Topics Addressed Below:
- Accidental ingestions
- Immunization reactions
- Cough and Nasal congestion
- Earache and Sore throat
- Pink eye
Fever is a normal response by your body to various
causes (i.e., infections, vaccines). Our
group defines fever in a child older
than 3 months as a temperature ≥
101ºF. There are many ways to take
temperature including under the arm (axillary), rectally, orally, in the ear,
or with a temporal scanner. Keep track
of your child’s actual temperature and how you take the temperature. If your child has a fever, we recommend
treating the fever only when the child is uncomfortable. In most cases the anti-fever medicine (i.e.,
ibuprofen (Motrin, Advil) and acetaminophen (Tylenol, Feverall)) will only bring
the child’s temperature down 1º-2º degrees. For example, if your child has a
104ºF temperature, we expect the fever to drop to 102º-103ºF with
medication. As an adjunct to fever
reducers, you can give your child a tepid (water temperature of 85º-90ºF) bath. Notify
the on-call physician of your child’s fever if it meets one of the criteria
When to call the on-call doctor:
your child is younger than 3 months with a rectal temperature >100.4ºF
your child has a very high fever
your child is inconsolable despite giving an adequate dose of a fever reducer
Fever, resulting from an infection, of ≤ 104ºF is
beneficial. It helps the body fight
infections; turns on the body’s immune system; and may help shorten the course
of the illness.
Fever reducers are only designed to make your child more
comfortable. It will NOT stop your child from having a fever.
average, fever reducers take up to one hour to work. Acetaminophen can last as
long as 4-6 hours and can be safely given at any age. Ibuprofen can last as long as 6-8 hours and
can be safely given to children ≥ 6
months of age.
over-the-counter cold medicines, avoid preparations which also contain
acetaminophen or ibuprofen in order to minimize the chance of overdosing on a
fever reducing agent.
If you know or suspect that your child has swallowed or
otherwise has been exposed to a harmful substance, please call the Poison
Control Center at 1-800-222-1222. This 24/7 hotline number will let you talk to experts in
poisoning. They will give you further instructions.
There are many illnesses that will cause vomiting
and/or diarrhea. These illnesses are
commonly referred to as viral gastroenteritis. In most cases, children do not need to be
seen immediately for these symptoms. The
most important thing you can do is keep
your child hydrated. The best way to
keep small children (< 3 years old) hydrated is with an oral rehydration
liquid (i.e., Pedialyte). Older children
can take water, flat ginger ale, or Gatorade.
Avoid red or green colored drinks for it may artificially make the vomit
appear to be blood-stained or bile-stained.
Also avoid drinks high in sugar such as apple juice. If your child has begun to vomit, let him/her
rest for 1-2 hours to allow the stomach to settle then start with small sips of
liquids (i.e., 5cc every 5 minutes for 1-2 hours). Some children will continue to vomit but in
most cases the frequent small amount of liquid will keep them hydrated.
When to call the on-call
- If your child is unable to keep
liquids down for several hours (6 hours for infants or 12 hours for older
- If your child is having severe
pain in his/her stomach with vomiting.
- If the vomit has blood or is
green in color.
- If your child appears very
dehydrated (sunken eyes, not urinating for > 8 hours if your child is < 1
year old, or > 12 hours if your child is > 1 year old)
As with vomiting, diarrhea is most often caused by
a viral gastroenteritis. The key is to keep your child hydrated with
water. Avoid juices (especially apple,
pear, or prune juice) or any drinks high in sugar for these types of drinks can
worsen the diarrhea. For formula fed
infants, continue normal feeds. In older
children (> 1 year old), give more starchy foods (rice, bread, plain
pasta). In most cases, diarrhea is not an emergency and can be
addressed during office hours.
We do not recommend any medication to stop diarrhea. These medications may prolong the illness.
When to call the on-call doctor:
your child is having bloody stools
your child has become very dehydrated (sunken eyes, not urinating for > 8
hours if your child is < 1 year old, or > 12 hours if your child is >
1 year old)
In the best interest of a
sick child, an examination shouldalways be done first
before any antibiotic, if warranted, is prescribed. If you are concerned about your child’s illness
and think your child cannot wait until the morning to be evaluated, take your
child to an emergency room or urgent care center. Should issues arise with a refill request,
please call during regular business hours when we are best able to handle these
When your child receives vaccines, it is quite
common for him/her to have fever, discomfort, swelling and redness around the
injection site. For more information about shot reactions, consult the vaccine
handout you received in the office. In most cases shot reactions are not
Cough and Nasal congestion
nasal congestion are usually due to the common cold, which is,
indeed, very common and is caused by a virus. Other symptoms may include fever,
headache, sore throat, sore muscles and fatigue. A visit to the doctor's office
is often not needed, and colds usually get better in 3 to 4 days. There are many types
of viruses that can cause a cold. There are no medicines
that will make the cold go away, but some may help your child feel better; for
(Motrin, Advil) or acetaminophen (Tylenol, Feverall) if your child has fever or
pain. Antibiotics are not used to treat a common cold. Over-the-counter (OTC) cold and cough medicines are
not recommended for children under age 6. Make sure your child drinks plenty of fluids, gets enough sleep, and stays
away from secondhand smoke.
Call during office hours:
- If your child’s symptoms get worse after the first 2-3 days or do
not go away after 7 to 10 days
- Call the on-call doctor or take your child to the Emergency
- If your child is having
trouble breathing or is breathing rapidly
- If your child has asthma or
reactive airway disease and his/her breathing is not responding to breathing
treatments given every four hours
Earache and Sore throat
In general, both earache
and sore throat are not emergencies, but may need to be seen in the morning. Antibiotics, if warranted, will be prescribed
after your child has been evaluated. If
you feel that your child cannot wait to be seen until the office opens, please
take him/her to an urgent care center.
In the meantime, pain relievers may provide comfort.
In most cases,rash or unusual skin changes are not emergencies and cannot be
diagnosed over the phone. If you are
concerned about a rash, please call during regular office hours. If your child has recently started a medicine
and develops a rash, stop the medication and call our office in the
When to call the on-call doctor:
- If the rash is associated
with other worrisome symptoms or if your child looks or acts sick
Conjunctivitis is commonly
referred to as pink eye. If your child
has developed redness in the eye or discharge from the eye, please call our
office during business hours. In the
meantime, you can treat the eye with warm compresses or artificial tear drops
(available at most drug stores). The tear drops can be used as often as needed
to irrigate away the discharge. Remember, conjunctivitis may be contagious so
wash your hands after caring for your child.
When to call the on-call doctor:
- If your child sustained
trauma to the eye
- If your child is unable to
see from the eye or complaining of severe pain
- If your child cannot open his/her eye because of
eyelid swelling. Wipe away any discharge
with a lukewarm washcloth to help the eye open.
especially scalds from hot water and liquids, are very common childhood accidents. They
can be categorized as minor or major. Minor burns present with redness, pain,
and minor swelling. The skin is dry without blisters. Healing time is about 3
to 6 days; the superficial skin layer over the burn may peel off in 1 or 2
days. Major burns produce blisters, severe pain, and redness; the blisters sometimes
break open and the area is wet looking with a bright pink to cherry red color;
or, with even more severe burn, the surface may appear dry and waxy white,
leathery, brown, or charred. Any burn
that produces blisters should be considered major, unless it is very small and
does not involve the hands, feet, face, groin, buttocks, or a major joint.All major burns need immediate medical
attention. If a burn occurs, you
- Remove the child from the heat source.
- Run cool water over the
area of the burn or soak it in a cool water bath (not ice water). Keep the area
under water for at least 5 minutes. A clean, cold, wet towel will also help
- Calm and reassure the child.
- Over-the-counter ibuprofen or acetaminophen can help relieve pain
- For minor burns, if the skin is unbroken and
after it has
cooled, moisturizing lotion also can help.
- If a blister has formed, do not break it.
- Protect the burn with a dry, sterile gauze, bandage or with a
clean bed sheet or cloth.
- If your child's clothing is stuck to the burned area, do not
attempt to remove it. Instead, cut around the clothing, leaving the burn
- Do not apply any ointments,
oils, or sprays to the burned area.
If your child has burns on the hands, feet,
face, groin, buttocks, or a major joint, or if the burn covers a large area, take your child to the
Emergency Room or dial 911 for emergency medical attention.
If your child is a patient of Lansdowne Park Pediatrics and you need to reach the on call doctor after office hours, please call us at