Well Check Exams
Children need well check exams regularly to ensure they are growing well, development is on target for their age, and to evaluate for early signs of disorders or delays. In addition, children receive necessary vaccines to protect them from diseases, and parents have the opportunity to ask questions regarding concerns they may have. For the older child/teen, well checks encompass sports physicals, vaccines, lab work as needed, and sensitive topics for the age. Teens visit with the provider alone at well exams as recommended by the AAP to answer questions they may have as well as promote teen involvement in their healthcare.Parents will have the opportunity to discuss concerns with the provider if desired. Well check exams should occur on the following schedule: birth, 2 weeks, 1month, 2 months, 4 months, 6 months, 9 months, 12 months, 15 months, 18 months, 2 years, 2 ½ years, 3 years and annually thereafter until 21 years old.
Fever is the body's normal response to infections and plays a role in fighting them. Fever turns on the body's immune system, raising the temperature so viruses and bacteria cannot survive as easily. The usual fevers for children range from 100.4 to 104 degrees F and are not harmful. Most fevers with viral illnesses range from 101-104 degrees and last 2-3 days. The height of the fever does not correlate to the seriousness of the illness. What counts is how sick your child acts. Fevers do not cause permanent harm until they reach 107 degrees. Encourage children to drink extra fluids, and keep clothing to a minimum to allow heat to leave the skin. Only use acetaminophen or ibuprofen if the fever is over 102 and your child is uncomfortable. The American Academy of Pediatrics recommends that children through age 21 years avoid aspirin products. In general, it is not recommended to alternate acetaminophen and ibuprofen. There is no added benefit in reducing fever, and can lead to dosing errors and poisonings.
Most vomiting and diarrhea are caused by viral infections or eating something that disagrees with your child. Viral vomiting usually stops within 24 hours, however the diarrhea usually continues for days. Bottle fed infants who vomit once should receive half strength formula. If vomiting two or more times, they should be offered oral rehydration solutions (ORS) such as pedialyte for 8 hours. For breast fed infants, offer breast milk in smaller amounts. For children over 1 year old, offer clear fluids such as water, ice chips, or half-strength lemon lime soda or popsicles. For all children, give small amounts every 10 minutes. After 4 hours without vomiting, increase the amount. After 8 hours, bland foods such as saltine crackers, white bread, rice, mashed potatoes, etc may be added. Return to a normal diet in 24- 48 hours. For diarrhea alone, increase fluid consumption. Avoid all fruit juice or high sugar drinks as they make diarrhea worse. Starchy foods are absorbed best so give cereals, breads, pasta, etc. For young children, ORS may be needed. Probiotics may also be given to help lessen diarrhea. Call or go to the ER if your child has blood in the vomit or stool, has no urine in over 8 hours, severe abdominal pain that lasts more than 4 hours, or starts acting very sick.
Although it is a common problem, the cause of colic is unknown. Most babies have fussy periods, however babies with colic tend to have long periods of sudden, unexplained crying that will not stop. Babies need to be evaluated by a doctor to eliminate other causes of crying such as infections or other medical problems. Healthy babies may be colicky if they cry for at least 3 hours per day, 3 days in a row, for at least 3 weeks. Symptoms start during the first 3 weeks of life, peak at 6 weeks, and usually disappear by 12 weeks of age. There is no cure for colic, however making home life as calm as possible helps.
Colds and Coughs
The U.S. Food and Drug Administration has warned against giving over the counter cough/cold medicines to children under 2 years of age due to multiple reports of serious and life-threatening events in babies and toddlers. In addition, there has never been good evidence that the cold medicines work in this age group. The FDA is continuing to review research on the safety and effectiveness of cough and cold medicines in children 2-11 years old. The cough reflex is a mechanism to protect the lungs. Cough suppressants should not be used for productive coughs, in children with asthma, or for young children. Children should not be given these medications until older than 5 years, and then only once at bedtime to allow sleep. Treat colds and coughs for children under 2 years old by using saline drops and bulb suction for congestion and use a cool-mist humidifier.
Antibiotics are for bacterial infections only. They are not helpful in treating viral infections, and may actually be harmful if given. Antibiotics should only be given once a child is evaluated by a professional, and it is determined the antibiotic is needed. If given for viral infections, or not taken as directed, antibiotic resistance may develop. This may lead to deadly bacterial infections for which no antibiotic will work. In addition, antibiotics are not all equal. Certain antibiotics work for certain infections, and it is in the best interest of the patient to be evaluated in order to prescribe antibiotics if needed.