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Newborn Skin Care

Bathing

You may bathe your baby daily, but for the first few months, 2 or 3 times a week is often enough for a full bath. Clean your baby’s drools and spills as they happen and keep the face, hands and diaper area clean.
Keep the bath water level below the naval or give sponge baths until a few days after the navel cord has fallen off. Submerging the cord could cause infection or interfere with its drying out and falling off. Getting the cord a little wet doesn’t matter.

Use tap water without any soap or with a nondrying baby soap. Don’t forget to wash the face and neck; otherwise, chemicals from dribbled milk and food can build up and cause an irritated rash. Also rinse off the eyelids with water.
Don’t forget to wash the genital area. However, when you wash the inside of the female genital area (the vulva), never use soap. Rinse the area with plain water and wipe from front to back to prevent irritation. This practice and the avoidance of any bubble baths before puberty may prevent many urinary tract infections and vaginal irritations. At the end of the bath, rinse your baby well; soap residue can be irritating.

Changing Diapers

After you remove a wet diaper, just rinse your baby’s bottom off with a wet washcloth or diaper wipe. After soiled diapers, rinse the bottom under running warm water or in a basin of warm water. You can’t clean BMs off the skin with diaper wipes alone. Millions of bacteria will remain and cause diaper rashes. After you clean the rear, cleanse the genital area by wiping front to back with a wet cloth. In boys, stool can hide under the scrotum, so rinse carefully there. If you have a girl, carefully clean the creases of the vaginal lips (labia).

Shampoo

Wash your baby’s hair once or twice a week with a special baby shampoo that doesn’t sting the eyes. Don’t be concerned about hurting the anterior fontanelle (soft spot on the head). It is well protected.

Lotions, Ointments, and Powder

Newborn skin normally does not require any ointments or creams. Especially avoid putting any oil, ointment, or greasy substance on your baby’s skin because this will almost always block the small sweat glands and lead to pimples or a heat rash. If the skin starts to become dry and cracked, use a baby lotion, hand lotion, or moisturizing cream twice a day. Apply it within 3 minutes after a bath to keep moisture in the skin.
Cornstarch powder can be helpful for preventing rashes in areas of friction. Avoid talcum powder because it can cause a serious chemical pneumonia if inhaled into the lungs.

Umbilical Cord

Try to keep the cord dry. Put rubbing alcohol on the base of the cord (where it attaches to the skin) twice a day (including after the bath) until 1 week after it falls off. Although using alcohol can delay the separation of the cord by 1 or 2 days, it does prevent cord infections, and that’s what is most important. Air exposure helps the cord stay dry and eventually fall off, so keep diapers folded down below the cord area. If you are using disposable diapers, you can cut a wedge out of the diaper scissors so the cord is not covered.

Fingernails and Toenails

Cut the toenails straight across to prevent ingrown toenails. When you cut fingernails, round off the corners of the nails so your baby doesn’t scratch himself or others.
Trim the nails once a week after a bath, when the nails are softened by the bath. Use clippers or special baby scissors. This job usually takes two people unless you do it while your child is asleep.

Written by B.D. Schmitt, M.D., author of “Your Child’s Health,” Bantam Books.
Published by RelayHealth.
Last modified: 2007-05-10
Last reviewed: 2007-03-22
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.

Toilet Training Your Child: The Basics

What is toilet training?

Your child is toilet trained when, without any reminders, he walks to the potty, pulls down his pants, urinates or passes a bowel movement (BM), and pulls up his pants. Some children will learn to control their bladders first. Others will start with bowel control. Both kinds of control can be worked on simultaneously. Bladder control through the night normally happens several years later than daytime control. The gradual type of toilet training discussed here can usually be completed in 1 to 3 months, if your child is ready.

How can I help my child get ready for toilet training?

Don’t begin training until your child is clearly ready. Readiness doesn’t just happen. It involves concepts and skills you can begin teaching your child at 18 months of age or earlier. All children can be made ready for toilet training by 3 years, most by 2 1/2 years, many by 2 years and some earlier.

Ways to help a child become ready include the following:

18 months:

Begin teaching about pee, poop and how the body works.
Teach the vocabulary (pee, poop, potty, etc.).
Clarify that everyone makes pee and poop.
Point out when dogs or other animals are going pee or poop.
Clarify the body’s signals when you observe them: “Your body wants to make some pee or poop.”
Praise your child for passing poop in the diaper.
Do not refer to poop as dirty or yucky stuff.
Make changing diapers pleasant for the child so he will come to you.
Change your child frequently so he will prefer dry diapers.
Teach your child to come to a parent whenever he is wet or soiled.

21 months:

Begin teaching about the potty and toilet.
Teach what the toilet and potty chair are for (“the pee or poop goes in this special place”). Demonstrate by dumping poop from
diapers into the toilet.
Portray using the toilet and potty chair as a privilege.
Have him observe toilet-trained children use the toilet or potty chair (having an older toilet-trained sibling can be very helpful).
Buy a floor-level type potty chair. You want your child’s feet to touch the floor when he sits on the potty. This provides leverage for pushing and a sense of security. He also can get on and off whenever he wants to. Take your child with you to buy the potty chair.
Make it clear that this is your child’s own special chair. Have your child help you put his name on it. Allow your child to decorate it or even paint it a different color.
Have your child sit on the potty chair for fun. Have your child sit on it fully clothed until he is comfortable with using it as a chair.
Have your child use it while eating snacks, playing games, or looking at books. Keep it in the room in which your child usually plays.
Never start actual toilet training unless your child clearly has good feelings toward the potty chair. Help the child develop a sense of ownership (“my chair”).
Then, bring his potty chair in the bathroom and have him sit on it (bare-bottom) when you sit on the toilet. Don’t allow diapers or pull-ups in the bathroom.

2 years:

Begin using teaching aids.
Read toilet learning books and watch toilet learning videos.
Help your child pretend she’s training a doll or stuffed animal on the potty chair.
Present underwear as a privilege. Buy special underwear and keep it in a place where the child can see it.

How do I toilet train my child?

Encourage practice runs to the potty. A practice run (potty sit) is encouraging your child to walk to the potty and sit there with his diapers or pants off. Your child can then be told, “Try to go pee-pee in the potty.” Only do practice runs when your child gives a signal that looks promising, such as a certain facial expression, grunting, holding the genital area, pulling at his pants, pacing, squatting, squirming, etc. Other good times are after naps, 2 hours without urinating, or 20 minutes after meals. Say encouragingly, “The poop or pee wants to come out. Let’s use the potty.” If your child is reluctant to sit on the potty, you may want to read him a story. If your child wants to get up after 1 minute of encouragement, let him get up. Never force your child to sit there. Never physically hold your child there. Even if your child seems to be enjoying it, end each session after 5 minutes unless something is happening. Initially, keep the potty chair in the room your child usually plays in. This easy access greatly increases the chances that he will use it without your asking him. Consider owning 2 potty chairs. During toilet training, children need to wear clothing that’s conducive to using the potty. That means one layer, usually the diaper. Avoid shoes and pants. (In the wintertime, turning up the heat is helpful.) Another option (though less effective) is loose sweatpants with an elastic waistband. Avoid pants with zippers, buttons, snaps, or a belt.
Praise or reward your child for cooperation or any success. All cooperation with these practice sessions should be praised. For example, you might say, “You are sitting on the potty just like Mommy,” or “You’re trying real hard to go pee-pee in the potty.” If your child urinates into the potty, he can be rewarded with treats such as, animal cookies or stickers, as well as praise and hugs. Although a sense of accomplishment is enough for some children, many need treats to stay focused. Big rewards (such as going to the toy store) should be reserved for when your child walks over to the potty on his own and uses it or asks to go there with you and then uses it. Once your child uses the potty by himself two or more times, you can stop the practice runs. For the following week, continue to praise your child frequently for using the potty. Practice runs and reminders should not be necessary for more than 1 or 2 months.
Change your child after accidents. Change your child as soon as it’s convenient, but respond sympathetically. Say something like, “You wanted to go pee-pee in the potty, but you went pee-pee in your pants. I know that makes you sad. You like to be dry. You’ll get better at this.” If you feel a need to be critical, keep it to mild verbal disapproval and use it rarely (for example, “Big boys don’t go pee-pee in their pants,” or mention the name of another child whom he likes and who is trained). Then change your child into a dry diaper or training pants in as pleasant and non-angry a way as possible. Avoid physical punishment, yelling, or scolding. Pressure or force can make a child completely uncooperative.
Introduce underpants after your child starts using the potty. Regular underwear can spark motivation. Switch from diapers to underpants after your child is cooperative about sitting on the potty chair and passes urine into the toilet spontaneously 10 or more times. Take your child with you to buy the underwear and make it a reward for his success. Buy loose-fitting ones that he can easily lower and pull up by himself. Once you start using underpants, use diapers only for naps, bedtime and travel outside the home.
Plan a bare bottom weekend. If your child is older than 30 months and has successfully used the potty a few times with your help and clearly understands the process, commit 6 hours or a weekend exclusively to toilet training. This can usually lead to a breakthrough. Avoid interruptions or distractions during this time. Younger siblings must spend the day elsewhere. Turn off the TV and do not answer the phone. Success requires monitoring your child during these hours of training.
The bare bottom technique means not wearing any diapers, pull-ups, underwear or any clothing below the waist. This causes most children to become acutely aware of their body’s plumbing. Children innately dislike pee or poop running down their legs. You and your child should stay in the vicinity of the potty chair. This can be in the kitchen or other room without a carpet. A gate may help your child stay on task. During bare bottom times, supervise your child but refrain from all practice runs and most reminders, allowing the child to learn by trial and error with your support.
Create a frequent need to urinate by offering your child lots of her favorite fluids. Have just enough toys and books handy to keep your child playing near the potty chair. Keep the process upbeat with hugs, smiles and good cheer. You are your child’s coach and ally.

What if toilet training isn’t working?

There are some children who are resistant to toilet training. Your child is considered resistant if after trying to toilet train your child using the method described above:

Your child is over 2 1/2 years old and has a negative attitude about toilet training.
Your child is over 3 years old and not daytime toilet trained.
Your child won’t sit on the potty or toilet.
Your child holds back bowel movements.
The approach described here isn’t working after 6 months.

If your child is resistant to toilet training, ask your healthcare provider for ideas and information about toilet training resistance.

Written by B.D. Schmitt, M.D., author of “Your Child’s Health,” Bantam Books.
Published by RelayHealth.
Last modified: 2005-04-14
Last reviewed: 2006-03-02
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.

Prevention of Sleep Problems: 6 Months to 2 Years

Your 6 month-old baby should be sleeping through the night. Hopefully he’s been doing it for several months. Sleep is very important for children. Well-rested children behave better and learn faster.

6-Month-Old Babies

Continue to place your baby in the crib when drowsy but partially awake. The ability to go to sleep by themselves is very important for children to learn.
Provide a friendly soft toy for your child to hold in her crib. At the age of 6 months, children start to be aware and sometimes fearful of separation from their parents. A stuffed animal, doll, or blanket can comfort your child when he wakes up during the night. Exception: if your baby can’t easily roll over both ways, don’t place any soft objects in the crib until he can.
During the day, respond to any separation fears by holding and reassuring your child. This lessens nighttime fears and is especially important for children who have limited hours with their mother because she has to return to work.
For middle-of-the-night fears, make contacts prompt and reassuring. For mild nighttime fears, check on your child promptly. Reassure the child, but do not stay very long. If your child panics when you leave, or vomits with crying, stay in your child’s room until she is either calm or goes to sleep. Do not take her out of the crib. Keep the light off and do not talk too much. You may sit next to the crib with your hand on her. These measures will calm even a severely upset infant.

1-Year-Old Children

Establish a pleasant and predictable bedtime routine. Bedtime routines, which can start in the early months, become very important to a child by 1 year of age. Children need a familiar routine. This could include reading or making up stories, as well as kissing and hugging the child “goodnight.” Make sure that your child’s security objects are nearby. Finish the bedtime routine before your child falls asleep.
Encourage naps. Naps are important to young children. It is best to keep naps less than 2 hours long. Children stop having morning naps between 18 months and 2 years of age and give up their afternoon naps between 3 and 6 years of age.
Don’t worry about noises or movements during your child’s sleep. During dreams, children often display face-twitching, fist-clenching, or even eye-rolling. This does not mean the child is having a bad dream. Many children also have muscle jerks while dozing off to sleep. Overall, anything short of not breathing is probably normal sleep behavior.

2-Year-Old-Children

Switch from a crib to a bed at age 2 or 2 1/2. Climbing out of a crib could result in a serious head injury. It is not possible to climb-proof a crib. Change to a bed if your child learns how to climb out of a crib with the springs at the lowest setting. Until you find a bed, put the mattress on the floor, use a sleeping bag, or keep the crib railing down and place a chair next to the crib so your child can descend safely. Do not buy bunk beds. They have a terrible injury rate with children of all ages.
Once put to bed, your child should stay there. Some toddlers have temper tantrums at bedtime. They may protest about bedtime or even refuse to lie down. You should ignore these protests and leave the room. You can ignore any ongoing questions or demands your child makes. Once your child is in a regular bed, you must enforce the rule that your child can’t leave the bedroom. If your child comes out, return her quickly to the bedroom and avoid any conversation. If you respond to her protests in this way every time, she will learn not to try to prolong bedtime.
If your child has nightmares or bedtime fears, reassure him. Never ignore your child’s fears or punish him for having fears. Everyone has 4 or 5 dreams a night. Some of these are bad dreams. If nightmares become frequent, try to determine what might be causing them, such as something your child might have seen on TV. R-rated movies (especially horror movies) are a high risk factor at any age.
Don’t worry about the amount of sleep your child is getting. Different children need different amounts of sleep at different ages. If your child is not tired upon awakening or during the day, she is probably getting enough sleep.

Written by B.D. Schmitt, M.D., author of “Your Child’s Health,” Bantam Books.
Published by RelayHealth.
Last modified: 2006-06-28
Last reviewed: 2007-03-22
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.

What to do for Itching

What is causing the itching?

If itching is in just one area (localized) it could have many possible causes including:

contact dermatitis (skin irritation from a plant, chemicals, fiberglass, detergents, new cosmetic, new jewelry, or other substance)
fungus (such as athlete’s foot, jock itch, or ringworm)
head lice
dandruff
insect bite.

There are many possible causes if your child is itching all over. Some possible causes include:

dry skin
eczema
heat rash
chickenpox
hives

How can I take care of my child?

Localized itching – For itching caused by an irritant, wash the area once thoroughly with soap to remove any remaining irritants. Thereafter avoid using soaps on this area. Put cold, moist compresses or ice on the area for 20 minutes every 3 to 4 hours to reduce itching. Follow this with 1% hydrocortisone cream (no prescription needed) 4 times a day. Cut your child’s fingernails short and encourage him not to scratch.
Try to figure out what caused the rash and avoid this substance in the future.
For other causes of localized itching, see related topics.

Widespread itching

The following measures may help to relieve itching regardless of the cause:

Wash the skin once with soap to remove irritants.
Give your child cool baths every 3 to 4 hours unless your child has dry skin.
Then put calamine lotion (nonprescription) or a baking soda solution (1 teaspoon in 4 ounces of water on the skin). For very itchy spots, apply 1% hydrocortisone cream (no prescription needed) unless your child has chickenpox.
Encourage your child not to scratch and cut your child’s fingernails short.
Your child should not wear itchy or tight clothes and should temporarily avoid excessive heat, sweating, soaps, and swimming pools.
For hives, antihistamines are helpful.

When should I call my child’s healthcare provider?

Call during office hours if:

The itching keeps your child from sleeping.
The itching becomes severe.
The itching lasts more than 1 week.
You have other concerns or questions.

Written by B.D. Schmitt, M.D., author of “Your Child’s Health,” Bantam Books.
Published by RelayHealth.
Last modified: 2007-03-14
Last reviewed: 2007-03-14
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.

What to do for Itchy or Painful Insect Bites

What are insect bites?

Insect bites cause itchy, red bumps. Some bites are painful.

How can I take care of my child?

If the bite is itchy:

Put calamine lotion or a mixture of baking soda and water on the bite.
If it is very itchy, put on 1% hydrocortisone cream. You can get this cream at the drug store.
Put firm, direct, steady pressure on the bite for 10 seconds. Use your fingernail or pen cap.

If the bite is painful:

Rub the bite with a cotton ball soaked in meat tenderizer and water for 20 minutes. This will help the pain. Don’t use meat tenderizer near the eye.
If you don’t have any meat tenderizer, use baking soda and water.
Give acetaminophen (Tylenol) or ibuprofen (Advil) to help the pain.

How can I protect my child from insect bites?

Keep skin covered when outside. You can use insect repellent to prevent bites. There are 2 kinds of insect repellent. One kind is put on the skin. This includes DEET, picaridin, and oil of lemon eucalyptus. Another kind of insect repellent is put on clothes.This kind is called permethrin.

When using a product with DEET in it:

Put some on skin before your child goes outdoors. You do not need to use more than a few drops. (Do not use DEET on children younger than 2 months old. Do not use oil of lemon eucalyptus on children under 3 years old.)
Don’t put any repellent on the hands or on a sunburn or rash.
Wash repellent off after your child comes indoors.

You can also spray an insect repellent that contains permethrin on your child’s clothes. Put it on the clothes before your child gets dressed. You can also spray this product on shoes, sleeping bags, or other items.

Call your child’s doctor right away if:

A bite looks infected. You may see red streaks. It may feel more tender.

Call your child’s doctor during office hours if:

The bite still itches or is very painful even after it has been treated.
You have other questions or concerns.

Written by B.D. Schmitt, M.D., author of “Your Child’s Health,” Bantam Books.
Published by RelayHealth.
Last modified: 2007-03-23
Last reviewed: 2007-03-22
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.

Medicines for Fever or Pain Relief

Acetaminophen

Acetaminophen (Tylenol) is available without a prescription. Determine the correct dosage by finding your child’s weight on the label instructions. You may repeat the dosage every 4-6 hours as needed. Do not give acetaminophen more than 5 times a day. Do not use acetaminophen in children under 3 months of age. If your infant has a fever during the first 12 weeks of life, see your child’s healthcare provider.

Suppositories: Acetaminophen is also available as a rectal suppository in various dosages. Suppositories are useful if a child with a fever is vomiting often or having seizures caused by the fever. Use the same dose as listed above for the suppository. Most suppositories can be cut (for example, cut in half) to supply the right dose for your child’s age.

Ibuprofen

Determine the correct dosage by finding your child’s weight on the label instructions. You may repeat the dosage every 6 to 8 hours as needed. Not that some medicines come with a 1.25 ml dropper and others come with a 1.875 ml syringe. Don’t let the dropper/syringe difference confuse you. The milligram amount you should give is the same. Do not give ibuprofen to children under 6 months of age.

Note:
If instructed by your healthcare provider to alternate ibuprofen and acetaminophen, do it as follows:
Alternate doses of ibuprofen and acetaminophen every 4 hours.
Alternate medicines for only 24 hours or less, then return to a single product.
Combining acetaminophen and ibuprofen is generally not recommended. Combining can cause confusion, dosage errors and poisoning.

Children (through age 21 years) should not take aspirin if they have chickenpox or influenza (any cold, cough, or sore throat symptoms). This recommendation is based on several studies that have linked aspirin to Reye’s syndrome, a severe encephalitis-like illness. Most pediatricians have stopped using aspirin for fevers associated with any illness.

What to do for Stool, Unusual Color

What is an unusual color of stool?

Any color other than brown is an unusual color for stools (bowel movements). Stool color relates more to what is eaten than to any disease. Unusual colors of the stool are almost always due to food coloring or food additives. In children with diarrhea, food passes through the body very quickly, and stools often come out the same color as the Kool-Aid or gelatin water that went in.

What are some common colors and causes?

Red: blood, red gelatin, red Kool-Aid, cranberries, red cereals, tomato juice, tomato soup, beets, red medicines
Black: blood from the stomach, iron, bismuth (for example, Pepto-Bismol), licorice, cigarette ashes, charcoal, Oreo cookies, grape juice
Green: green gelatin, iron, spinach, diarrhea, breast-feeding (especially during the first 2 months of life)
Yellow-white: aluminum hydroxide (antacids), excessive milk, hepatitis.

When should I call my child’s healthcare provider?

CALL IMMEDIATELY IF:

The stools are red or black and tarry without explanation.
Your child starts acting very sick.

Call during office hours if:

Other unusual colors continue for more than 3 days after you have eliminated any suspected foods. Be prepared to bring in a stool sample.
You have other questions or concerns.

Written by B.D. Schmitt, M.D., author of “Your Child’s Health,” Bantam Books.
Published by RelayHealth.
Last modified: 2004-03-31
Last reviewed: 2007-03-22
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.

What to do for Hay Fever

What is hay fever?

Hay fever is an allergy to something your child breathes in. Plant pollens most often cause it. Your child probably has hay fever if:

There is a clear discharge from your child’s nose
AND your child’s nose itches
AND your child sneezes and sniffs
Your child’s eyes may also itch and water

Here are the months of the year you may expect problems with hay fever:

In April and May, the most common pollen is from trees.
From May to July, most of the time it is from grass.
From late August through the fall, ragweed pollen is the big problem.

Animal fur and other things could cause your child’s hay fever.

How can I take care of my child?

Give your child an antihistamine.
This medicine works best for hay fever.
Your child’s medicine is ________________. Give __________ every ______ hours during the day.
If your child has hay fever every day, it’s a good idea to give him the antihistamine all during the pollen season.

Shower your child and wash his/her hair every night before bed.

This will clean away the pollen. Your child should have fewer symptoms at night.

Help your child stay away from pollen and other things that may cause hay fever.

Make sure your child stays away when someone cuts grass.
Your child should stay indoors when it is windy or if there is a lot of pollen in the air.
Make sure your child stays away from anything that causes his hay fever. Watch out for feather pillows, pets, farms, stables, and tobacco smoke.

Wash your child’s itchy or watery eyes.

Wash your child’s face and eyelids with water. That will clean away any pollen.
Put a cold wet cloth on your child’s eyelids for 10 minutes.

Call your child’s doctor during office hours if:

The hay fever does not get better after your child takes medicine for 2 days.
Your child gets sinus pain or pressure.
You have other questions or concerns.

Written by B.D. Schmitt, M.D., author of “Your Child’s Health,” Bantam Books.
Published by RelayHealth.
Last modified: 2006-03-01
Last reviewed: 2007-03-22
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.

What to do for Lead Poisoning

What is lead poisoning?

Being around lead too much can cause lead poisoning. A child with lead poisoning may:

Have stomach pains.
Vomit.
Be confused.
Have weak muscles.
Have seizures.
Lose hair.
Have anemia.

Some children have no symptoms.
Children who have lead poisoning need to see a doctor and be treated. Even small amounts of lead can cause problems. Lead poisoning causes brain damage that results in:

Poor hearing.
Problems learning to speak.
Other learning problems.

Where does the lead come from?
Lead is most often found in houses built before 1950. These houses were painted with lead-based paint. (This is against the law now.)

When paint chips or peels:

Young children can pick up these chips and chew them.
They may swallow dust or soil with lead paint in it.

When people remodel or repaint houses built before 1978:

This can put the old paint into the dust and soil.
Young children put their hands in their mouths, suck their thumbs, and taste everything. This means they have a higher chance of getting lead into their bodies.

Other sources of lead are air, water, food, and toys:

There is less lead in the air now because we use unleaded gasoline.
There may be lead in some drinking water. In the past, lead was used for water pipes.
Lead can sometimes be found in fruit juice or in food stored in lead-glazed pottery.
Lead is sometimes found in low-quality toys, trinkets, and crayons.

How can I protect my child?

Keep your child away from peeling paint. Peeling paint is common on windowsills.
Wash your child’s hands and face before she eats. If your child sucks his thumb or fingers, rinse his hands often.
Rinse toys and pacifiers often.
Wet-mop your hard surface floors.
Close off any rooms you remodel.
If you have lead paint on the outside of your house, keep lead dust from being tracked into your house. Put a washable mat at each door. Make sure everyone wipes his or her feet. Ask everyone to take their shoes off before coming into the house.
Take out the soil with lead and put in new soil. Plant bushes next to the walls so children cannot play there.
Use water from your cold water tap. Let the water run for 2 minutes before you use it. You can have your water tested for lead.
Do not store food or drink in pottery that has lead in the glaze.
Make sure your child’s diet has plenty of iron and calcium. Both of these minerals make it harder for the body to take in lead.
If you work with lead, make sure you shower and change your clothes before spending time with your child.
Talk to your state or local health department about testing paint and dust from your home for lead. Ask them for more advice and information about how to prevent lead poisoning.
Ask your doctor about a blood test that checks your child for lead exposure.

Written by B.D. Schmitt, M.D., and Robert Brayden, M.D.
Published by RelayHealth.
Last modified: 2007-02-20
Last reviewed: 2007-12-03
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.

What to do for Head Injury

What is a head injury?

Most head injuries hurt only the scalp, not the brain. Your child might have a big lump even if it was a minor injury because there is a large blood supply to the scalp. For the same reason small cuts on the head may bleed a lot. Only 1% to 2% of injured children have a skull fracture. Your child has not had a concussion unless he passes out, acts very confused, or cannot remember what happened.

How can I take care of my child?

Wound care. Call the doctor right away if the skin is split open and might need stitches. Wash any minor scrapes with soap and water. Apply pressure with a clean cloth (sterile gauze if you have it) for 10 minutes to stop any bleeding. For swelling, apply ice for 20 minutes.
Rest. Encourage your child to lie down and rest until all symptoms are gone (or for at least 2 hours). It is okay for your child to sleep. You don’t have to try to keep him awake. Just have him sleep nearby so you can check on him from time to time. Don’t give any pain medicine. If the headache is bad enough to need medicine, your child should be checked by your doctor.
Diet. Give only clear fluids (ones you can see through) until your child has gone 2 hours without vomiting.
Special precautions. Wake up your child twice during the night, once at your bedtime and once 4 hours later. Wake him up and get him to walk and talk. Do this for 2 nights. After that, go back to a normal routine.

Call your child’s doctor right away if:

The skin is split open and might need stitches.
The headache becomes severe.
Vomiting occurs three or more times.
Your child’s vision becomes blurred or double.
Your child becomes difficult to awaken or confused.
Walking or talking becomes difficult.
Your child’s symptoms get worse in any other way.

Written by B.D. Schmitt, M.D., author of “Your Child’s Health,” Bantam Books.
Published by RelayHealth.
Last modified: 2006-02-24
Last reviewed: 2007-03-22
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.

Formula (Bottle) Feeding

Breast milk is best for babies, but breast-feeding isn’t always possible. If you choose to bottle-feed, be sure to always use formula until your baby is 1 year old. When your baby is 1 year old, you may start to give your baby whole cow’s milk.

Formulas are made especially for babies. Most are made with cow’s milk. Others are made from soybeans for babies who are allergic to or have a hard time digesting regular formula.

You can get formula in 3 ways:

Powder
Concentrated liquid
Ready-to-serve liquid

How do I mix formula?

If you use powder, mix each level scoop of powder with 2 ounces of water.
If you use concentrate, mix it with equal parts of water.
If you use ready-to-serve formula, do not add any water.

Always follow the directions. Do not add more powder or liquid or water than you are directed. If the formula is too concentrated or too diluted, your baby will not get what he needs.
Most city water supplies are safe. If you are making one bottle at a time you can use fresh, cold water from your tap. Let the water run for 2 minutes before you use it. Do not use warm or hot tap water. The warm water can cause lead to get into the water from the pipes. After you mix the formula with cold water, you can heat the bottle to the temperature your baby prefers.
If you have well water, you need to boil the water for 10 minutes (plus 1 extra minute for each 1000 feet you are above sea level). You can buy and use distilled water instead of boiling well water.
If you would rather make a batch of formula:
Use boiled or bottled water. Follow the directions printed on the side of the formula can. Put formula in the refrigerator. Use it within 48 hours.

How often should I feed my baby?

Most babies need:

6 to 8 formula feedings per day for the first month
5 to 6 formula feedings per day from 1 to 3 months
4 to 5 formula feedings per day from 3 to 7 months
3 to 4 formula feedings per day from 7 to 9 months

Your baby may start with 1 ounce per feeding. By 7 days, he may take 3 ounces. Divide your baby’s weight (in pounds) in half to find the amount (in ounces) he will probably need. For example, if your baby weighs 8 pounds, your baby will probably drink 4 ounces per feeding.

When you are traveling, ready-to-serve formulas are the easiest.

What about fluoride?

When your baby is 6 months old and until she is 16 years of age, she may need fluoride to prevent dental caries. If the water supply where you live has fluoride and your child drinks at least 1 pint each day, the water should provide enough. Otherwise, it may be a good idea to use fluoride drops or tablets. Formula-fed babies should not take vitamins with the fluoride drops or tablets. Talk to your healthcare provider.

Written by B.D. Schmitt, M.D., author of “Your Child’s Health,” Bantam Books.
Published by RelayHealth.
Last modified: 2006-03-02
Last reviewed: 2006-03-01
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.

What to do for Fever

What is a fever?

A fever means the body temperature is above normal. Your child has a fever if:

The rectal temperature is over 100.4° F (38° C).
The temperature taken by mouth is over 99.5° F (37.5° C).
The armpit temperature is over 99.0° F (37.2° C).
The ear temperature is over 100.4° F (38° C).
The pacifier temperature is over 100° F (37.8° C).

Fever helps fight infections. Most fevers are not harmful. They may last 2 or 3 days.

How can I take care of my child?

Use medicine only if the child needs it. Remember that fever helps your child fight the infection. Use medicine only if the fever is over 102° F (39° C) and your child is uncomfortable.
You can give acetaminophen (Tylenol) to children older than 3 months. Fever medicine lowers the fever by 2 to 3° F (1 to 2° C).
Your child’s dosage is ______ every 4 to 6 hours, as needed.
You may want to give your child ibuprofen instead. Ibuprofen (Advil) works 2 hours longer than acetaminophen. Give the right dose for your child’s weight, every 6 to 8 hours, as needed. You can give ibuprofen to children over 6 months of age.
Do not give your child or teen aspirin.
Sponge your child if the fever does not go down. Sponge your child if your child’s temperature stays over 104° F (40° C) 30 minutes after your child has taken acetaminophen or ibuprofen. Always give your child acetaminophen or ibuprofen first. Sit your child in only 2 inches of lukewarm water. Sponge off the child’s skin. If your child shivers, stop sponging or put in more warm water.
Have your child drink a lot of cold fluids.
Have your child wear as little clothing as possible. Do not bundle up your child. It will make the fever go higher.
For fevers of 100 to 102° F (37.8 to 38.9° C), cold fluids and little clothing may be all your child needs. Your child may not need acetaminophen.

Call your child’s doctor right away if:

Your child is less than 3 months old.
Your child’s fever is over 105° F (40.6° C).
Your child has a seizure.
Your child looks or acts very sick.

Call your child’s doctor within 24 hours if:

Your child is 3 to 6 months old (unless the fever is due to a DTaP shot).
The fever is between 104 and 105° F (40 to 40.6° C).
Your child has had a fever more than 24 hours and you don’t know what is causing it.
Your child has had a fever for more than 3 days.
The fever went away for over 24 hours and then came back.
You have other concerns or questions.

Written by B.D. Schmitt, M.D., author of “Your Child’s Health,” Bantam Books.
Published by RelayHealth.
Last modified: 2007-03-26
Last reviewed: 2007-03-14
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.

What to do for Eczema

What is eczema?

Eczema is a red, extremely itchy rash. The rash often starts on the cheeks at 2 to 6 months of age. The rash is mostly on the inside of elbows, wrists, and knees.
Eczema is a type of sensitive, dry skin that runs in families. Eczema is triggered by contact with things like soap or chlorine. Hot baths can also make it worse. In 30% of infants with eczema, flare-ups occur within 2 hours of eating certain foods (such as cow’s milk, eggs, or peanut butter.

How can I take care of my child?

Steroid creams – are a way to treat the itch of eczema. Most children need 2 types of steroid creams: one preventive cream to treat mild eczema and another stronger cream to stop a flare-up once it has started.
Preventive steroid cream. Your child’s preventive steroid cream is _________________________. Apply this cream ________ times a day to any spot that itches. Also use it for mild flare-ups. After the rash quiets down, use it for another week. Always take the cream with you when you travel and make sure you buy more before you run out.
Rescue steroid cream. Your child’s rescue cream is _______________________. Apply this cream ________ times a day for severe itching or rash.
Never apply this more powerful steroid cream to the face.
Moisturize the skin – Keeping skin from drying out prevents flare-ups. Soaking in a bath once a day for 10 minutes also helps the itching.
Soaps make eczema worse. Young children usually do not need soap. Teenagers need a gentle soap such as Dove or Tone to wash under the arms, the genital area, and the feet.
Lubricating cream – After the bath, apply a cream such as Keri, Lubriderm, Nivea, or Nutraderm. Put on the cream within 3 minutes after the bath to trap the moisture in the skin.
Antihistamine medicine – An antihistamine pill is needed at bedtime for itching that is keeping your child from getting to sleep or causes your child to wake up during the night. Your child’s antihistamine is ___________________. Give _________ at bedtime for _____________ days.

How can I prevent eczema?

Cotton clothes should be worn as much as possible. Do not overdress your child. Avoid triggers that cause eczema to flare up, such as too much heat or cold, sweating, dry air (use a humidifier), chlorine, harsh chemicals, and soaps. Never use bubble bath.

Call your child’s doctor right away if:

The rash looks infected and your child has a fever.
The rash flares up after contact with fever blisters.

Call your child’s doctor during office hours if:

The rash becomes raw and open in several places.
The rash looks infected (red streaks, pus, yellow scabs).
The rash hasn’t improved after 7 days of treatment.
You have other concerns or questions.

Written by B.D. Schmitt, M.D., author of “Your Child’s Health,” Bantam Books.
Published by RelayHealth.
Last modified: 2007-03-22
Last reviewed: 2007-03-22
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
Pediatric Advisor 2008.1 Index

What to do for Colic (The Crying Baby)

What is colic?

Colic is unexplained crying (not due to pain or hunger). The bouts of crying usually last 1 to 2 hours and the child acts fine between bouts. Your child usually stops crying when held. The colic begins before 2 weeks of age and usually stops by 3 months of age.

Colic tends to occur in high-need babies with a sensitive temperament. Colic is not the result of bad parenting, so don’t blame yourself. Colic is not caused by too much gas.

How can I help my child?

Hold and soothe your baby whenever he cries without a reason. A soothing, gentle activity is the best approach to helping a baby relax, settle down, and go to sleep. Consider using the following to calm your baby:

cuddling your child in a rocking chair
rocking your child in a cradle
swaddling your baby in a light blanket
placing your child in a frontpack or pouch
placing your child in a windup swing or vibrating chair
going for a stroller (buggy) ride, outdoors or indoors (instead of a ride in the car
running a washing machine or vacuum cleaner or playing a CD with a boring sound
other things that might help, such as a warm bath or massage.

A last resort: Let your baby cry himself to sleep. If your baby has not stopped crying after 30 minutes of holding and comforting and he has been fed recently, your baby is probably trying to go to sleep. Wrap him up and place him in his crib. He will probably be somewhat restless until he falls asleep. But if he cries for over 15 minutes, pick him up and try the soothing activities again.

Get rest and help for yourself. Avoid getting exhausted. Get at least one nap a day. Ask your spouse, a friend, or a relative for help with other children and chores. Caring for a colicky baby is a two-person job.

Call your child’s doctor right away if:

You can’t find a way to soothe your baby’s crying.
Your baby is less than 1 month old AND now acts sick.
You are afraid you might hurt your baby.
Your baby is acting very sick.

Call your child’s doctor during office hours if:

Your baby is not gaining weight and may be hungry.
You have other concerns or questions.

What to do in Breath-Holding Spells

What is a breath-holding spell?

Breath-holding spells begin at age 6 months to 2 years. These spells usually stop when a child is 4 or 5 years old. Breath-holding spells are not dangerous. They don’t lead to any brain problems. Your child may hold his breath when he is suddenly injured, frustrated, angry, or frightened.

During a breath-holding spell:

Your child may make one or two cries and then hold his breath until he becomes blue around the lips and passes out.
Your child may stiffen out when he or she passes out.
Your child will breath normally again and become fully alert in less than 1 minute.

People have a reflex that causes them to breathe after they have been holding their breath. This reflex doesn’t work well in some children and they pass out before taking a breath.

How can I take care of my child?

Treatment during breath-holding. These spells are harmless and stop by themselves. During a spell, your child should lie flat. Lying down makes more blood go to the brain and may keep the muscles from jerking. Put a cold, wet washcloth on your child’s forehead until he starts breathing again. Don’t start mouth-to-mouth resuscitation or call a rescue squad (911)–it’s not necessary.

Treatment after breath-holding. Give your child a quick hug and go about your business. A relaxed attitude is best. If your child had a temper tantrum because he wanted his way, don’t give in after the spell. If your child has a lot of attacks, ask your doctor to check your child for anemia.

Call your child’s doctor during office hours if:

More than one spell occurs each week.
The attacks change.
You have other concerns or questions.

CAUTION:

Call a rescue squad (911) if your child stops breathing for more than 1 minute.

Written by B.D. Schmitt, M.D., author of “Your Child’s Health,” Bantam Books.
Published by RelayHealth.
Last modified: 2007-03-22
Last reviewed: 2006-02-23
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.

Tooth Decay Prevention

What is tooth decay?

Tooth decay is when the enamel of a tooth is destroyed. It may cause toothaches, lost teeth, malocclusion (poor bite), and costly visits to the dentist. Fortunately, modern dentistry can prevent 80% to 90% of tooth decay.

How can I help my child prevent tooth decay?

Here are some tips for raising cavity-free kids.

Fluoride:
Fluoride builds strong, decay-resistant enamel and reduces cavities by 70%. Children 6 months to 16 years old need fluoride. By 16 years, the enamel formation on the 3rd molars is completed. Drinking fluoridated water (containing 0.7 to 1.2 parts fluoride per million) or taking a prescription fluoride supplement is the best protection against tooth decay.

To get enough fluoride from drinking water, a child must drink at least 1 pint of fluoridated water each day. By school age a child should drink 1 quart of fluoridated water per day. Fluoride is safe. Over half of all Americans drink fluoridated water. Fluoride has been added to water supplies for over 50 years.

If fluoride isn’t added to your city’s water supply or you are breast-feeding, ask your healthcare provider for a prescription for fluoride drops or tablets during your next routine visit. The dosage of fluoride is:

0.25 mg per day for children up to 3 years old
0.5 mg per day for children 3 to 6 years old
1.0 mg for children over age 6

Mixing fluoride with milk reduces absorption of the fluoride to 70%. For this reason you should give fluoride to your child when he or she has an empty stomach.

Bottled water usually doesn’t contain enough fluoride. Call the bottled water producer for information. If your child drinks bottled water containing 0.6 or less parts fluoride per million, ask your provider for a fluoride supplement.
One concern about fluoride is white spots or mottling on the teeth (called fluorosis). This can occur when a child has 2 mg or more fluoride per day. Children may get too much fluoride if they receive fluoride supplements when fluoride is already present in the city water supply. Occasionally they can get extra fluoride by eating their toothpaste. A ribbon of toothpaste contains about 1 mg of fluoride. Therefore, people of all ages should use only a drop of toothpaste the size of a pea. This precaution, and encouraging your child not to swallow most of the toothpaste, will prevent fluorosis.

Toothbrushing and flossing:
The purpose of toothbrushing is to remove plaque from the teeth. Plaque is the invisible scum that forms on the surface of teeth. Within this plaque, mouth bacteria change sugars to acids, which in turn etches the tooth enamel.
Toothbrushing should begin before a child is 1 year old. Help your child brush at least until after the age of 6 years. Most children don’t have the coordination or strength to brush their own teeth adequately before then. If your child is negative about tooth-brushing, have him brush your teeth first before you brush his.
Try to brush after each meal, but especially after the last meal or snack of the day. To prevent mouth bacteria from changing food caught in the teeth into acid, brush the teeth within the first 5 to 10 minutes after meals. If your child is in a setting where he can’t brush his teeth, teach him to rinse his mouth with water after meals instead.
Brush the molars (back teeth) carefully. Decay usually starts in the pits and crevices in these teeth. Dental floss is very useful for cleaning between the teeth where a brush can’t reach. This should begin when your child’s molars start to touch. In the early years, most of the teeth have spaces between them.
A fluoride toothpaste is beneficial at all ages starting at 1 year. Adults and children tend to use too much toothpaste. An amount the size of a small pea is all that you need.

Diet:
A healthy diet from a dental standpoint is one that keeps the sugar concentration in the mouth at a low level. The worst foods for your teeth contain sugar and also stick to the teeth.
If your child is a baby, prevent baby-bottle cavities by not letting your infant sleep with a bottle of milk or juice. After the first teeth appear give your baby a bottle of water if your child must have a bottle at night. It is better to put your child to bed after he or she is finished with the bottle.
Avoid letting your child carry around a bottle or sippy-cups during waking hours. Young children who use milk, juice or other sweetened liquid for comforting, are prone to severe dental decay.
Discourage your child from eating foods such as hard candy or sticky sweets (for example, caramels or raisins). When a child eats these foods his or her teeth are in contact with sugar for a long time. Since no one can keep children away from candy completely, try to teach your child to brush after eating it. Avoid frequent snacks and offer foods that contain sugar with meals only.

Dental sealants:
The latest breakthrough in dental research is dental sealing of the pits and fissures of the biting surfaces of the molars. Fluoride does little to prevent decay on these surfaces. A special plastic seal can be applied to the top surfaces of the permanent molars at about age 6. The seal may protect against decay for 10 to 20 years without needing replacement. Ask your child’s dentist about the latest recommendations.

Dentist visits:
The American Dental Association recommends that dental checkups begin at the age of 3 years (sooner for dental symptoms or teeth that look abnormal).

Written by B.D. Schmitt, M.D., author of “Your Child’s Health,” Bantam Books.
Published by RelayHealth.
Last modified: 2005-03-15
Last reviewed: 2006-03-01
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.

What to do for Eye Infection

What is an eye infection?

When your child has an eye infection, you may see:

Yellow discharge (pus) in the eye.
Eyelids stuck together with pus.
Redness or pinkness of the white part of the eyes.
Puffy eyelids.

Bacteria cause eye infections with pus. Pink eyes with no pus are caused by a virus.

How can I take care of my child?

Clean the eye.

Take away all pus with warm water and wet cotton balls.
Do this before you put in any medicine. This will give the medicine a chance to work.

Put in eyedrops or ointment.
This kind of infection must be treated with an antibiotic eye medicine. Your child’s doctor must prescribe it. Your child’s eye medicine is _________________________.

For eyedrops:

Put 1 drop in each eye every 4 hours while your child is awake.
Gently pull down on the lower lid and place the drops inside the lower lid.

For ointment:

Use the ointment just four times a day. It stays in the eyes longer than eyedrops.
Open the eyelids.
Put a ribbon of ointment along the lower eyelid from one corner of the eye to the other.

How can I prevent my child from spreading the infection?

Give your child his own washcloth and towel.
Wash your child’s hands often.

Call your child’s doctor right away if:

The outer eyelids get very red or swollen.
The eye is painful.
Your child’s vision is blurred.
Your child starts to act very sick.

Call your child’s doctor within 24 hours if:

The infection hasn’t cleared up after you’ve treated it for 3 days.
Your child gets an earache.
You have other concerns or questions.

What to do for Diarrhea

What is diarrhea?

Diarrhea can be caused by a virus or bacteria in your child’s intestines. This makes your child’s bowel movements (BMs) looser and come more often. Mild diarrhea is when your child has a few loose BMs. When the BMs are watery, the diarrhea is severe.

When your child has diarrhea, it is important to make sure your child does not lose too much water. If your child has these signs, he or she could be dehydrated:

Dry, sticky mouth.
No tears.
No urine in over 8 hours (over 12 hours if more than 1 year old).
Dark urine.

Taking care of the diarrhea can keep your child from losing too much water.

What is the cause?

Diarrhea is usually caused by a viral infection. Sometimes it is caused by bacteria or parasites. Sometimes a food allergy or drinking too much fruit juice may cause diarrhea. Antibiotics can upset the natural balance of bacteria in the digestive tract.

What should I feed my child?

Extra fluids and diet changes work best. Note: One loose bowel movement can mean nothing. Don’t change your child’s diet until your child has had several loose bowel movements.

Taking Care of Watery (Severe) Diarrhea

If your baby is less than 1 year old and bottle-fed:

Give him fluids more often than you would normally and as much as he wants. Fluids prevent dehydration.
Give your baby Pedialyte instead of formula for 4 to 6 hours.
After 4 to 6 hours, give your baby formula again. You may need soy formulas if the diarrhea is severe or doesn’t improve in 3 days.
If your baby is over 4 months old, continue rice cereal, strained carrots, strained bananas, and mashed potatoes.

If your baby is less than 1 year old and breast-fed:

Breast-feed more often.
If your baby is over 4 months old, continue rice cereal, strained carrots, strained bananas, and mashed potatoes.
Offer Pedialyte between feedings only if your baby does not urinate as often as usual or has dark-colored urine.

If your child is over 1 year old:

Give dried cereal, saltine crackers, yogurt, oatmeal, bread, noodles, mashed potatoes, carrots, applesauce, and strained bananas.
Give water or diluted Gatorade as the main fluids.
Caution: If your child does not want to eat solid food, give your child milk or formula rather than water.

Taking Care of Mild Diarrhea

Feed your child cereal, breads, crackers, rice, mashed potatoes, and noodles. (You can keep giving formula to your baby.)
Stay away from all fruit juices. Have your child drink more water.

Call your child’s doctor right away if:

Your child has not urinated in 8 hours (12 hours for older children) or has a very dry mouth or no tears.
There is any blood in the diarrhea.
Your child has had more than 8 BMs in the last 8 hours.
The diarrhea is watery AND your child also throws up repeatedly.
Your child starts acting very sick.

Call your child’s doctor during office hours if:

There is mucus or pus in the BMs.
Your child has a fever that lasts more than 3 days.
The mild diarrhea lasts more than 2 weeks.
You have other concerns or questions.

What to do for Constipation

What is constipation?

When your child is constipated, your child may:

Have a hard time having a bowel movement (BM).
Have a painful BM.
Go 3 or more days without a BM.

This could happen because your child:

Does not eat enough fiber.
Drinks or eats too many milk products.
Does not drink enough liquid.
Does not get enough exercise.
Remembers painful BMs. That can make some children hold back.

How can I take care of my child?

For babies less than 1 year old.

If your baby is over 2 months old, give fruit juices (such as apple or pear juice) twice a day.
If your baby is over 4 months old, you can add strained, high-fiber foods twice a day. Cereals, apricots, prunes, peaches, pears, bananas, apples, beans, or peas are good fiber foods.

For children over 1 year old.

Feed your child fruits or vegetables at least 3 times a day.\
Give more foods rich in bran and fiber. Try bran flakes, bran muffins, shredded wheat, graham crackers, oatmeal, brown rice, or whole wheat bread.
Decrease the amount of milk products (such as cow’s milk, ice cream, cheese, and yogurt) to 3 servings per day.

For children who are toilet trained.

Have your child sit on the toilet for 10 minutes after meals. This will help your child have a BM every day.

Call your child’s doctor right away if:

Your child starts to have very bad rectal or stomach pain.

Call your child’s doctor during office hours if:

Your child has not had a BM after you have fed your child fiber foods and reduced milk products for 3 days.
You are using suppositories or enemas for your child.
You have other concerns or questions.

What to do for Colds

What is a cold?

When your child has a cold, he often has a runny or stuffy nose. He may also have a fever, sore throat, cough, or hoarseness.
Viruses cause most colds. You can expect a healthy child to get about 6 colds a year.

How can I take care of my child?

Runny nose. If your child has a lot of clear discharge from the nose, it may not be a good idea to blow his nose. Sniffing and swallowing the mucus is probably better than blowing. Blowing the nose can make the infection go into the ears or sinuses. For babies, use a soft rubber suction bulb to take out the mucus.

Stuffy nose. Most stuffy noses are blocked by dry mucus. Try nose-drops of warm tap water or saline. They are better than any medicine you can buy.

Mix 1/2 teaspoon of table salt in 8 ounces of water.
Put 3 drops in each nostril. (For children less than 1 year old, use 1 drop.)
Wait 1 minute.
Then have the child blow or you can use suction bulb. Use a wet cotton swab to remove mucus that’s very sticky.

Aches and fever. Give your child acetaminophen (Tylenol) or ibuprofen (Advil) for fever over 102°F (39°C). Do not give aspirin.

Cough or sore throat. Use cough drops for children over 6 years old. Use 1/2 to 1 teaspoon of honey for children over 1 year old. If you do not have honey, you can use corn syrup.

How long does it last?

Usually the fever lasts less than 3 days, and all nose and throat symptoms are gone in a week. A cough may last 2 to 3 weeks. Watch for signs of bacterial infections such as an earache, sinus pain, yellow drainage from the eyes, or breathing trouble.

Call your child’s doctor right away if:

Your child has a hard time breathing AND is no better after you clear the nose.
Your child starts acting very sick.

Call your child’s doctor during office hours if:

The fever lasts more than 3 days.
The runny nose lasts more than 10 days.
The eyes get yellow discharge.
You think your child may have an earache or sinus pain.
You have other questions or concerns.

Written by B.D. Schmitt, M.D., author of “Your Child’s Health,” Bantam Books.
Published by RelayHealth.
Last modified: 2007-12-17
Last reviewed: 2007-03-22
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.