For your child's protection and aid in diagnosis, do not give gum, candy, or food to the child before the exam. Objects in the mouth could cause your child to choke during the examination or when an injection is given, and candy can discolor the mouth and throat making it more difficult or impossible to make an accurate evaluation.

Tips on administering medicine: It is important to maintain a firm, positive approach when giving required medications. Most children will resist unpleasant tasting medications, but will be accepting when they realize there is no choice. A child old enough to do so, may feel more control and more agreeable to taking medicine if it is offered in a large, plastic measuring dropper with a spoon-like end. These spoons are available in most pharmacies. The important thing to remember is that each sick child must take the medication for the full time period prescribed. Do not give left over antibiotics to a child who has not been seen by the physician unless specifically advised to do so. There are medications that may be kept and used again, unless expired. Such things as ointments, ear drops, decongestants, and medications used for asthma or coughs should not be thrown away. Frequently you will be advised to use them again. For symptomatic relief, we often use medications that can be purchased from a drug store without a prescription. These medications may be used before or after a physician has been consulted.

Listed below are some of the drugs that fall into this category:

(1). Neosporin, Bacitracin, or similar, topical, antibacterial ointments for superficial abrasions or mild skin infections, may be applied 3-4 times a day.

(2). Sudafed, Dimetapp, Naldecon, or Triaminic. Antihistamines provide relief from a runny nose, watery eyes, and allergic-type symptoms. Decongestants are for nasal/sinus congestion and head cold symptoms.

(3). Robitussin DM, Benylin DM, or Rondec DM. Cough suppressant and cough expectorants are available over the counter and may be effective for some individuals. Your druggist can give you the names of other cough medicines.

(4). Tylenol, Tempra, Advil, Motrin or other fever reducing medicines.

(5). Benadryl or Tavist orally can relieve itching caused by chicken pox or other skin disorders. Calamine lotion applied topically is also helpful for itching; however, do not give Caladryl and oral Benadryl at the same time because the child may receive too large a dose of the medicine.

(6). Hydrocortisone lotions, creams, or ointments (eg. Cortaid) may be useful for rashes such as eczema, poison ivy, allergic or contact dermatitis.

Common Childhood Problems

Chicken pox: The incubation period is 5-21 days after being exposed to someone who has chicken pox. The first symptoms can be fever or runny nose followed by a rash which appears in crops of small, watery blisters on the back, chest, and/or scalp. For suspected or confirmed cases of chicken pox, do not use aspirin to reduce fever. The fever usually goes away by the second or third day. The rash is itchy. Try to prevent the child from scratching, as this may cause an infection and/or scarring. Keep the child's nails cut short, bathe him or her in cool water with Aveeno Bath or with enough baking soda (or cornstarch) to make the water cloudy. Calamine lotion can be used also for itching, as well as oral Benadryl or Tavist. Your child is contagious one day before the rash appears and until no more new spots have appeared for 24 hours. Most children with chicken pox break out with new spots for 3-5 days. A vaccine to prevent chicken pox has recently been developed. It can be given to children over 12 months of age. Although the vaccination is not required by schools, it is recommended by the American Academy of Pediatrics.

Common colds: Colds are caused by a virus that does not respond to penicillin or other antibiotics. The only cure for a cold is time. The average child under five may have as many as 8-10 colds per year. There should be no fever with a common cold, but Tylenol or Advil may be used for discomfort after the temperature has been taken. A cold mist vaporizer and nasal aspirator may help in younger children. It is important to encourage fluids to prevent dehydration. Most colds last 7-10 days, but if other symptoms develop such as earache, elevated temperature, or persistent cough, call your doctor. Antihistamine, decongestants, and over-the-counter cold medicines can be used to relieve the symptoms.

Constipation: Each child has different bowel habits. No child must move his or her bowels every 24 hours. However, if your child has pain during bowel movements, the stools are abnormally hard or large, or there is mucus or blood in the stool, call your doctor. Do not give a child laxative or an enema unless instructed to do so by a physician. Some common causes of constipation are too much milk or dairy product in the child's diet or not enough bulk such as wheat products, vegetables, or fruit. Frequently a dietary change alone will improve the situation.

Ear infections: Some children are prone to recurrent ear infections. These infections may be the result of a secondary infection following a cold or upper respiratory infection. They may also occur as an unrelated infection or allergy. Ear infections are more common in children who attend daycare/school and who live with a smoker. It can be very distressing to a parent to continually be bringing a child in with the same type of infection. As a child grows older, they have less frequent ear infections because the child develops better immunity to various bacteria and viruses, and as the head size increases, the Eustachian tube becomes large, thus making it less likely for nasal drainage to find its way into the middle ear and for fluid in the ear to drain efficiently. Some things to do during this difficult time with your child are:

(1). Teach the child to blow his or her nose.

(2). At the first sign of a cold, start giving a decongestant on a regular basis. This is beneficial for some, but not all, children.

(3). Always make an appointment if your child has an earache, since it is unlikely that it will go away.

(4). Frequent ear infections may necessitate a referral to an ENT specialist. Always feel free to discuss this possibility with your doctor.

Hernia: This is a protrusion of a portion of the intestines through the wall of the abdomen. An inguinal hernia is the most common and occurs more frequently in boys. If you notice a lump in the groin or scrotum that comes and goes as the child strains or cries, call the office. The hernia will need to be surgically corrected. It is not a medical emergency unless the hernia becomes grabbed (strangulated) and cannot be pushed back into the abdomen. If this happens, your child will be in pain and may vomit. In this case, call your doctor immediately. In very small infants, an umbilical hernia is not uncommon and usually disappears when the infant gets older. It is not painful and usually the only symptom is a lump at the naval that becomes larger when the child strains or cries. These rarely become strangulated.

Impetigo: This is a contagious skin infection that scabs and oozes. In most cases, the infection starts on the face. Impetigo occurs most frequently during the summer and early fall. If you think your child has impetigo, please make an appointment with your doctor.

Lice: The first sign of lice is usually itching. The eggs (nits) are tiny, pearly-white, oval-shaped objects that stick tightly to the hair shaft. Lice are transmitted by direct contact or indirectly through contaminated combs or clothing. Treatment consists of special shampoo that is available at the pharmacy. Please talk with the pharmacist. This shampoo kills both the lice and their eggs. It is also important to wash bedding and clothes. If your child has lice or you suspect lice, make an appointment with your doctor.

Motion sickness: Many children get car or air sick. To prevent this, give your child an anti-motion drug such as Dramamine or Bonine before you start out. Depending on your child's age, you can purchase the drug from the pharmacy.

Pinworms: Pinworms are common among preschool and elementary aged children. Itching around the rectum at night is usually the first, and may be the only symptom. To check for pinworms in your child, wait one hour after your child is asleep, take a flashlight into the dark room, and check the rectal area. You should see small, thread-like worms that are approximately 1/4 inch long. Make an appointment with your doctor if you suspect your child has pinworms.

Scabies: Scabies is a skin condition caused by a small mite which tunnels under the top layer of the skin and causes itching. It is more common on the hands and feet and can be spread when the child scratches an infected area and then touches a new area. Make an appointment with your doctor if you feel your child may have scabies.

Strep throat/Scarlet fever: Scarlet fever is a Strep throat with a rash. The symptoms usually include a sore throat, fever, headaches, and possibly vomiting. It is necessary to treat with a full course of antibiotic, as untreated Strep throat may lead to complications. Scarlet fever was feared before antibiotics were discovered because of the danger of Rheumatic Fever. However, with prompt, adequate treatment there is no danger today.

Urinary tract infections: Although urinary tract infections are generally not medical emergencies, their frequency and importance warrants some discussion here. Symptoms include frequent urination, urgency (feeling that one needs to void but cannot), itching or burning with urination, lower abdominal pain, or back ache in the flank area. Your child may or may not have a fever. Some patients have few or no symptoms. It is important to check a freshly voided urine specimen on any patient where the diagnosis is not clear. Urinary tract infections are more common in females. Bubble baths should not be used because they may cause irritation and subsequent infection. Children should be encouraged to urinate when necessary and not hold their urine for prolonged periods. Girls should be taught to wipe from front to back. Medication and close follow-up are necessary with a confirmed diagnosis of urinary infection in any child. Urinary tract infections in children under five years of age require further investigation. It is a good policy to observe the urine of all children periodically. The urine should be clear, yellow. Boys should have a good, strong urinary stream. Dribbling, incontinence, (urine staining of the underwear) poor urine stream, or cloudy, smoky, or bloody urine should be called to the attention of your doctor.