Parent Handbook

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Common Pediatric Symptoms (alphabetical by condition)

Allergies, Recurrent Colds, and Ear Infections

If your child suffers from recurrent ear infections or sinus infections, or if he seems to keep a cold all the time, he may be showing symptoms of allergies.  The following may help:

  1. Avoid cigarette smoke.  Children of smokers have more colds and ear infections and more hospitalizations for asthma and pneumonia than do children of non-smokers.  Do not smoke around your child.  Smoking should be outside: even if you smoke in another room, that smoke gradually spreads throughout the house and is contained in your clothing.
  2. Avoid exposure to other sick children when possible.  If arrangements can be made to have your child around only a few small children, your child will be exposed to fewer contagious illnesses.
  3. Avoid house dust.  For the child with a confirmed or strongly suspected allergy to dust,  the child should not sleep with stuffed animals which cannot be washed.  Pillows should be featherless, washable, and enclosed in zippered, hypoallergenic covers.  The child’s bedroom should be dusted and vacuumed several times a week.  Curtains should be washed regularly and carpet should be removed if possible.  
  4. If a child has a suspected allergy, dogs and cats should be kept out of the house and should never be allowed in the child’s room.
  5. If you suspect food allergies, contact your physician to discuss possible evaluation.

ADHD (Attention Deficit Hyperactivity Disorder)

Children with attention deficit hyperactivity disorder have problems with inattention, hyperactivity, and impulsivity.  Kids with ADHD may find it very difficult to sit still, concentrate on their schoolwork, focus their attention for long periods of time, and finish their work.  Because of these factors, they generally begin to have problems at school.  In addition to inattention and hyperactivity, kids with ADHD may have problems controlling their impulses. In their dealing with other people, some children with ADHD tend not to be sensitive to the feelings, desires, and reactions of others.  If left untreated, the disorder can have major complications of school failure, a sense of worthlessness and failure, and family chaos.

If you suspect your child may have attention deficit hyperactivity, you should schedule an appointment with your PCP to discuss these concerns.    It is very important for you to tell the receptionist that the appointment is for an ADHD evaluation for appropriate scheduling.  ADHD appointments are usually scheduled well in advance.

For children on ADHD medications, yearly physicals are required with weight checks scheduled every 3 months.  Renewals for ADHD prescriptions require a 72-hour notice to allow sufficient time to prepare the prescriptions and obtain your physician’s signatureThe prescriptions will be ready for pick-up at your child’s weight check appointment.  


Antibiotics are used for only certain kinds of bacterial infections and are not used to treat viruses.  Because of the potential dangers of the illnesses that require antibiotics and because of the potential side effects and overuse of antibiotics in general, we do not usually prescribe these medications over the phone. 

If you feel your child may need an antibiotic, an appointment should be scheduled.  

Colic in Infants

Colic is a poorly understood condition of young infants associated with crying spells usually in the evening.  Typically, an infant with colic has periods of extreme fussiness characterized by crying, sucking on fist, wanting to eat often, passing gas, flailing the arms and legs, turning red in the face, and pulling knees to the abdomen as if in severe pain.  The following approaches may be helpful:

  1. Check your baby carefully to make sure there is no other reason for crying.  This should be done with the baby completely undressed.  If there is nothing obviously wrong, make sure your baby is well fed, adequately burped, and appropriately dressed, including a clean, dry diaper.
  2. Swaddle the baby snugly in a blanket, holding the baby close to you with his head near your voice box as you hum quietly.
  3. Rock baby gently or use an automatic swing.  Some babies are comforted by a ride in the car.
  4. Burp the infant after every one to two ounces of formula and several times during breastfeeding.  Mylicon drops (simethicone) (0.3 ml every 2 hours) may help decrease gas and is available without prescription.
  5. If your baby is bottle-fed, try changing the type of bottle and/or nipple.  We recommend that you call the office before changing formulas.

If the above measures are not helpful and your baby continues to scream, it is possible that your child has another problem besides colic.  Unusual screaming which is inconsolable and persists for more than two hours should probably be evaluated or prompt a call to our office.

Common Cold (Upper Respiratory Infection)

Colds are caused by viruses and are extremely common (small children may have six to ten colds per year).  Symptoms usually include sneezing, runny nose, congestion, low grade fever, sore throat, and cough.  As the cold progresses, the nasal drainage often becomes thicker and may turn yellow or green. 

In most cases, the cough is a productive cough and is the result of upper respiratory drainage into the throat rather than actual infection in the chest.  Over-the-counter cold medicines do not shorten the course of the illness, but in some cases may lessen the discomfort.  Because colds are caused by viruses rather than bacteria, antibiotics are not helpful.  The common cold usually lasts from 5 to 10 days.  Recommended treatments include:

  1. Rest
  2. Encourage plenty of fluids, especially clear liquids to keep mucus thin.
  3. Acetaminophen for fever or aches (Click Here for dosing information)
  4. Saline nose drops (Ayr, Ocean) to loosen mucus.  Put 2 to 3 drops into the nostril, wait a minute then suction with nasal aspirator, repeat on the second nostril.  Repeat the entire procedure as necessary to keep comfortable.  Clear the nose, especially before feeding infants and before sleep.  Saline nose drops can be made by adding half a teaspoon of salt to 4 oz. warm water.  Allow to cool before using and make fresh daily.
  5. Vaporizer.  Use a cool mist vaporizer to decrease nasal congestion, especially at night.  Be sure to wash the water reservoir daily to avoid mold from forming.  We do not recommend warm mist machines because of the risk of burns.  
  6. Allergy and/or cough medicine may help older infants and children be more comfortable.  Generally, cold medications are not recommended for children less than 4 years old unless advised by a physician.

If the cold is not improving after 7 to 10 days or if the cold is complicated by ear ache, bad cough, persisting fever, or eye mattering, call the office for an appointment.


Constipation in Infants (birth – 12 months):

Constipation is having stools which are hard and difficult to pass.  The frequency and character of bowel movements in infancy are quite variable.  Some infants may have a stool with almost every feeding while others only have a stool every few days. 

Both patterns are probably normal.  Some straining and grunting is normal when a baby passes a stool.  If, however, it has been four days since a bowel movement or if the stool is extremely thick, pasty, or firm balls, the baby may be constipated.  To treat constipation in the infant:

  1. For infants less than 2 months, contact the clinic.
  2. For infants over 2 months, add 2 ounces of 100% fruit juice (pear, prune, or apple) to their daily diet as needed.
  3. Often, using a rectal thermometer (like checking temperature) will stimulate your baby to have a bowel movement.  This should not be done on a daily basis.
  4. Glycerin suppository – this may be done daily for one to two days but no longer.

Constipation in Older Children (12 months & older): 

Constipation in older children is usually due to a combination of a poor diet and bad bowel habits.  The treatment is mainly directed at increasing dietary fiber.  To treat constipation in the older child:

  1. Increase the amount of juices and water in the diet
  2. Increase the amount of fiber in the diet.  Use bran, uncooked vegetables, and raw fruit.  Unprocessed bran can be added to casseroles, hamburger, meatloaf, and baked goods.  Bran crackers or wafers can be given.
  3. Decrease the amount of dairy products in the diet.  Reduce total milk to approximately 12 oz. per day.  Other dairy products include cheese, ice cream, cottage cheese, yogurt, etc.
  4. If the above measures are not helping, you can try over-the-counter MiraLAX, one capful twice daily added to juice or water.  This is safe to use as long as needed.
  5. If your child is acutely constipated give a pediatric Fleets enema.

If the above measures fail,  your child should be evaluated in the office.


The majority of coughs seen in children are productive coughs caused by mucus draining into the throat from the sinuses.  These coughs are not a sign that the cold has “moved into the chest” but simply the body’s way of clearing mucus that is blocking the airway.  A child needs to cough to clear his throat. 

Over-the-counter (OTC) cough and cold medications can be harmful to young children.   From ages 4-6 years, cough medicine should be used only if recommended by your child’s healthcare provider.  After age of 6 years, cough medications are safe to use, but follow the instructions on the package about the right dose of medication to give.

Non-medicinal cough treatments can be effective, for example:  

  • For children over 1 years of age, use 2-5 mls of honey or corn syrup
  • For children over 2 years of age, rub a layer of mentholated rub (Vick’s) on the chest and throat.

Another cause of cough is wheezing which may produce a frequent, harsh, nonproductive cough.  This condition should be examined by a doctor.  If the child is not in distress and an Albuterol inhaler has been prescribed before, Albuterol may be given until the child is seen by appointment.



Croup is a viral infection of the upper part of the airway near the voice box.  It is common in younger children and is associated with low grade fever, hoarseness, a loud barking-type cough, and occasionally breathing difficulty.  Though it is usually not serious, croup frequently occurs in the night time and can be alarming.  During these attacks, you will notice the child having difficulty drawing his breath in and some breathing movements will be noted above the collar bone and over the stomach.  

Treatment for croup is as follows:

  1. Encourage fluids
  2. Use a cool mist humidifier in the room where the child sleeps
  3. Treat fever with acetaminophen if needed (Click Here for dosing information)
  4. During an attack of breathing difficulty, go to the bathroom with the child and put the shower on hot to produce a steamy mist.  15 to 20 minutes in this environment will often relieve the attack.  If this doesn’t work, wrap the child up and take him out into the cool night air for a few minutes.  If these measures fail and you believe your child is in distress with rapid and labored breathing, the child will need to be seen in the office or in the emergency room.

Ear Aches

Earaches can be caused by several things including increased pressure, bacterial infection, and viral illness and teething.  A sudden earache following a cough, sneeze, crying, or yelling is probably caused by pressure and will likely resolve spontaneously after a short time.  Earaches may occur when a child has a cold: the Eustachian tube connecting the throat and the middle ear is blocked, causing increased pressure and pain, but there is not necessarily middle ear infection.  Finally, earaches may be caused by bacterial infection which will likely require antibiotic therapy. 

Most earaches, especially when associated with fever, should be evaluated in the office during regular hours.  To provide relief at home prior to the office visit, the following things can be tried:

  1. Acetaminophen of Ibuprofen for pain (Click the links for dosing information)
  2. Resting the head on a hot water bottle.
  3. If there is not drainage and the child does not have ear tubes and you have some numbing drops on hand, these may be warmed and placed in the ear to relieve pain.
  4. Earache pain is usually worse at night and the child should be brought in the following day even if he seems better.  Earaches are not generally treated over the phone as an accurate diagnosis is important.


Your child’s normal temperature will vary with his age, activity, time of day, the environment, and the route (oral, rectal, or axillary) of taking the temperature.  A tympanic (ear) thermometer is another option but is not recommended in infants less than 3 months old.  A rectal temperature is the preferred method in children under 3 years of age.  Other methods are available, but not recommended.

A normal rectal temperature is about 99.6° F, but may range between 98° F to 100.2° F.

Taking a Child’s Temperature:

A rectal temperature of 100.4° or higher in an infant less than 3 months of age should be reported to the physician.  DO NOT GIVE TYLENOL unless advised by a physician.

Rectal Temperature:

  1. Get the Thermometer Ready
    • If using a digital thermometer, turn on, place in plastic cover, lubricate with petroleum jelly.
    • If you don’t have plastic covers, just wash the thermometer with warm, soapy water and rinse then lubricate tip of thermometer with petroleum jelly.
  2. Position your baby in the position that is best for you.  Here are two of the safest positions:
    • Put baby on his back on a firm surface.  Hold baby’s ankles and lift legs, as if you are changing a diaper.
    • Or place baby on stomach and spread buttocks so anus (opening where bowel movements leave baby’s body) is easily seen.
  3. Taking the Temperature
    • Gently slip the tip of the thermometer into the anus ½ inch to 1 inch so the tip will no longer be seen and push the start button.
    • Hold the thermometer in place for a couple of minutes until you hear a beep.
    • Remove thermometer
    • Read degree of temperature exactly as displayed on the thermometer.

Under arm temperatures (axillary): may be taken in children over the age of 3 years.  You should always report the temperature exactly as displayed on the thermometer and report the route taken.  

Oral temperature: may be taken when the child is able to hold the thermometer properly in their mouth (under their tongue) for the required amount of time.

Treating a Fever:

Fever is common in childhood and usually signifies an infection of some kind.  Fever itself is not an illness.  In fact, fever is a positive sign that the body is fighting an infection.  Fever may be present with simple viral illnesses (colds), or more significant infections like an ear infection, pneumonia, or bladder infections.  Fever is treated when it makes the child feel bad. In the majority of situations acetaminophen (Click Here for dosing guide) or a room temperature sponge bath is all that is needed to decrease the fever.


  1. Dress your child only in light clothing like a T-shirt and underwear or diaper.  Bundling the child tightly or wrapping in a blanket will only make the temperature rise.
  2. Give acetaminophen (Click Here for dosing guide) if your child is uncomfortable, has a high fever, it is bedtime, or there is a history of febrile seizures.
  3. Give the child cool liquids to drink.
  4. If the child has a high fever (105̊ rectal) that does not respond to the above measures within 30 to 60 minutes, it is possible to lower the temperature by giving a sponge bath.  Place the child in a tub of room-temperature water (do not use ice water or alcohol) and sponge him off thoroughly.  Using a cup and pouring water over his head will be even more effective in bringing down the temperature.  You can expect your child to shiver and cry during the bath, this is no cause for alarm.
  5. Ibuprofen may be given to relieve fever in children over 6 months of age.  Acetaminophen and ibuprofen may be alternated every 3 hours for high fevers not controlled by acetaminophen alone: acetaminophen given now, then ibuprofen given in three hours, and then alternate them every three hours.  (Click links for dosing guides).

*Ibuprofen is not recommended for children less than 6 months of age.

When to call the clinic for a child’s fever:
  1. If your child is less than 3 months of age,  This is an emergency.
  2. If your child is 3-6 months of age and the temperature is greater than 103° degrees F.
  3. If your child has an accompanying symptom that warrants exam:
    • A stiff neck and irritability (emergency)
    • Has a rash that doesn’t blanch, or turn pale with pressure (emergency)
    • Has a seizure (needs to be seen immediately)
    • Ear pain, cough, burning upon urination-all should be examined

Insect Bites and Stings

 Most insect bites are not serious unless the child is severely allergic. Treatment includes:

  1. Removing the stinger if present with horizontal scraping motion.
  2. Placing cool, wet compresses on the area.
  3. Benadryl elixir (Click Here for dosing guide) for severe itching.
  4. Apply 0.5% or 1 % hydrocortisone cream for itching.
  5. Acetaminophen for pain (Click Here for dosing guide).
  6. Go to the nearest emergency room if your child develops difficulty breathing, a sensation of fullness of tongue or throat, passes out, or becomes very pale.

Kidney-Urinary Problems

Any symptoms suspicious for urinary tract infection including painful urination, urinary frequency, and urgency should be evaluated in the office.  A urine sample will be collected during the visit to check for infection.  If your child needs to urinate prior to being called back to see the doctor, please notify a member of our staff.

Nose Bleeds

Nose bleeds can be caused by dryness of the lining of the nose or by picking the nose.  Allergies or upper respiratory infections may aggravate the problem.  Having the child sleep with a cool mist humidifier can decrease the dryness of the air, which may help.  Polysporin ointment or Vaseline applied into the nose with a Q-tip may also be of benefit.

To stop active bleeding, have the child sit up, tilt his head forward, and pinch the entire nose together for at least 5 to 10 minutes or use an ice pack.  After the bleeding stops, do not remove the clot from the nostril.  Chronic nose bleeds should be evaluated by appointment during regular office hours.


If your child swallows a potentially dangerous substance, call Poison Control immediately.  

Poison Control #:   501-686-6161 or 1-800-376-4766 (1-800-3POISON).


Diaper Rash: Diaper rashes are usually due to either irritation from a wet diaper or to yeast which grows on the skin in moist areas.  The following treatments are recommended:

  1. Change wet or soiled diapers frequently
  2. Use a washcloth with water only; avoid wipes and soaps that will sting the inflamed skin
  3. Apply zinc oxide (Desitin) or other diaper ointment (A&D; Diaper Goop; Vaseline)
  4. Allow exposure to air by leaving diaper off; this is most convenient during naps when the child can be laid on a towel

If the rash is red and bumpy and fails to respond to the above measures, try an over-the-counter yeast cream such as Monistat or Gyne-Lotrimin applied to diaper area three or four times per day.  If rash does not respond, call office for an appointment (501-847-2500).

Poison Ivy: If your child has come in contact with poison ivy or another irritant, it is important to wash the involved area thoroughly with soap and water to remove the poison ivy toxin.  Benadryl elixir (Click Here for dosing guide) can be used to control itching.  Calamine lotion and Aveeno baths may also be helpful for itching (trim fingernails to prevent scratching).  ½% to 1% Hydrocortisone cream applied to the area can decrease inflammation.  If the rash is particularly severe, you should call for an appointment during regular business hours.

Viral Rashes: A red rash over the whole body in a child with a low grade fever, who otherwise feels well, is probably due to a virus.  If the rash causes no symptoms, then no treatment is required.  Itching can be treated with Benadryl (Click Here for dosing guide). A rash in an ill-appearing child should be evaluated by the doctor.

Rashes due to drugs: If a rash develops while a child is taking a drug, that medication should be stopped and the doctor notified during office hours.

Roseola:  This is a viral infection of small children.  It begins with a high fever of 2 to 4 days duration.  About the time the fever breaks, a red rash over the whole body appears.  The rash disappears after 1 to 2 days and requires no treatment.

Impetigo: This is a bacterial infection of the skin and is mildly contagious.  Impetigo is characterized by weeping, honey-colored drainage which dries and forms crusts around the lesion.  Mild impetigo can be managed with the following measures:

  1. Wash well with soap and water
  2. Apply antibiotic ointment (Polysporin) two or three times daily
  3. Keep fingernails clean and short to reduce spread of infection
  4. Place freshly laundered clothes on the child each day.  Repeated wearing of unwashed clothes will spread infection
  5. Benadryl may be used for itching (Click Here for dosing guide)

If your child has more than one area of skin involved or if the infection seems especially bad, call the office for an appointment, occasionally antibiotics by mouth may be indicated.

Hives and allergic rashes: 

Hives is a red, raised rash in various sizes which is usually due to an allergic reaction.  The rash seems to move to different areas of the child’s body and is often associated with itching and sometimes with swelling of the hands and feet.  The rash is usually not dangerous, but can be uncomfortable.  Hives can be caused by anything the child has eaten, breathed, or come in contact with.  Benadryl (Click Here for dosing guide) may help resolve the rash and control the itching.

Foods are the most prevalent trigger for allergic reactions.  Stinging insects and medications can also cause reactions.

Symptoms that should prompt immediate ER visit include:

  • Difficulty breathing
  • Swelling of the tongue or mouth
  • Difficulty swallowing
  • Confusion or anxiety
  • Pale or blue skin
  • Repeated vomiting

Scabies and Lice

Head Lice:

Head lice are an insect infestation of the hair which are identifiable by the oval, yellow/white ‘nits’ (lice eggs) which adhere to the hair close to the scalp, particularly just above the hairline on the back of the neck.  Lice can be treated with over-the-counter Rid or Nix and careful removal of the nits. 

If this treatment is ineffective, apply a liberal coat of Vaseline, mayonnaise, or olive oil to the entire scalp and sleep with a shower cap on to suffocate the lice.  The next morning, thoroughly wash the hair with dishwashing detergent (such as Dawn) to clean the hair and remove all the oil.  Next, remove ALL nits using a nit removal comb (fine-tooth comb).  This may be very time-consuming so be sure to allow enough time to thoroughly go through your child’s hair to remove ALL nits. If you cannot get rid of the problem with the above measures, call the office during regular hours.


Scabies is another skin infestation caused by a tiny mite which causes an extremely uncomfortable rash due to itching.  The rash is common on the trunk, groin, and between the fingers.  Sometimes ‘tracks’ can be identified where the mite has burrowed underneath the skin.  Call the clinic during office hours to schedule an appointment if you believe your child has scabies.

Sore Throat

A mild sore throat without fever can be treated with warm liquids, salt water gargles, throat lozenges or hard candy, and/or Chloraseptic spray.  If the sore throat persists over four days, even without fever, the child should have an appointment to be seen. If fever is present with a sore throat, the child should be evaluated in the office for strep throat.   

Stomach Ache

Stomach ache is very common in children and is somewhat comparable to headaches in adults.  Often it is caused by stress or fatigue and no other cause can be identified.  Another common and often unsuspected cause of abdominal pain in children is constipation.  If your child complains frequently of stomach ache, pay careful attention to the child’s bowel habits for a few days and refer to the section on constipation, page 12.  Rarely, abdominal pain is caused by appendicitis or other serious illness.  If any symptoms below are present, consult the physician:

  • Severe and persistent pain
  • Persistent vomiting
  • Pain localized in the right lower portion of the abdomen
  • Persistent fever
  • Painful urination
  • Bloody stools or black and tarry stools


The first teeth usually erupt around 6 months of age, but may erupt anywhere from 4 to 15 months of age.  It is not clear whether or not teething actually causes illness in children.  Drooling and chewing are also normal around 6 months of age and may be in part due to discomfort in teething. 

In general, it is not recommended that you put salve or lotion (Oragel) or teething tablets on the baby’s gums for teething symptoms as these can potentially be harmful.  Acetaminophen (Click Here for dosing guide) can be given for teething pain.  Chewing on cold objects (teething rings, wet washcloths) may be provided for comfort.  Frozen objects are not recommended.  Certainly, any severe symptoms such as high fever, prolonged vomiting, etc., should never be assumed to be due to teething, but rather treated as you would any illness in your baby.

Other Dental Problems: Young children take many falls and often injure their mouths in the process.  Bleeding after such a fall can be due to a tear of the frenulum, which is a small web of skin between the lip and gum.  Applying pressure to the lip will stop bleeding in a few minutes.  No other treatment is needed.  If teeth are loosened or knocked out, (if found, keep the tooth in milk) consult your dentist. Some teeth can be replaced.

Vomiting & Diarrhea (Dehydration)

Vomiting or forceful emptying of the stomach is usually caused by a viral infection, though there are other causes.  When vomiting is caused by a stomach virus, the child may also have diarrhea.  Although uncomfortable, vomiting itself is not dangerous to the child.  

Diarrhea is frequent, loose, watery stools.  It is most commonly caused by a viral infection called gastroenteritis.  Gastroenteritis often begins with vomiting and fever.  After several hours, the vomiting may stop and diarrhea begins.  Rarely, there are other more serious causes of diarrhea that include bacteria (Salmonella, E. Coli, Shigella, and others), parasitic infections (Giardia), and milk allergy.  Diarrhea caused by viruses resolve without specific treatment.  The main concern with vomiting and diarrhea is the loss of fluid that may lead to dehydration.  We do not recommend the use of medications to stop diarrhea unless specifically prescribed by our office.

Dehydration results when the child loses excessive fluid. This is usually due to vomiting and diarrhea.  Dehydration is serious and should be evaluated in our office or emergency room. Signs of dehydration include:

  1. Dry mouth: Place your finger inside the child’s cheek and then rub your thumb and forefinger together.  If it is wet, there is no need to worry about dehydration.  If, however, it feels sticky, tacky, or definitely dry, then dehydration may be present.  A child that is drooling is not dehydrated.
  2. Poor urine output: Infants and children usually urinate at least once every eight hours.  Decreased urine output in the presence of vomiting and/or diarrhea may mean dehydration is present.  No urine output in a 24 hour period is a serious sign of dehydration.
  3. No tears when crying.
  4. Fussy, tired or acting ill:  a child that is alert, happy and playful is not dehydrated.

Your child should be evaluated if:

  • Signs of dehydration are present
  • Diarrhea is associated with high fever over 104° degrees unresponsive to acetaminophen.
  • There is pus or blood in the stool.
  • Diarrhea continues for more than three days despite diet changed listed below.
  • The vomiting continues more than 24 hours.
  • Your child becomes confused or difficult to wake.
  • The vomiting is associated with a severe headache.
  • The vomitus is green stained (bilious).
  • Your child is less than three months old and is vomiting forcefully.
  • Your child is less than three months old and is having a high volume of diarrhea after 24 hours.

Treating Vomiting & Diarrhea in Infants and Children:


  1. Initial therapy is to encourage adequate hydration.  Breastfeeding can continue during vomiting and diarrhea.  If your baby is formula fed, you may continue his/her regular formula in small, frequent amounts.  If your baby is not allergic to soy, you may start soy formula which may decrease the duration of the diarrhea.  You may also offer Pedialyte.
  1. Monitor closely for signs of dehydration. (See Dehydration Page 19)
  2. You may resume an age-appropriate diet once your child appears to be well hydrated.  Within the age-appropriate diet, complex carbohydrates, lean meats, yogurt, fruits and vegetables are better tolerated than foods containing high levels of fats and simple sugars.
  3. Do not give your infant or child any antidiarrheal or anti-vomiting medications without a specific recommendation from your physician, as these can be harmful in infants and children.

CHILDREN (12 months and older):

Vomiting You may offer your child small amounts of fluid frequently, gradually increasing the volume.  If vomiting persists, begin fluids anyway in between vomiting episodes. 

Diarrhea If diarrhea alone is present, begin fluids as outlined below in large amounts.  The goal of fluid therapy in vomiting and diarrhea illnesses in children is to give more fluid to the child than is lost in the diarrhea and vomiting so that dehydration won’t result.

Clear fluids in small amounts at room temperature and frequently offer fluids such as:

  • Pedialyte
  • Gatorade
  • Jello, Jello water
  • Sprite or 7-Up
  • Ginger ale
  • Bouillon or chicken soup
  • Popsicles

You may want to avoid milk/ lactose products.


Wheezing is caused by congestion deep in the lungs and is associated with a squeaking or whistling sound when the child breathes out.  Audible nasal congestion is sometimes confused with wheezing.  Wheezing can be caused by an infection or by asthma.  A child with wheezing should be evaluated promptly unless the child has had wheezing treated repeatedly in the past and parents are very comfortable with its management.  If the wheezing is accompanied by breathing difficulty, the child should be taken to the ER.  For severe or life threatening breathing difficulty, call 911.

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Today, most children in the United States lead healthier lives and parents live with less anxiety and worry over infections during childhood. Immunizations are one of the success stories of modern medicine. The recommended schedule of immunizations can change and your child’s immunization status will be evaluated with each well child evaluation visit.

The American Academy of Pediatrics, and its 67,000 members, urges parents to make the decision to immunize. CAPC Pediatricians strongly recommend timely vaccinations because of what we know to be true: Vaccines are simply the best way to protect our children from these viruses and bacteria that can cause real and devastating harm.

We recommend the following websites for the latest immunization recommendations and up-to-date vaccine information:

Checkups (Well Child Evaluations)

Your baby’s first visit to our office will be scheduled by 1 week of age. This important visit allows us to identify and manage any problems which may have developed after the baby’s hospital stay. We will evaluate your baby’s weight gain, answer questions, and plan for future visits.

The American Academy of Pediatrics recommends routine health maintenance visits (“check-ups”) at 2 months, 4 months, 6 months, 9 months, 12 months, 15 months, 18 months, 2 years, and then annually. These visits assure that your child’s growth and development are monitored appropriately.

A complete physical exam is performed, thus well-child checkups are separate from sick visits

A complete physical exam is performed rather than the more focused exam of a “sick visit.” Therefore, well-child check-ups are scheduled separate from sick visits. Well-child visits provide parents an opportunity to ask about issues such as nutrition, behavior, and development. It is recommended that you schedule regular check-ups even if your child’s immunizations are obtained at the Health Department. Well-child evaluations must be up-to-date for specialty referrals and for refills of some medications.

Dosing Guides

Our Dosing Guide gives dosages for common over-the-counter medications used in children.  These medications are dosed according to weight. 

To calculate your child’s dose, look up his or her weight in the Dosing Guide and read across to the proper dose for each medicine listed.  If you do not know your child’s weight and if your child is too young to stand on bathroom scales, a simple way to determine his or her weight is to first weigh both you and your child as you hold him.  Then weigh yourself alone.  Subtracting these two numbers will give you a fairly accurate weight for your child. 

The doses listed in the Dosing Chart are standard doses which are safe for your child.  In some situations we recommend doses of these medications which may be slightly higher or lower than the doses recommended on the packaging of the medication.  This should not concern you.  If our advice calls for doses which are dramatically different, please ask us the reason for this.


If your child takes an overdose of any medication, call POISON CONTROL right away.

The phone number is 1-800-376-4766 or 501-686-6161