Genesis Advice Packet (GAP)

Information for Rochester, NY Parents

Read the following symptoms and suggested treatments for when your child is sick. Call our pediatricians at (585) 426-4100 to schedule an appointment. 


Earache

Symptoms:

  • Pain or discomfort around the ear.
  • Child reporting ear pain.
  • Crying when lying flat, poor sleep.
  • Different cry, as if in pain.

Treatment:

  • Give Acetaminophen (Tylenol) if child is older than 2 months or Ibuprofen (Motrin or Advil) if child is older than 6 months for discomfort. See dosing charts. 
  • Raise the head of the bed 30 – 45°.
  • Apply warm compress to ear – if child is older than 1 year.
  • Try a few drops of warm Orajel to affected ear. DO NOT USE IF EAR IS DRAINING.
  • If symptoms persist to the morning, the child should be seen.  Not all children with an ear infection will have fever. 

EARACHES DO NOT ALWAYS INDICATE AN INFECTION. 

Nosebleeds

Cause:

  • Picking.
  • Injury.
  • Polyps.
  • Rare – bleeding disorders

Treatment: 

  • Pressure to upper sides of nose.
  • Head forward.
  • Apply ice to nose.

Fever

Symptoms:

  • Warmer to the touch.
  • Increased fussiness.
  • Increased heart rate, flushed face.
  • Child not wanting to eat or drink or play like normal. 

Be Reassured:

  • Fever is a “friend.” It is a sign that the body is fighting off an infection. 
  • Fever is often higher in the evening and lower in the morning.
  • Fever generally lasts 2-3 days.
  • Fevers of 104° F or higher are generally not dangerous; treat the same as a lower fever.

Treatments:

  • If temperature is below 100° F and child is acting well, no treatment is necessary.
  • Increase daily fluid intake.
  • Keep child lightly dressed with loose cotton layers.
  • Give Acetaminophen (Tylenol) if child is older than 2 months, or Ibuprofen (Motrin or Advil) if child is older than 6 months for comfort. See dosing charts.
    • Acetaminophen alone can be given every 4 hours.
    • Ibuprofen alone can be given every 6 hours.
    • May alternate Acetaminophen and Ibuprofen every 3 hours with high fevers or persistent pain (for 1-2 days only). 
  • Call during regular office hours for an appointment if your child’s fever (101° F or higher) persists for more than 3 days.
  • Call immediately if:
    • your child is under 2 months of age and has a rectal temperature 100.4° F   or higher
    • your child is difficult to arouse or does not interact with you.
    • your child is complaining of stiff neck or not able to move neck.
    • your child has a rash that does not lose color when pressed. 
  • If your child has a seizure with the fever, please call the office to determine further course of action. 

Congestion

Symptoms:

  • Runny or stuffy nose (drainage may be clear, cloudy, yellow or green).
  • Associated symptoms: fever, sore throat, cough, red eyes.
  • The average child will have as many as 8 colds per year. Children in day care setting may get a cold every 2-3 weeks during the winter season.
  • Antibiotics and cold medication will not cure a cold.

Treatment:

There is no cure for a cold but offer comfort support including:

  • Give acetaminophen for fever or discomfort.
  • Increase daily fluid intake.
  • Use a cool mist humidifier to moisturize secretions (remember to change water daily).
  • Raise the head of the bed 30-45 degrees by placing a towel roll underneath an infant/toddler mattress, or by adding additional pillows for propping older children (only for children >1 year of age).
  • Nasal saline drops or spray and nasal suctioning as needed.

Cough is one of the body’s own way of getting rid of mucus, so unless it is painful or keeping the child awake, do not give cough suppressants.

Sore Throat

banner-sore-throatSymptoms:

  • Pain or discomfort in the throat, worsens with swallowing.
  • Child under 2 years of age doesn’t know how to complain of a sore throat, but may refuse previously enjoyed foods or cry with feedings.

Treatment:

  • Gargle with warm salt water (1 tsp per 8 oz glass of water)
  • Give Acetaminophen (Tylenol) if child older than 2 months, or Ibuprofen (Motrin or Advil) if child older than 6 months for comfort. See dosing charts. 
  • Encourage cold fluids or foods.
  • Soft bland diet – avoiding spicy, acidic or rough textured foods.
  • Call during regular office hours if:
    • Sore throat lasts longer than 24 hours.
    • Accompanied by fever (101° F  or higher).
    • The child has had recent contact or exposure to strep throat.
    • Accompanied by abdominal pain, vomiting or headache.
    • A rash develops.
  • Call immediately if there is:
    • Drooling.
    • Difficulty breathing.
    • Difficulty swallowing.

Head Injuries

Symptoms:

  • Strike or blow of the head, may not always include loss of consciousness.
  • If loss of consciousness call office immediately.
  • If child remains unconscious or appears critically ill, call 9-1-1.

Treatment (if no loss of consciousness):

  • Clean any scrapes or cuts with soap and water.
  • Apply direct pressure to cuts for 10 minutes to control bleeding (Caution: head injuries tend to bleed heavily).
  • Apply cool compress or ice pack to affected area to decrease swelling.
  • Give Acetaminophen (Tylenol) for headache. See dosing charts. 
  • If child is sleepy and it is their normal sleep/nap time, allow them to sleep, but stay nearby and arouse every two hours during the day or four hours during the night.

Observe child and notify your doctor if any of the following are noticed:

  • Child has a deep cut in the scalp that may need suturing.
  • Child becomes disoriented, confused or dizzy.
  • Child begins vomiting more than twice ( is not uncommon for child to vomit right after injury occurs if upset).
  • Child is having difficulty speaking or blurred vision.
  • Child is having blood or watery fluid from nose or ears.
  • Child cannot remember how injury occurred.
  • Child is unusually sleepy.

Orthopedic Injuries

Strains and Sprains

Symptoms:

  • Swelling.
  • Pain.

Treatment:

  • Rest.
  • Ice – 15 minutes on, 15 minutes off.
  • Elevation.
  • If there is a break, swelling, pain or deformity, call the office for an appointment.
  • If there is a laceration, and the edges are spread apart, it may need stitches. 

Nursemaid’s Elbow

A dislocation of the elbow caused by pulling on the arm Accidents happen. Putting on a coat, vigorous play or grabbing a child’s arm in case of an emergency all can cause this to occur.  

Symptoms:

  • Sudden pain and not moving arm normally.
  • Possible deformity. 

Treatment:

  • Child should be seen for evaluation and probable treatment. .

Croup, Barky Cough

Symptoms:

  • Tight, low pitched barky cough (seal- like bark).
  • Voice or cry hoarse sounding.
  • Child may have stridor* – crowing like noise when child breathes in as croup becomes worse.
  • Symptoms tend to increase in the evening and last for 5 -6 days.
  • Associated symptoms include fever or nasal congestion.

Treatment:

Croup without stridor:

  • Cool mist vaporizer at night.
  • Increase daily fluid intake. Use warm fluids if having cough spasms to relax airways.
  • Give Ibuprofen if child is older than 6 months. Cold medications or antibiotics do not cure the illness.

Croup with stridor*:

  • Take child outside for 5 -10 minutes into cold night air or have the child breathe in air from an open freezer.
  • Foggy bathroom – turn on the hot water in the shower and close the bathroom door. Bring the child into the foggy room to breathe the warm moist air for 10-15 minutes.
  • If these measures are unsuccessful call the office immediately. If your child has severe difficulty breathing, go straight to the Emergency Department or call 9-1-1. 

Constipation

Symptoms:

  • Hard, dry or very large thick stools that come infrequently.
  • Sometimes cause pain and bleeding during BM.
  • No BM longer than 4 days (exception – exclusively breast fed infants may go longer periods up to 7 days).

Treatment:

Infant (0 – 2 months)

  • Try using a well lubricated thermometer or Q-tip to stimulate the rectum.
  • Give 1/2 – 1 oz prune juice mixed with an equal amount of water once daily as needed.
  • If these steps do not work, call for further consultation during regular office hours.

2 months – 1 year

  • Above treatments.
  • Limit binding foods such as bananas, rice cereal, and applesauce.
  • Increase high fiber content foods (fresh fruits and veggies).
  • Add fruit juices to diet (no more than 8-10 oz per day).
  • A warm bath may decrease abdominal cramps and encourage a BM.
  • If these steps do not work, call for further consultation during regular office hours.

Over 1 year

  • Above treatments.
  • Limiting binding foods above plus excessive dairy products (milk >16-20 oz a day, cheese, yogurt).
  • Increase high fiber foods including bran, whole grains, oatmeal, (popcorn if over 3 years of age).
  • May try pediatric glycerin suppository once or twice.
  • If these steps do not work, call for further consultation during regular office hours.

Diarrhea, Vomiting

Definition:

Most vomiting and diarrhea is caused by viral infections. This is a common illness and rarely dangerous. If vomiting doesn’t stop within 12-24 hours, please call your doctor. Diarrhea is a watery stool that occurs more than four times per day and can last for several days.

Treatment For Vomiting:

  • Rest the stomach for 1 hour by giving nothing.
  • Then give 1-2 tsp. of room temperature clear liquids such as Pedialyte, juices or soda every 5 minutes for one hour. If breastfeeding continue but for shorter intervals more frequently.
  • If the liquids are retained increase the liquids by small amounts 2-3 tsp. until child is retaining 2-4 oz at a time. But if vomiting occurs must restart the process. Pedialyte should not be continued for more than 24 hours.
  • Gradually (over 2 days) return to regular diet. Start with small amounts of low-fat, bland diet (i.e., dry toast or crackers).
  • Monitor for signs and symptoms of dehydration, which include dry mouth, no tears, and decreased urine output (less than 3 wet diapers).

Treatment For Diarrhea:

  • If vomiting is also occurring, just follow the above instructions.
  • If there is no vomiting, adequate fluid intake is essential to prevent dehydration. It is important to provide more fluid than the child looses through diarrhea. Signs of adequate hydration include a normal or near normal urine output, a moist mouth, and an alert child who is reasonably active.
  • If breastfeeding: Continue to breastfeed at more frequent intervals. Supplement with Pedialyte by bottle or dropper if urine output decreases. Call office immediately for a dry diaper.
  • If formula feeding: increase the amount of formula or supplement with Pedialyte to make up for additional fluid losses.
  • Provide a regular diet with a few simple changes. Avoid grape, pear, or prune juices, which can loosen stools. If diarrhea is prolonged avoid milk products which may become difficult to digest. Encourage starchy foods as they are absorbed the best (i.e., cereals, rice, bread, cracker, noodles, potatoes, applesauce, bananas).
  • Monitor for signs and symptoms of dehydration, which include dry mouth, no tears, and decreased urine output (less than 3 wet diapers).
  • Despite the above steps, diarrhea may last days after the illness seems over. If the child seems well, there is nothing to worry about.