently fall and hit their heads. Most of the time the injury is minor and no treatment is necessary. If your child has had such a fall, give some Tylenol to relieve the pain and observe him or her over the next several hours. Call us if any of the following occur:

  Pink Eye: See "Conjunctivitis".

  Runny Nose: See "Colds".

  Sinusitis: Sinusitis is a rather uncommon condition in children. It is also difficult to diagnose without x-rays in children under 5 years old. Because of this, we define sinusitis based on how long the symptoms have lasted. To be diagnosed with sinusitis, a child must have a runny nose lasting for 14 days and not improving. Runny noses lasting less than 14 days are more typical of the common cold. Remember, the color of the drainage means NOTHING!

  Sore Throat: Although everyone worries about Strep when a child has a sore throat, most sore throats are caused by viruses similar to the common cold. Strep Throat is more likely when a child has a sore throat, fever over 101 degrees, swollen neck glands, and NO COUGH. If your child fits this picture, call us. Otherwise, it is probably a viral sore throat. Treat with Tylenol or Ibuprofen, rest, and plenty of cold liquids. Remember, children under the age of 2 years rarely, if ever, get Strep Throat.

  Vomiting: Vomiting is a common problem in children and is usually caused by a stomach flu virus. There may or may not be diarrhea and fever as well. A stomach virus usually lasts about 6-7 days. Vomiting is usually the first sign of stomach flu and usually lasts anywhere from 2-5 days. A child vomits because the stomach is very irritated and anything that goes into the stomach makes the irritation worse and causes the vomiting. Vomiting can lead to dehydration and that is what we try to prevent. The key to preventing dehydration is to trickle fluids into your child a little at a time. Do not try solid foods unless the vomiting has been gone at least 8 hours. Also avoid milk or formula if the vomiting occurs with these liquids. Clear liquids are tolerated the best. Pedialyte or another similar solution is ideal, but many children will not drink this because of its salty taste. If this is the case with your child, try one of the sports drinks such as Gatorade. Popsicles are also frequently helpful. Use juice as a last resort, as it can worsen diarrhea. Only give these liquids in very small amounts. For infants, start with half of an ounce every 20 minutes. Older children can probably tolerate 2 ounces. Slowly increase the amount over the next 12 hours as tolerated. If your child starts to vomit, you will need to start over after waiting about 2 to 3 hours. Using this strategy of very small amounts given frequently, most children can keep down enough liquids to prevent dehydration. DO NOT let your child gulp down the liquids even if it means pulling the bottle or cup away! If he or she drinks a large amount, vomiting will likely happen again. Slowly reintroduce your child’s regular diet over 3-4 days after the vomiting stops. If you think your child is showing signs of dehydration, call us.

Signs of dehydration that we consider concerning are:

Disclaimer:
All pages and contents are provided as information only. This is not a substitute for medical care or your doctor's attention. Please seek the advice of your physician. Boca Raton pediatrics Associates presents this data as is, without any warranty of any kind, expressed or implied. It is impossible to cover every eventuality in any answer, which makes direct contact with your health care provider imperative. In view of the possibility of human error or changes in medical sciences, neither the authors nor Boca Raton Pediatrics Associates nor any other party who has been involved in the preparation or publication of this work are held responsible for any errors or omissions or for the results obtained from the use of such information.