All children catch colds. In fact, children average 8 colds a year. Colds are spread throughout families, daycares, schools and anywhere people come together. Babies and young children are very susceptible to colds because their immune systems are less mature.Colds may cause fever, which should be treated as discussed in the previous section. If fevers greater than 101 degrees persist for more than 72 hours, your pediatrician should examine your child to rule out a complication of the cold, such as an ear infection.The nasal congestion of a cold may be relieved by a cool mist vaporizer or humidifying the air. Elevating the head of the bed will allow gravity to help drain the nose.A congested nose may make it difficult for babies to nurse. Excess mucous drainage in babies may be removed by gentle suctioning with a bulb syringe. If the drainage is particularly thick and difficult to remove, you may use saline nose drops. Place 2-3 drops in one nostril and gently suction with the bulb syringe after 3-4 breaths. Wait a few minutes and repeat on the opposite side.
An ear infection is a common complication of a cold. This is caused by a build-up of fluid in the middle ear space (behind the ear drum) during the cold. When bacteria infect this fluid it results in “acute otitis media”. Some symptoms of acute otitis media include fever, pain, decrease in appetite, fussiness when lying down, and a temporary hearing loss.If you suspect your child has an ear infection, please make an appointment for a sick visit. You can keep your child comfortable in the meantime by using acetaminophen, holding a warm water bottle next to the ear, allowing time to rest, and lots of cuddling. Treatment could involve an antibiotic given for 5-10 days. We prescribe antibiotics only when we are able to make an accurate diagnosis. You may have to bring your child back at the end of treatment to assess the progress of healing. Also, recent studies have shown many cases of otitis media heal on their own without antibiotic treatment.There are some children who have great difficulty with ear infections, either by experiencing frequent episodes, the sudden perforation of the eardrum, or persistence of fluid within the middle ear. There are different treatment options for each of these problems. Frequent episodes may be lessened by altering the child’s environment, such as removal from daycare, eliminating cigarette smoke, a perforated ear drum may need topical antibiotics in addition to oral antibiotics.Occasionally the persistence of middle ear fluid, without infection, may interfere with hearing. Your child may require referral to an audiologist to assess this.Children with frequent ear infections or complications may require consultation with an Otolaryngologist (ENT surgeon) for the insertion of ventilating tubes.
Vomiting more than 2-3 times a day can occur with many illnesses. Viral infections are the most common cause. Important things to look for are:
- Signs or symptoms of dehydration (see below)
- Blood or bile (a green-colored material) in the vomitus
- Severe abdominal pain
- Lethargy or severe irritability
- Continuous vomiting
The treatment of vomiting is aimed at avoiding dehydration and replacing what has been lost. Do not use over-the-counter remedies unless recommended by your doctor. For children 6-12 months old you may offer 1-2 oz of pedialyte, an electrolyte solution, as often as every 15-20 minutes. If the infant is breastfed you may continue to do so but in small increments. For children greater than 1 year, you may use pedialyte, water or Gatorade, gradually increasing the amount as the vomiting subsides.
Within 24 – 48 hours a child should be ready to resume their normal diet. Gradually offer foods as hunger dictates. If this does not successfully manage the vomiting, please notify us.
Dehydration occurs when the body loses so much water that it cannot function properly. It is important for you to recognize the signs and symptoms of dehydration so that you can prevent any serious problems. The following suggest mild dehydration:
- Dry lips
- Fewer tears when crying
- Acts thirsty
Mild dehydration may be treated as outlined above for vomiting.
Severe dehydration (in addition to above) please call as soon as you recognize any of these:
- Sunken eyes
- No urine output in 12 hours
- Listless, no energy
- Irritable or lethargic
- Not interested in drinking
- Dry, parched mouth
Bowel patterns vary widely in children. You can help establish normal bowel patterns by encouraging routine potty times, drinking water, limiting the intake of cow’s milk, and feeding your child high fiber foods such as: prunes, apricots, raisins, peas, beans, broccoli, and whole-grain cereals and breads. Constipation occurs when the stools are less frequent than usual and are hard and compact, associated with painful bowel movements or abdominal pain, blood in or around the stool, or soiling between bowel movements. This may cause your child to be anxious when the sensation for passing stool occurs again. Try to reassure your child that stools should come out. If this becomes a consistent pattern please call during office hours for further treatment plans.
Diarrhea is a change in the child’s usual bowel pattern resulting in frequent watery stools. It occurs when the lining of the intestine is injured, usually by infection. The injury affects the ability of the intestine to digest foods and fluids. Diarrhea may be caused by viral infections (most common), allergy to foods or milk, medication (such as an antibiotic), bacterial or parasitic infections, or too much milk or fruit juice. The goal of treatment for diarrhea is to prevent dehydration and malnutrition until the injury is healed. The sooner lost fluids and calories are replenished, the better. There are no medications we routinely recommend. If your child has mild diarrhea and is still active and hungry, no changes need to be made in his usual diet. You may encourage extra water between feedings. Avoid foods or liquids which may cause diarrhea–fruits, juices, sugary liquids. If the diarrhea seems severe, look for signs of dehydration. Increase fluids and call the office for further guidelines. It is important to try to replace nutrients as soon as your child is willing to eat. A return to a regular, sensible diet is recommended as soon as the child will tolerate it.
Call us if:
- Diarrhea lasts longer than seven days
- Fever lasts longer than 72 hours
- Stools are bloody
- Severe abdominal pain
- Signs of severe dehydration.
12065 Old Meridian St., Carmel, IN 46032
TEL: (317) 844 - 5351 - FAX (317) 844-0310