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Abdominal Pain

• Acute gastroenteritis.
• Gas (less than 6 months old).
• Severe Pain – rule out appendicitis, pancreatitis.
• Recurrent cyclical pain.
• Worms.

What you can do?

• If your child has diarrhea, wait for it to resolve.
• Give stomach rest by increasing fluids, giving prebiotics like curd & banana.

For less than 6 months old

• Give tummy time.
• Increase burdping duration.
• Colicaid drops (dosage as per your Doctor).

Fever

What you can do?

• Check if temperature is more than 100 °F.
• Give Paracetamol (dosage as per your Doctor).
• If temperature is more than 101 °F, immediately sponge the child’s forehead, chest, neck.

Earpain

What you can do?

• Give steam.
• Do Valsalva maneuver.
  

Cough

What you can do?

Crying Child – 3 Months and Older

• A child more than 3 months old is crying and you don’t know why
• Your child is too young to tell you why
• Age: most of these children are younger than 2 years old
• Crying is the only symptom
• For crying with an illness or other symptom, go to that care guide

Causes of Unexplained Crying

• New Illness. Coming down with an illness is the main physical cause. Young children cry about being sick, even if they don’t have any pain.
• Physical Pain. Painful causes include earache, sore throat, mouth ulcers, or a raw diaper rash. A sore on the penis or constipation may also cause pain or crying.
• Behavioral Causes. Most crying means the child is upset about something. Crying can occur when a young child is separated from his parents. Other examples are crying with tantrums or when overtired. This guide detects many babies with sleep problems. Crying always occurs during re-training programs for bad sleep habits. Some preverbal children cry any time they want something.
• Hunger. After the early months, most parents can recognize hunger and feed their child. If they don’t, the child may cry.
• Cold Medicines. Drugs like Sudafed can also cause crying. Note: FDA does not advise cough and cold medicines for children under 6 years.

Myths About Causes of Crying

• Not Due to Teething. Teething may cause some babies to be fussy. But, in general, it does not cause crying.
• Not Due to Gas. Gas passing through normal intestines does not cause pain or crying.

Diaper Rash

• Any rash on the skin covered by a diaper
• Age: diaper-wearing age group (birth to 3 years)

Causes of Diaper Rash

• Irritant Diaper Rash. Mild rashes can be caused by the drying effect of soaps.
• Stool Diaper Rash. Stool left on the skin can be very irritating because it contains bacteria. Urine alone has no germs in it and usually doesn’t irritate the skin. This rash is common on the scrotum or anywhere that stool can hide. Small ulcers around the anus are often from prolonged stool contact.
• Ammonia Diaper Rash. Stool and urine left in diaper too long can combine to make ammonia. It can cause a mild chemical burn. The fumes when you change the diaper will smell like ammonia. This is more common with cloth diapers.
• Diarrhea Diaper Rash. Rashes just found around the anus are common during bouts of diarrhea. Diarrhea stools also contain enzymes that digest food and irritate the skin.
• Yeast Diaper Rash. Rashes from irritants can get a secondary infection with yeast. Yeast infections are bright red. They can be raw and weepy. The borders are sharp. Small red bumps or even pimples may occur just beyond the border. If treated correctly, a diaper rash should be cured in 3 days. If not, it has probably been invaded by yeast. Treat with an anti-yeast cream.
• Bacterial Diaper Rash. Bacteria can also cause a secondary infection of irritated skin. This is less common than yeast rashes. Bacteria cause sores, yellow scabs, pimples or draining pus. They look like impetigo, a local skin bacterial infection. Can also become a painful red lump (boil).
• Cellulitis (Serious). The bacterial infection spreads into the skin. Gives redness that spreads out from the sore. The red area is painful to the touch.
• Staph Scalded Skin Syndrome (Serious). SSSS is caused by a Staph bacteria. The main finding is widespread large blisters. The skin is bright red. The baby acts very sick.

Symptoms of Diaper Rash

• Mild rashes just have areas of pink, dry skin.
• Severe rashes have areas of red skin. In some areas, the skin may become raw or even bleed.
• Pink rashes are not painful, but raw ones can be very painful. This can lead crying and poor sleep.

Prevention of Recurrent Diaper Rash

• Change diapers more often. Focus on preventing skin contact with stool.
• Rinse your baby’s skin with lots of warm water when cleaning off stool. Don’t depend on diaper wipes alone to cleanse the skin.
• Be sure to clean stool off all the skin folds. Cleaning the scrotum can be a challenge.

Immunization Reaction

• Reactions to a recent immunization (vaccine)
• Most are reactions at the shot site (such as pain, swelling, redness)
• General reactions (such as a fever or being fussy) may also occur

Reactions to These Vaccines are Covered:

• Chickenpox (varicella) virus
• DTaP (Diphtheria, Tetanus, Pertussis)
• Hemophilus influenzae type b
• Hepatitis A virus
• Hepatitis B virus
• Human Papilloma virus
• Influenza virus
• MMR (Measles, Mumps, Rubella)
• Meningococcal
• Polio virus
• Pneumococcal
• Rotavirus
• Tuberculosis (BCG vaccine)

Symptoms of Vaccine Reactions

• Local Reactions. Shot sites can have swelling, redness and pain. Most often, these symptoms start within 24 hours of the shot. They most often last 3 to 5 days. With the DTaP vaccine, they can last up to 7 days.
• Fever. Fever with most vaccines begins within 24 hours and lasts 1 to 2 days.
• Delayed Reactions. With the MMR and chickenpox shots, fever and rash can occur. These symptoms start later. They usually begin between 1 and 4 weeks.
• Anaphylaxis. Severe allergic reactions are very rare, but can occur with any vaccine. They start within 2 hours.

Vaccine Free App

• Vaccines on the Go app from Children’s Hospital of Philadelphia
• This free app can answer any vaccine questions you may have
• It is fact-based and up-to-date

Spitting Up – Reflux

• Spitting up small amounts of breastmilk or formula. Also called reflux.
• Spitting up 1 or 2 mouthfuls of milk at a time
• No effort or crying
• Normal symptom in half of young babies

Symptoms of Normal Spitting Up

• Smaller amounts often occur with burping (“wet burps”)
• Larger amounts can occur after overfeeding
• Most often seen during or shortly after feedings
• Occurs mainly in children under 1 year of age
• Begins in the first weeks of life
• Caution: normal reflux does not cause any crying

Complications of Spitting Up (GERD)

• Most infants are “happy spitters.” Normal spitting up (normal reflux) occurs in half of babies. It does not cause crying or colic.
• Normal crying occurs in all babies. Frequent crying (called colic) occurs in 15% of babies. Crying and colic are not helped by heartburn meds. These meds also have side effects.
• If they develop complications, it’s called GERD (gastro-esophageal reflux disease). This occurs in less than 1% of babies.

Symptoms of GERD

GERD problems occur in less than 1% of infants:

• Choking on spit up milk
• Heartburn from acid on lower esophagus. Infants with this problem cry numerous times per day. They also act very unhappy when they are not crying. They are in almost constant discomfort.
• Poor Weight Gain

Cause

• Poor closure of the valve at the upper end of the stomach (weak valve)
• Main trigger: overfeeding of formula or breastmilk
• More than half of all infants have occasional spitting up (“happy spitters”)

Reflux Versus Vomiting: How to Tell

• During the first month of life, newborns with true vomiting need to be seen quickly. The causes of vomiting in this age group can be serious. Therefore, it’s important to tell the difference between reflux and true vomiting.

Reflux. The following suggests reflux (normal spitting up):

• You’ve been told by a doctor your baby has reflux
• Onset early in life (85% by 7 days of life)
• Present for several days or weeks
• No pain or crying during reflux
• No effort with spitting up
• No diarrhea
• Your baby acts hungry, looks well and acts happy.

Vomiting. The following suggests vomiting:

• Uncomfortable during vomiting
• New symptom starting today or yesterday
• Forceful vomiting
• Contains bile (green color)
• Diarrhea is also present or
• Your baby looks or acts sick.

Pyloric Stenosis (Serious Cause)

• This is the most common cause of true vomiting in young babies.
• Onset of vomiting age 2 weeks to 2 months
• Vomiting is forceful. It shoots out of the baby’s mouth. This is called projectile vomiting.
• Right after vomiting, the baby is hungry and wants to feed. (“hungry vomiter”)
• Cause: the pylorus is the channel between the stomach and the gut. In these babies, it becomes narrow and tight.
• Risk: weight loss or dehydration
• Treatment: cured by surgery.

Tear Duct – Blocked

• Blocked tube that normally carries tears from the eye to the nose
• It’s blocked in 10% of newborns
• Use this guide only if a doctor has told you it’s a blocked tear duct

Symptoms of a Blocked Tear Duct

• A constant watery eye
• Tears fill the eye and run down the face. This happens even when not crying.
• The eye is not red and the eyelid is not swollen.
• Both sides are blocked in 30% of these children.

Cause of a Blocked Tear Duct

• Caused by blockage of the lacrimal duct. This duct carries tears from the corner of the eye to the nose.
• A watery eye may not be noticed until 1 or 2 months old. Reason: that’s when the eye starts making more tears.

Teething

• The normal process of new teeth working their way through the gums
• Questions about teething
• Baby teeth come in between 6 and 24 months of age
• Caution: At least one tooth should be seen before using this care guide

Proven Symptoms of Teething

Teething has been researched in-depth. Kids who are teething are little different from kids who are not teething. Here are the main symptoms that have been proven:

• Drooling. Increased spit and drooling.
• Rash. Face rash from drooling. The drool contains little bits of food that are irritating to the skin.
• Chewing. Increased need to chew on things.
• Gum Pain. Gum pain is mild and not always present. May be due to mouth germs getting into the new break in the gum. Most often, your baby just acts a little more fussy. There’s not enough discomfort to cause crying. It also doesn’t hurt enough to cause sleep problems.

False Symptoms of Teething

• Teething does not cause fever, diarrhea, diaper rash or runny nose.
• It does not cause a lot of crying.
• It does not cause your baby to be more prone to getting sick.
• Caution about Fevers. Blaming teething for fevers can lead to a delay in seeking care for infections. Examples are ear and urinary tract infections. Another example is meningitis.
• There are 2 reasons why infections start between 6 and 12 months of age. One is the loss of antibodies transferred to baby from the mother at birth. The other is the developmental milestone of chewing on everything.
• Caution about Crying. Blaming teething for crying can lead to a delay of care for other illnesses. Examples are ear infections or other causes of pain.

Thrush

• A yeast infection of the mouth in young babies
• White patches in the front of the mouth

Symptoms of Thrush

• White, odd shaped patches in the mouth
• Coats the inner cheeks or inner lips
• Sometimes also coats the tongue
• Sticks to the mouth. It can’t be washed away or wiped off easily like milk curds.
• Sometimes causes a painful mouth, decreased sucking and reduced milk intake
• Mild discomfort or no symptoms in most newborns
• The infant is bottle-fed or breast-fed

Cause of Thrush

• Caused by a yeast (called Candida)
• Occurs on parts of the mouth involved with sucking
• Made worse by friction from too much time sucking on a pacifier

White Tongue Alone: Not Thrush

• If a white tongue is the only finding, it’s not due to thrush.
• A milk diet often causes a white coated tongue.
• This is normal.
• It will go away after your baby starts eating solid foods.
• If white patches occur inside the lips or cheeks, call your child’s doctor. It’s safe to call during office hours.

Cradle Cap

• A scaly rash on the scalp that starts in newborns

Symptoms of Cradle Cap

• Yellow scales and crusts attached to the scalp
• Occurs in patches
• Scales can be greasy or dry
• Not itchy or painful
• Begins in the first 2 to 6 weeks of life

Cause of Cradle Cap

• Cradle cap is probably caused by hormones from the mother. These hormones cross the placenta before birth. The hormones cause the oil glands in the skin to become overactive. They then release more oil than normal.
• Dead skin cells normally fall off. The extra oil causes these cells to “stick” to the skin. These cells form yellow crusts and scales on the scalp.

Hand-Foot-and-Mouth Disease-Viral Rash

Definition

• Tiny red spots and water blisters on the hands and feet caused by a virus
• Rash is seen on the palms, fingers, soles and toes
• The diagnosis cannot be made without these
• Also can cause small mouth ulcers (sores)

Symptoms of Hand-Foot-and-Mouth Disease (HFMD)

• Small red spots and tiny water blisters on the hands and feet. Seen on the palms, fingers, soles and toes.
• The diagnosis cannot be made without these.
• Small painful ulcers (sores) in the mouth. Look for them on the tongue and sides of mouth. Most children with HFMD have these, but they can be hard to see.
• Also, small blisters or red spots on the buttocks (30%)
• Low-grade fever less than 102° F (39° C)
• Mainly occurs in children age 6 months to 4 years

Cause of HFMD

• Coxsackie A-16 virus and other enteroviruses
• Not related to any animal disease

Severe Form of HFMD

• Since 2012, a severe form of HFMD has occurred in much of the world. It’s caused by a new Coxsackie A6 virus.
• The rash spreads to the arms, legs and face. The rash is made up of many small blisters.
• Children with such a severe rash may need to be seen. Reason: to confirm the diagnosis. Exception: close contact with HFMD within the last 7 days.
• Treatment is the same. Drink enough fluids to prevent dehydration.
• Peeling of the fingers and toes is common. It looks bad but is harmless. It happens at 1 to 2 weeks. Use a moisturizing cream on the raw skin.
• Some fingernails and toenails may fall off. It occurs in 4% of severe cases. It happens at 3 to 6 weeks out. Trim them if they catch on things.
• Fingernails grow back by 3 to 6 months and toenails by 9 to 12 months. They will look normal.