Tips for caring for common childhood illnesses.

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Simple Illness Care

Bug Bites

Insect bites cause itchy, red bumps; some bites may be painful
Mosquitoes breed in water. Eliminate standing water near your home
Many bugs and mosquitoes are prevalent in woods and grassy areas

Home Care

Avoid scented soaps, perfume and hair spray (these attract insects)
Wear light colored clothing covering most of the body
Keep children indoors from dusk to dawn, which is when mosquitoes bite
Insect repellent containing a concentration of 10% to 30% DEET appears to be safe for children over the age of 2 months. Insect repellant is not recommended for children under the age of 2 months
Apply DEET sparingly to exposed skin and NOT under clothing
Always wash DEET off skin with soap and water when returning indoors and wash treated clothing
If the bite is itchy apply calamine lotion; If bit is very itchy apply 1% hydrocortisone

Has an infected looking bite
Has a bite that becomes very tender
Has any other symptoms that are a concern

Call Office if Child:

Chickenpox

Acute viral illness that is very contagious; exposure approximately 2 weeks ago to someone with chicken pox
Can have a mild fever
Generalized rash begins on the chest, back, underarms, neck, and face
Rash begins as red bumps and develop a fluid filled center, blister, breaks open and small brown scab forms
Rash will continue to develop over the next 4-5 days in crops
When all sores have crusted over child is no longer contagious; generally takes 5-7 days

Home Care

Itching - baking soda baths (add ¼ cup of baking soda to the tub) or an oatmeal bath
Benadryl
Acetaminophen
DO NOT GIVE IBUPROFEN or ASPIRIN
Trim nails short to prevent infecting sores
Offer soft foods, encourage fluids

Has chicken pox sores that look infected
Develops a speckled, red rash
Is acting very sick
Complains of eye pain
Has Fever >105 or fever returns after going away for 24 hours
Is < one month of age
Has any new chicken pox after day 6
Has any other symptoms that are a concern

Call Office if Child:

Colds

A viral infection of the nose and throat
Most common symptoms include runny or congested nose, sore throat and cough
Nasal drainage (even if viral) can vary in color from clear, to cloudy, yellow or green
Typically the first symptom noted is a sore throat
Healthy children average 6 colds a year

Home Care

Increase humidity in child's room if the air is dry (cool mist humidifier) or have child sit in steamy bathroom with shower running for 10-15 minutes
For infants use bulb syringe to help remove nasal secretions from nose
May use saline drops in nose to help with congestion at any age
Encourage extra fluids
Elevate head of bed or have child sleep with head on more pillows (avoid laying flat in bed)
Multi-symptom cold medications not recommended
No cold medication recommended under age 4 years
May give fever reducers for fever as needed

Has a fever that persists for more than 3 days or if > 105 F
Pulling at ears/or complains of ear pain
Has symptoms for 10–14 days
Is not taking fluids well
Is not sleeping well
Is wheezing
Has any other symptoms that are a concern

Call Office if Child:

Cough

The sound made when the cough reflex expels air and secretions from the lungs
A cough spasm is more than 5 minutes of continuous coughing

Home Care

Increase humidity in child's room if the air is dry (cool mist humidifier) or have child sit in a steamy bathroom with shower running for 10-15 minutes
Elevate head of bed
or have child sleep with head on pillows (avoid laying flat)
Encourage fluid intake
Warm fluids like apple juice may help
Cough medication is not recommended for children under 4 years of age

Sounding congested in the chest
Is wheezing
Seems to be working hard to breath
Has a fever lasting for more than 3 days
Has a cough lasting more than 2 weeks
Has any other symptoms that are a concern

Call Office if Child:

Croup

The narrowing of the air passage through the larynx (voice box) and the trachea (windpipe)
Is most often caused by a virus
Symptoms can occur suddenly, often at night
Symptoms may come and go for 5-6 days getting better during the day and worse at night
Harsh barky cough
Retractions ("pulling in" of the chest or hollow of the neck with breathing)

Home Care

Run shower to steam up the bathroom, sit with your child 15-20 minutes to breathe in the warm moist air
In cold weather wrap child up warmly and take outside to breath in cold air for about 10 minutes, or open the freezer door and have child breathe in cold air
Cool mist humidifier in childs room at night may help

Is breathing in cold air or steam for 10-15 minutes and it does not help
Child is having retractions ("pulling in" of the chest or hollow of the neck with breathing)
Is refusing to drink
Is drooling
Has any other symptoms that are a concern

Call Office if Child:

Diarrhea

Noted to be a sudden increase in the number and looseness of stools (bowel movements)
Typically caused by a virus
Can last 5-14 days with the most severe diarrhea on days 1-2
Can be isolated or can also occur with vomiting

Home Care

Encourage to breast feed or give formula to infants as tolerated; avoid plain water
Avoid fruit juices and other drinks high in sugar as these will make diarrhea worse
If diarrhea is frequent and watery, pedialyte or another oral rehydration solution may be offered to help prevent dehydration (no longer than 12-24 hours)
Encourage more starchy food--bananas, rice, applesauce, toast, noodles, crackers, etc.
Yogurt can be helpful in restoring healthy bacteria into the stomach, offer plain or vanilla yogurt as tolerated

Has signs of dehydration: no urine output noted for more than 8 hours, no tears with crying, very dry mouth, and increased drowsiness
Has blood or mucous in stools
Has fever persisting more than 3 days or if > 105 F
Is having more than 8-10 episodes in a day
Has severe stomach cramps that don't go away with the passage of the diarrhea stool
Has any other symptoms that are a concern

Call Office if Child:

Earache/Ear Pain

Pain or discomfort in or around the ear
Usually due to an ear infection
Ear infections peak at age 6 months to 2 years
Onset of ear infections peak on day 3 of a cold
Only way to know if ear infection present is to have ear examined

Home Care

May give fever/pain reducers as needed
May apply either cold washcloth or local heat (warm washcloth, heating pad on low setting, hot water bottle) to outer ear for 20 minutes to reduce pain
Ear drops not recommended until ear pain evaluated

Has a fever that persists for more than 3 days or if >105 F
Ear pain gets severe
Drainage noted from ear
Is not taking fluids well
Is not sleeping well
Pulling or tugging at ear
Fussy or irritable
Has some loss of hearing
Has any other symptoms that are a concern

Call Office if Child:

Eye Discharge

Yellow or green discharge from eye

Home Care

Place a wet warm wash cloth on the eye as needed
Avoid wearing contact lenses

Has continuous discharge from eye
Has redness or puffiness around eye
Has a fever or cold symptoms
Is complaining of ear pain
Has any other symptoms that are a concern

Call Office if Child:

Fever

Is a symptom and not a disease
Is the body's normal response to infections and plays a role in fighting them
Fever is present > 100.4 F
The height of the fever does not relate to the seriousness of the illness, the behavior of your child is the best indicator of the severity of the illness
Fever causes no permanent harm until it reaches 107 F

Home Care

Encourage extra fluids
Keep clothing to a minimum, do not bundle up
Acetaminophen (Tylenol) or Ibuprofen (Motrin) may be given following the guidelines in Over the Counter Dosage Information
AVOID aspirin in ALL children under the age of 21 years

Is under 3 months of age and has a temp > 100.4 F rectally
Has a fever > 105 F
Is very irritable and unable to console
Complains of stiff neck with a headache
Has a fever persisting over 3 days
Has any other symptoms that are a concern

Call Office if Child:

Hay Fever

An allergic reaction of the nose and sinuses to an inhaled substance, usually pollen
Clear nasal drainage with sneezing, sniffing and nasal itching
Eyes may also itch and water or look pink
No fever
Noted to have had similar symptoms during same time of the previous year
Most common pollens are grass, trees and ragweed
Can also be caused by allergens from cats, dogs, horses, rabbits and other animals

Home Care

Give antihistamine continuously during the pollen season
May use warm water or salt water nose drops to wash pollen out of the nose – put 2-3 drops in each nostril and then blow nose
Shower and wash hair every night before bed
Stay away from pollen and other things that may cause symptoms to develop or worsen
Keep windows closed in the house and car
Avoid playing outdoors on a windy days
Wash eyes to clean away any pollen
May apply cold washcloth to eyes/eyelids for 10 minutes

Develops a fever
Develops sinus pain or pressure
Has congested sounding cough in chest
Continues to have symptoms with no improvement noted after taking antihistamine continuously for >2 days
Has any other symptoms that are a concern

Call Office if Child:

Poison Ivy

A very itchy blistering rash caused by contact with the poison ivy plant
Rash is shaped like streaks or lines
Leaves, stems, roots and berries of these plants cause the rash
More than 50% of people are sensitive to the oil of the poison ivy plant
Onset 1-2 days after being in a forest or field; usually last two weeks
Poison Ivy is not contagious to others but may be carried by pets

Home Care

If you think your child has come in contact with a poison ivy plant, wash the skin with soap and water as soon as possible
The oil from the plant may be on pet"s fur or on shoes or clothes. Wash it off pets or clothes with soap and water
Soak the involved area in cold water or massage with an ice cube for 20 minutes as often as necessary
Apply 1% hydrocortisone cream 4 times a day to reduce itching
If itching persists give Benadryl orally

Has rash lasting longer than 3 weeks
Looks infected
Has severe itching
Poison ivy on face, eyes, lips or genitals
Rash covers more than ¼ of the body
Has any other symptoms that are a concern

Call Office if Child:

Sore Throat

Most sore throats are caused by viruses and are part of a cold (usually noted at the beginning of a cold)
About 10% of sore throats are due to strep bacteria
A rapid strep test or throat culture is the only way to distinguish strep throat from a viral sore throat
Children that sleep with their mouth open often awaken with a dry mouth and a sore throat

Home Care

Acetaminophen (Tylenol) or Ibuprofen (Motrin) may be used for severe discomfort or fever
Over 1 year of age: sip warm chicken broth or apple juice
Over 4 years of age: suck on hard candy or lollipops
Over 6 years of age: gargle with warm salt water (Mix ¼ tsp of salt per 8oz glass of water)
Encourage extra fluids
Offer a soft diet; easy to swallow foods

Has a Fever lasting more than 3 days
Has a sore throat lasts more than 2 days
Seems dehydrated
Is drooling
Has any other symptoms that are a concern

Call Office if Child:

Stye

An infection of the hair follicle of the eyelash
Will look like a red bump at the base of the eyelash,(either upper or lower eyelid)
Usually comes to a head and forms a pimple in 2-3 days
Will usually drain in about 6 days but may last up to several weeks
Will feel tender to touch

Home Care

Apply warm packs to the eye for 10 minutes 4 times a day
Keep hands away from eye, as rubbing may cause more styes
Do not try to open the stye yourself

Eye lid becomes red and swollen
Has a fever
Stye comes to a head and has not drained after 3 days or has not completely healed by 10 days
Stye comes back
Has any other symptoms that are a concern

Call Office if Child:

Sunburn

Burning, redness, or blistering of the skin caused by sun overexposure
Can happen within 15 minutes of being in the sun
Minor sunburn is a first degree burn which turns skin pink or red
Prolonged sun exposure can cause blistering and a second degree burn
Sunburn never causes a third degree burn or scarring
Pain and swelling start at 4 hours, peaks at 24 hours, and improves after 48 hours

Home Care

Give child Ibuprofen
Apply 1% hydrocortisone cream 3 times a day to sunburn
Apply cool compresses to area several times a day
Encourage child to drink extra water
Leave closed blisters alone
For broken blisters, trim skin with a fine scissors cleaned with rubbing alcohol
For open blisters, apply over the counter antibiotic ointment

Has a sunburn covering a large part of the body
Is extremely painful or if blisters have formed
Has a fever
Feels faint or confused
Has signs of dehydration
Has symptoms of infection
Has any other symptoms that are a concern

Call Office if Child:

Swimmer's Ear

Infection or irritation of the skin that lines the ear canal
Associated with swimming/water activities
Ear canals can be itchy and somewhat painful; ear feels plugged
Discomfort noted when earlobe is moved up and down
Can have a slight amount of clear drainage from the ear

Home Care

May give pain reducers as needed
May apply local heat (warm washcloth, heating pad on low setting, hot water bottle) to outer ear for 20 minutes to help with pain and drainage
Reduce/avoid swimming until symptoms are improved

Pain gets severe and / or symptoms last more than 3 days
Has any other symptoms that are a concern

Call Office if Child:

Swimmer's Itch

Skin rash caused by an allergic reaction to certain parasites that normally live on water fowl and freshwater snails
Occurs typically in calm freshwater lakes and ponds
Parasites burrow into the skin causing symptoms of burning, tingling or itching
Parasites are unable to live off humans so they soon die
Usually only affects exposed skin (skin not covered by swimsuits, waders, wetsuits)
Rash may appear up to 48 hours after swimming in infected water and clears up on its own within a few days
Swimming or wading frequently in contaminated water can lead to more intense and immediate symptoms
Sometimes itching without a rash is the only symptom
Itching at rash too much may lead to secondary bacterial infection

Home Care

Rinse skin immediately after swimming and then vigorously dry skin with a towel
Launder swimsuits after
Apply cool compresses to affected areas
Soak in a bath with baking soda or oatmeal
Stir water into baking soda until it makes a paste and then apply to affected areas
Use over the counter antihistamine or anti-itch creams as directed by label on product
Avoid swimming in areas where swimmer's itch is a known problem

If itching not relieved by over the counter medications
Develops signs of infection due to itching (ie increased redness, fever, drainage at site)
If symptoms last more than one week
Has any other symptoms that are a concern

Call Office if Child:

Vomiting

Is the forceful emptying of the stomach contents (throwing up)
Spitting up is the effortless regurgitation of one to two mouthfuls of stomach contents
Vomiting usually stops in 12 – 24 hours
Dehydration (getting dried out) can be dangerous, but is unlikely in the first 12 hours of vomiting

Home Care

If no vomiting has occurred for at least ½ hour begin to offer clear liquids (for younger children pedialyte, for older children flat 7-up, Gatorade freeze pops, chicken broth); begin with ½ oz every 15 minutes; if no vomiting after 1 hour begin to double the amount of fluid every other time. If vomiting occurs again wait ½ hour and begin offering ½ oz of clear liquid
Once the child is able to drink a normal amount of fluid without vomiting (usually 12-24 hours of clear liquids) ok to begin solid foods ie: toast, crackers, and rice
Help your child go to sleep; sleep will often help empty the stomach and relieves the need to vomit

Has signs of dehydration (no urine output for over 8 hours, dry mouth, no tears when crying)
Has blood in the vomited material
Starts to act very sick
Has abdominal pain lasting over 12 hours
Has vomiting over 24 hours
Is under 12 weeks of age and has vomited more than 2 times
Seems confused or difficult to arouse
Has ingested any TOXIC material call the poison center 1-800-222-1222
Has any other symptoms that are a concern