Frequently Asked Medical Questions

Acetaminophen can be given up to every 4-6 hours for fever or pain.

Ibuprofen can be given every 6-8 hours as needed for fever or pain.  Please do not give Ibuprofen in a child under 6 months old.

Vomiting and diarrhea have many causes, the most common of which are viral gastroenteritis and other viral illnesses.  Vomiting and diarrhea can be problems because they can lead to dehydration, especially in young infants.  Signs of dehydration include 1) mouth dryness, 2) decreased urination (or no urine in over 8 hours), 3) lack of tears, 4) sunken eyes, and 5) lethargy or irritability. 

What you can do at home: Try oral fluid replacement at the onset of your child’s illness.  For children who are vomiting, you may need to start very slowly and work your way up to larger amounts of fluid gradually.  For example, you could start giving fluids at the rate of at 1 teaspoon every 5 minutes, and if your child is tolerating that amount, then increase to 2 teaspoons, then 1 tablespoon, then 1 ounce until he/she is able to tolerate larger amounts of fluid without vomiting.  The best fluid to use is Pedialyte, because it replaces the electrolytes your child is losing without making diarrhea worse.  Plain water has no electrolytes or sugar, so it is not the first choice when your child is dehydrated.  If you child has diarrhea, please avoid very sugary liquids such as juice and soda, which can make diarrhea worse.

When to seek medical help: Please call our office or the on call service if your child's symptoms are not improving or are worsening over the next several hours so that we can further guide you.  If your child’s dehydration is severe and you cannot get enough fluid into your child orally, your child will likely need to go to the emergency room for IV rehydration.  In addition, you should go straight to the emergency room if you notice blood or bile in your child's vomit.

Cough is a natural reflex that occurs in response to mucus or other irritants in the airways and lungs.  There are many causes for cough, such as common colds, croup, allergies, and asthma attacks.  Cough can be either acute (less than 2 weeks duration) or chronic (greater than 2 weeks duration).  If your child has had a chronic cough, you should make an appointment at our office to further discuss causes and treatment.  If your child has an acute cough, continue reading for tips on management. 

What you can do at home: Nasal saline drops with suctioning in young infants can help to reduce postnasal drip, thereby helping with mucus-induced coughing.  Repositioning your child into an upright or sitting position can help reduce cough.  You can also try a humidifier or vaporizer in your child's bedroom.  If your child has a history of asthma or wheezing, you can try using a nebulizer or inhaler breathing treatment.  If your child is uncomfortable, you can give Acetaminophen or Ibuprofen to reduce the pain.  If the cough sounds like a barking seal, the cause may be croup, and you can try letting your child breathe in cold air from the freezer or steam from a hot shower.  We do not recommend cough medicines as they suppress the body's natural reflexes and can result in worsening.

When to seek medical help: Please call our office or the on call service if your child is having any associated breathing problems, such as wheezing or rapid breathing, or if the cough is continuous.  Please go straight to the emergency room or call 911 if your child has any more serious signs of respiratory distress, such as retractions (chest caving in, ribs sticking out, nostrils flaring), cyanosis (blue skin), or gasping. 

Fever is defined as an elevated body temperature higher than 100.4 degrees Fahrenheit or 38 degrees Celsius (taken rectally).  The most common cause of fever is infection, either viral or bacterial.  The height of your child's temperature is never as important as how your child looks and responds to you.

What you can do at home: If your child has a fever but otherwise looks good, you do not need to give medications.  Keep in mind that the fever may actually help fight off the infection.  If your child is acting sick (ie: fussy, uncomfortable, or sleepy), you may want to give a dose of Acetaminophen or Ibuprofen to reduce the fever.  Please refer to the dosage charts listed in this section for the proper doses of these medications for your child's weight.  Be certain that you are not giving any other over the counter medications also containing either of these medicines as overdoses can happen.  If you suspect an overdose, please call Poison Control at 1-800-222-1222 immediately.  Never give your child aspirin for fever. 

When to seek medical help: Please call our office or the on call service if your child has fevers lasting more than 72 hours, has temperatures higher than 104 degrees Fahrenheit, or has seizures associated with the fever.  Please go straight to the emergency room if your child is younger than 30 days old with rectal temperature >100.4 or is acting very ill despite medications to reduce the fever.  If your child was placed on antibiotics for a bacterial infection and continues to have fevers 48 hours later, you should call our office for an appointment to get your child rechecked. 

Colic is defined as prolonged fussy periods of crying (at least 3 hours per day) for no obvious reason in a baby from birth to 3-4 months.  There is no known cause for colic, but it is thought to be due to a combination of a baby's temperament, a baby's response to stress (ie: overstimulation or understimulation), and parental responses to their baby's cries. 

What you can do at home: First look for other causes of crying, such as hunger or a dirty diaper.  When other causes have been ruled out, you can try other comfort measures such as tightly swaddling your baby, holding and rocking your baby, giving your baby a pacifier, or repositioning your baby on the side or stomach.  (Keep in mind that you should never let your baby sleep on his/her side or stomach).  You could also try a vibrating swing, carrying your baby around in a sling, or a warm bath.  For most babies, a combination of these techniques will help them to calm down.  Remember that intermittent crying, for up to 3 hours a day and which is consolable, is very normal during the first few months of life.

When to seek medical help: Please call our office or the on call service if your baby's crying is inconsolable or if there are other symptoms associated with the crying (ie: poor feeding, vomiting, diarrhea, fevers).

As a parent, you are bound to see your child fall multiple times as he/she explores the environment.  Most often, these falls are harmless.  However, you should be concerned about fractures and head injuries when your child has a more severe fall especially onto a very hard surface.   

Fractures- If your child has pain, swelling, or is unable to move or use an extremity after a fall, you should apply ice to the affected area to help with the swelling, give your child a dose of Ibuprofen, and elevate the extremity to see if the pain and mobility improves.  If pain persists, your child is unable to move or use the affected body part, or the swelling is not improving, you should make a visit to the emergency room to look for a fractured bone. 

Head injury- If your child is older than 2, cried immediately, had no loss of consciousness, has not vomited, and is behaving and walking normally, you can watch carefully at home.  Please call our office or the doctor on call for further advice if needed.  If your child is under the age of 2, you should make an office appointment or go to the emergency room because your child should be neurologically evaluated by a professional to determine if he/she has sustained a skull fracture or brain bleed.  If your child had any loss of consciousness, is vomiting, or is not acting like himself, please call 911 and go directly to the emergency room for evaluation and head CT scan.