1) What is the best treatment for a cold or upper respiratory infection?

Fortunate for the makers of Kleenex (but unfortunate for our little ones), children frequently get symptoms of the common cold or what is often times termed an upper respiratory infection. The typical symptoms associated with an upper respiratory infection (URI) include nasal drainage, nasal congestion, and cough.?Children with a URI also may have a low grade fever associated with their symptoms.?Some children will have some mild loss of appetite and may act fussy and less active or playful. These annoying "bugs" may last anywhere from 1-2 days to 7-10 days and may plague a youngster 6-10 times per year. Children in a daycare setting or who are exposed to other children typically get more URIs.?Treatment for this unpopular illness consists of what is termed supportive care. This means plenty of facial tissue, nasal suctioning for little ones not old enough to blow their noses, and Tylenol or Motrin for any associated fever. Over-the-counter (OTC) cold remedies or medications have not proven to be beneficial for helping this group of symptoms, and in fact, the FDA has issued a statement warning against the possible side effects of common OTC cough and cold medications. Occasionally, children will develop other illnesses associated with a URI and may need to be seen if fever is higher than 101 F or if they have additional symptoms not mentioned above.

2) What is the best treatment plan for vomiting and diarrhea?

Another common illness that affects many children from birth through young adulthood (and in fact, through entire adulthood) is gastroenteritis or vomiting with diarrhea. The most common causes of this type of illness are a group of viruses that exist within our environment. Symptoms of viral gastroenteritis may last anywhere from 12 hours to 3-5 days. Fever may be associated with the vomiting and diarrhea. Treatment needs to be centered around adequate hydration with an oral rehydration solution like Pedialyte or dilute Gatorade for older children. During the acute phase of the illness, we recommend small frequent sips of fluids and discourage letting your child drink fluids at an eager pace. Avoid juices because they can actually worsen diarrhea. Also, we recommend that you avoid OTC medications and anti-diarrhea drugs. Please call the physician, if your child develops fever greater than 102.5 F or has noticeable decrease in urine output, wet diapers, or is unable to keep fluids down. Once your child has stopped vomiting for at least 2-3 hours, you may slowly begin to introduce solid foods back if your child seems interested. It is common for many children to be uninterested in solid foods temporarily with a vomiting illness.

3) How much should my newborn/infant be eating?

Most full term newborns will require feeds quite frequently at first- up to every 1.5 to 2 hours. Don't fret, however, because this frantic pace slows as they grow up allowing parents and caregivers to space feeds out to every 3-4 hours. Breastfed little ones typically require feeds more frequently, but don't let that deter you from breastfeeding-this offers mothers a chance to bond with their little ones and this pace slows also as they mature. ?We recommend that in the first few days of life that your little one gets at least 45mL (1.5 oz) of either breastmilk or formula with each feed. (We do caution, however, to avoid giving your newborn more than 2.5 oz. with each feed.) As your little one grows, so does the amount that he/she will require with each feeding. A good rule of thumb is to feed an infant 2.5 ounces per pound of the infant's weight per day (to a max of 40 ounces) divided into those feeds of every 3-4 hours. Keep in mind that when your little one begins to eat solid foods, the frequency of bottles decreases. To avoid the pitfalls that come with overfeeding we recommend that your little one feed on each breast for 10-20 minutes per feeding.

4) When should I begin to introduce solid foods into my infant's diet?

There is no hard and fast rule here - having said that, we recommend that you begin slowly introducing solid foods at 4-6 months. Most infants establish good head control and lose the tongue thrust reflex which pushes solids out of the mouth during that time frame.?We ask that you start with infant iron fortified rice cereal mixed with either formula or breastmilk in a bowl, making the mixture quite "soupy" at first. Try offering this "meal" to your little one between bottles or breastfeeding to avoid them rejecting it because he/she was expecting a bottle instead. Once they have "gotten the hang" of eating the rice cereal, you can then progress to feeding them stage 1 jar foods or cooked, pureed vegetables more of a chore. Only introduce one new food every 5-6 days as to make identifying the cause of a "reaction" easier.

5) What should I use on my infant's diaper rash?

Most simple cases of diaper rash can be treated with a good barrier cream like Balmex, Desitin, or Boudreaux's Butt Paste. (We do caution against the use of baby powder as it poses a risk if your little one inhales any of the powder.) Other more complicated forms of diaper rash that are associated with fever, other signs of illness, or extend down into the skin creases should be evaluated by the doctor.

6) How do I know if my baby has reflux?

Gastroesophageal reflux is a common finding in little ones and is often accompanied by frequent spitting and/or fussiness after feeds. Good rules of thumb to avoid reflux symptoms are frequent pauses during feeds or burping and to slow feeds down. Also, avoid overfeeding with too much formula or breastmilk per feeding. We also recommend that you keep your little one upright following feeds for 30-45 minutes. If your baby continues to be fussy with feeds or is failing to gain weight/thrive, we recommend that you bring them to the office for an evaluation.

7) How do I know if my child has an ear infection?

Ear infections, both in the ear canal and in the middle ear, are common throughout childhood. Signs of an ear infection in younger children are fever, diarrhea, fussiness, and decreased appetite. Simply "tugging" at the ear isn't a reliable indicator in the younger age group as this can be a sign of teething or curiosity over a newfound body part. However, ear "tugging" associated with runny nose, or any of the symptoms noted above can be a sign of an ear infection. Older children often times will describe ear pain associated with an ear infection. Swimmer's ear or an infection of the ear canal is often times associated with pain on movement or touching of the ear. You may also note drainage from the affected ear canal.

8) Should I use Tylenol or Motrin for my child's pain and/or fever?

Tylenol (acetaminophen) or Motrin (ibuprofen) are both effective agents to lower fever and treat pain. Infants under the age of 6 months should NOT use Motrin (ibuprofen). Alternating Tylenol and Motrin every 3 hours is an acceptable option for hard to treat fever but we recommend that you keep track of your dosing schedule in a notebook or on a scratch sheet of paper to avoid confusion and possible double dosing of the same agent. Follow the manufacturer's dosing an age guidelines with all medication dosing.

9) How do I know if my child is constipated and what is the treatment for constipation?