Common Questions and Concerns

   Here you will find answers to general questions about common childhood health concerns. If you have an urgent concern and the information provided here does not fit your child's specific problem. please contact us by telephone at 615-833-6411 to speak to one of our nurses during regular office hours. After hours, your call will be directed to the doctor on call who will return your call as soon as possible. For life-threatnening emergencies (severe difficulty breathing, seizures,or severe head injury) call 911 immediately.

• FEVER
  Fever means the body temperature is above normal. It is a symptom not a disease. It is the body's normal response to infections. Fever helps fight infections by turning on the body's immune system.


• COLDS
  Your child will have more colds, or upper respiratory infections than any other illness. In the first 2 years of life alone, most youngsters have 8 to 10 colds.


• DIARHHEA
  Diarhhea is a common childhood condition usually caused by an intestinal virus. Frequent loose or watery stools may occur. If your child is otherwise well. Taking fluids without vomiting, and urinating at least once every eight hours, it is acceptable to continue feeding the child his/her usual diet and expect the diarrhea to resolve in 3-4 days. In the toddler or older child it may be helpful to eliminate milk and other dairy productsfor a day or two.


• COUGH
  Coughs are one of the most frequent symptoms of childhood illnesses, and altough they can sound awful at times, they usually are not a symptom of anything dangerous. Actually cough is a healthy reflex that helps clear the airways in the throat and chest.


• SORETHROAT
  Most sorethroats in children are mild and are caused by viruses that last 3-4 days before resolving on their own. More severe infections in children over 18 months might be due to Streptococcus bacteria. Clues that your child's sorethroat might be due to strep are sudden onset, headache and abdominal pain, enlarged tonsils and elarged, tender lymph nodes on either side of the neck. Typical cold symptoms are absent. Occassionaly a fine red sand-papery feeling rash may occur under the arms and in the groin.


• RASH
  Most rashes in infants and children accompany mild viral infections and look like scattered red dots and bumps that are not itchy or painful. Rashes occassionally are a sign of serious infection-specifically rashes that are purplish, do not disappear with pressure from a finger, and are accompanied by fever and /or headache.Call our office immediately if you observe a purplish rash.


• VOMITING
  Vomiting in children occurs in the early stages of an intestinal viral infection and may also be a sign of food poisoning. Vomiting may also be a sign of rare but serious conditions such as intestinal obstruction or appendicitis. If your child is NOT vomiting green material ( bile ) and does NOT have a high fever or severe abdominal pain, it is safe to try comfort measures for the first six hours at home. After the stomach is empty and your child's vomiting has ceased for one to two hours, begin rehydration using small amounts of clear liquids such as Pedialyte, or 1/2 strength Gatorade. Offer these every 10 to 20 minutes while your child is awake, gradually increasing the amounts. If your child is breastfeeding you may resume nursing. If vomiting is bile-colored or persists for longer than six hours, or is accompanied by high fever,severe abdominal pain, or signs of dehydration, please call the office. When vomiting has ceasd for eight hours and your child is tolerating 4 ounces of clear liquids at a time, it should be safe to begin feeding your child small amounts of food. Foods that are well tolerated include carbohydrates such as rice, white bread, white potatoes, pasta, jello, rice milk, soy milk or soy formula. Observe this diet for 24-36 hours, and then resume your child's regular diet.


• ABDOMINAL PAIN
  Mild abdominal pain is very common and may be caused by viral illness, overeating, over-stimulation, or constipation. More severe abdominal pain, especially if accompanied by fever or vomiting, may be sign of more serious illness such as appendicitis or urinary infection. Call the office if your child's abdominal pain is severe and has persisted for longer than four hours, or fever/vomiting is present.


• CONSTIPATION
  Constipation in infants and children refers to hard, painful bowel movements. Stools that are soft are normal, and may be infrequent as every 2 or 3 days in normal, healthy infants and children. In toddlers and older children, constipation can usually be relieved by increased amounts of fluid in the diet, especially pear and prune juice, and increased amounts of fruits and vegetables. For infants who have hard, painful stools, or in older children who do not improve with a change in the diet, please call during office hours to talk with one of the nurses for further advice.


• DEHYDRATION
  Excessive loss of body fluids through vomiting or diarrhea, combined with inadequate oral intake of fluids can lead to dehydration in infants and small children. Signs of dehydration include infrequent urination (fewer than 3 times in 24 hours), dry lips and tongue, sunken eyes, and skin that has a "doughy" feel, or which remains tented up when gently squeezed between your thumb and forefinger. Lack of tears or saliva are also signs of dehydration. If your child appears to be dehydrated, pleaase call the ofice for advice.


• HEADACHE
  Children often have headaches associated with viral infection, overheating, or mild dehydration. These headaches are usually brief and respond to comfort measures such as rest, fluids, and medications such as acetaminophen or ibuprofen. Headaches may also follow minor head injury and also respond to comfort measures. If the headache is severe, or accompanied by vomiting, fever, confusion, or stiff neck, call the office immediately. If your child develops a pattern of frequent or severe haedaches, especially if they interfere with normal activities or occur first thing in the morning, call the office to arrange for an evaluation.