Child Health Information

East Bay Pediatrics and Children's Hospital Oakland offer information on common health topics including fever medication dosages.

If your questions are not answered by the topics listed here or by the links under "Resources" please give our phone advice nurses a call during business hours at (925)254-9203, option 6. After hours, a physician is on call at the same number, option 4 to answer urgent questions.

Fever Reducing Medications  |  Resources  |  Vaccines

Colds  |  Diarrhea  |  Fever  |  Head Injury  |  Head Lice  |  Ingestions  |  Newborn Care  | 

Psychosocial Concerns  |  Vomiting | Sun Screen

Resources

  • Children's Hospital Oakland We cannot cover all illness topics here on this site, but the Children's Hospital Health Library has easy to read advice on many health topics, some with teen versions as well.
  • The American Academy of Pediatrics (AAP) has detailed information on some health topics.
  • First 5 California offers parenting advice for children ages 0-5. Includes county based programs and new parent kits.
  • San Francisco Poison Control is available by phone at 800-222-1222

Colds

Colds are caused by viruses. During the first five years of life, children average nine colds per year. Antibiotics are not useful unless a complication occurs (such as ear infection, sinusitis, pneumonia). Colds usually last three to ten days.

Symptomatic treatment includes:

  1. Relief of nasal congestion.
    a. elevating the head of the bed
    b. cool mist humidifier
    c. decongestants: every 6 hours, for children over 6 years
    d. nasal suction with a bulb syringe in small infants may be helpful
    e. salt water nose drops (1/4 teaspoon of salt in 8 ounces of water; maximum three days).
    f. 1/8% Neosynephrine Nose Drops in each nostril before feeding and at bedtime may help to shrink swollen mucous membranes; maximum 3 days.

  2. Diet: clear liquids, juices, and clear soups.

  3. Rest is important.

  4. Call the office if:
    a. fever lasts for over 3 days (greater than 72 hours)
    b. unusual lethargy, irritability or inactivity occurs
    c. your child seems to be in pain, is having significant breathing problems, or is repeatedly vomiting.

Diarrhea

Most parents worry about their child’s bowel movements. From a medical standpoint, diarrhea (i.e., increased number of bowel movements or very liquid stools) is not dangerous. Aside from its being unpleasant and mildly uncomfortable for your child, diarrhea is a serious medical concern only when
it is associated with repeated vomiting (i.e., dehydration) or other related symptoms (e.g., blood in the stool).

If your child has diarrhea and is vomiting repeatedly, you should look for signs of dehydration that will require medical attention:

  1. Dry eyes (no tears) when crying

  2. Dry mouth

  3. No urine output for 8-12 hours

There are many ways to treat uncomplicated diarrhea. For the first 24 hours, you should encourage fluid intake rather than solids. Appropriate fluids include increased breast feeding and clear liquids, such as popsicles, flat sodas and Pedialyte®. Reintroduction of solids should begin as soon as an adequate fluid intake is established.

Medication is rarely needed to treat diarrhea.

If you have any questions, please call our advice nurse.

Fever

Fever is usually indicative of an underlying infection (most commonly a virus) and is usually self-limiting. The specific degree of temperature is less important than other signs and symptoms of your child’s illness. Rectal temperatures are most reliable for infants. In older children, ear thermometers can be used for screening but oral thermometers are more accurate.

  1. What is a fever?
    For children, fever is temperature greater than or equal to 100.4°F. when taken orally or by ear.

  2. What to do for fever.
    - remain calm
    - try to find out the cause of the fever
    - remove excess clothing and bedding
    - keep your child comfortable but not cold
    - give fever medication to relieve associated medical symptoms (e.g., excessive crankiness)

  3. When to call the doctor, if your child has a fever:
    a. promptly if the child is less than two months of age
    b. promptly if the child appears to be obviously ill (e.g., has excessive vomiting or diarrhea, has shaking chills, has breathing problems)
    c. if repeatedly vomiting prevents medication retention
    d. if fever is accompanied by localized pain (e.g., earache)
    e. if fever persists for more than 3 days (greater than 72 hours)

  4. Medications for fever.
    Two fever medications are commonly recommended. They are acetaminophen (Tylenol) and ibuprofen. Aspirin should NOT be used for fever in children. When using acetaminophen or ibuprofen, remember to use a dose appropriate to his or her weight.

Head Injury

Head injury is the leading cause of childhood injury. A blow to the head or fall on the head my lead to scalp swelling, bruising, lacerations, skull fractures, concussions, or even brain injuries. If you child has a head injury look for the following signs, which may be indications that your child needs to be evaluated by a physician.

  1. Loss of consciousness – loss of consciousness is the sign of a significant concussion. Talk to your doctor about when your child should resume normal activities or sports. Note: Infants who do not cry soon after a fall may have lost consciousness and may need to see a physician.

  2. Persistent bleeding – Some injuries my require stitches in order to stop the bleeding and improve healing outcomes.

  3. Swelling – Infants or young children with swelling over the far sides of their scalp may be at higher risk for skull fractures. Note: Infants and children may develop a large bump on the forehead (sometimes referred to as a “goose egg”) after a fall. A cool compress and pain medication may be all that is needed for such a bump, unless one of the following symptoms occur:

  4. Nausea or vomiting – Nausea or vomiting may be a sign of a skull fracture or brain contusion. Your child should be evaluated by a physician.

  5. Lethargy or confusion – If your child seems more sleepy than usual or confused after a head injury, he or she should be evaluated by a physician.

In order to prevent injuries, remind your child to wear a helmet when riding a bicycle, scooter, roller blades, skateboard, snowboard, downhill skis or other moving object.

Head Lice

Supplies:

  • white vinegar
  • stripping shampoo (baby shampoo, Prell, White Rain)
  • NIX brand cream rinse (Permethrin lice treatment)
  • metal lice comb (bought separately),Inomed for example
  • (optional) magnifying reading glasses (helps to see the nits)

Method:

  1. Rinse hair with solution of ½ water and ½ vinegar over a sink, not in the shower or tub.
  2. Use a fine-tooth comb (metal lice comb) and meticulously go through the hair, pulling off the nits. This is very time-consuming.
  3. After this is done, wash hair with the stripping shampoo. Use no conditioners as these may protect the lice from treatment. Rinse and towel dry.
  4. Apply NIX brand cream to hair. Leave on the hair for at least 4 hours. The medication could be left on for up to 12 hours (or overnight). May cover with a shower cap.
  5. Rinse hair only with clear water. Do not use vinegar at this point- this may neutralize the Nix.
  6. Go through the hair with a comb again and let hair air dry. Do not use conditioners, mousse, or hair spray for awhile. Again, these may help protect the nits and lice from treatments.
  7. Comb through the child's wet hair every 2 days to look for and remove nits...
  8. RETREAT the hair with NIX in 7-10 days.

Home Care:

  • Clean combs, brushes and hair accessories with Nix. Soak in bathroom sink and rinse with water.
  • Change child's clothes after Nix treatment.
  • Machine wash all clothing and bedding that have been in contact with infected person(s) in the past 3-4 days. Use hot water and hot dryer. Non-washables can be vacuumed.
  • Vacuum everything that hair strands could fall on: rugs, furniture, car seats and car upholstery.
  • Personal things that can't be washed or vacuumed can be tied up in plastic garbage bags for 2 weeks. Remember to keep bags out of children's reach!
  • The use of environmental products (sprays etc) is NOT recommended.

Ingestions

Accidental poisoning most frequently occurs in children 1 to 4 years old. All poisons, medications, and other toxic substances should be kept out of sight and reach of children. Cabinets and drawers containing such substances should be securely locked. Ipecac is no longer recommended for poisonings.

If you are worried that your child ingested a medication in error or overdosed on a medication, call the San Francisco Poison Control at 800-222-1222. Do not wait for symptoms to occur. Calling right away may prevent adverse outcomes.

Newborn Care

For information on newborn care including feeding, bathing, sleeping, rashes, jaundice, etc. please refer to the blue book from the office.

Psychosocial Concerns

As pediatricians we are interested in all aspects of your child’s well-being. Often parents and children have concerns about psychological and emotional development, including discipline, adjustment to divorce, personality/social development, school selection and performance, and transition to adolescence. We believe these to be equally as important in caring for your child as acute medical illness and routine edical care. We will be glad to consult with you about any such concerns you may have.

Vomiting

Vomiting is quite common in childhood, usually as part of gastroenteritis (stomach flu). Vomiting usually lasts one to three days, and may be accompanied by fever and diarrhea. The main concern with vomiting is that children are more susceptible to dehydration than adults. It is much easier to prevent dehydration than to treat it; treating it sometimes involves a stay in the hospital for intravenous fluids. To prevent this from happening, keep your child from getting dehydrated in the first place. If your child has thrown up more than one or two times, it is best to stop giving any milk or solid foods. Wait about an hour, then start offering very small amounts of clear liquid (Pedialyte®, Gatorade, apple or white grape juice, or flat coke or 7-Up) every 15 to 20 minutes for the next few hours.

Once your child has been able to keep that fluid down without vomiting, then start offering larger amounts, about two ounces. Do not offer milk or food until your child can keep down clear liquids, even if your child is complaining about being hungry – if you do, your child will likely throw it and all the clear liquids up. Do not continue an all clear liquid diet for more than 24 hours without consulting the doctor. If your child has dark green or dark yellow vomit (bile), call the office. See the section on diarrhea for signs of dehydration.

sunscreen

Sun Safety

Now that summer has arrived, it is time to review a few facts about sun safety.

  • Sun exposure helps our bodies produce vitamin D, which allows our bodies to absorb calcium for stronger, healthier bones. We recommend that you get vitamin D through a healthy diet. Do not seek the sun.                                               
  • Kids are exposed to approximately 50-80% of their lifetime sun exposure before age 18.
  • Sunlight consists of UVA and UVB rays. UVA rays can cause aging and wrinkling of the skin and UVB rays cause sunburns and can contribute to skin cancer or melanoma.
  • Anyone 6 month or older should use sunscreen. Sunscreen should be applied to all exposed areas and should be reapplied  at least every two hours or after swimming.
  • The best sunscreens are water resistant and are SPF 15 or higher in order to provide coverage against UVA and UVB light.
  • SPF stands for Sun Protection Factor and only reflects a products ability to screen out UVB rays. At present, there is no FDA-approved rating for UVA protection.  UVB protection does not increase proportionally with a designated SPF number. For example, SPF of 30 screens 97 percent of UVB rays while and SPF of 15 screens 93 percent of UVB rays. No sunscreen can provide 100 percent UVB protection.
  • Be Sun Smart by wearing a water-resistant sunscreen and protective clothing such as hats, glasses or longer sleeves. Seek the shade and avoid the sun when the rays are strongest between 10 am and 4pm.

    • Adapted from the American Academy of Dermatology