Don McInturff, MD David Denton, MD Matthew Murdoch, MD Brian Fulks, MD Gentry Yost, MD Shaun Summerill, MD Laura Duty, MD Elizabeth Parsons, MD Matthew Stelzer, MD David Larsen, MD Alison McInturff, MD 232-1443 www.pocatellochildren.com Table of Contents Office Hours . 3 About This Book . 4 Well-Child Care and Immunizations . 5 Fever . 6-7 Tylenol Dosing . 8 Motrin Dosing . 8 Vomiting and Diarrhea . 9-10 Common Cold . 11-12 Sore Throats and Strep Throat . 13 Ear Infections . 14 Pink Eye . 15 Fussiness in Infants . 16-17 Constipation in Newborns and Infants . 18 Diaper Rash . 19 Head Injuries . 20 Head Injury Prevention . 21 Poisoning . 22 Notes . 23 Important Telephone Numbers . 24 — 2 — Welcome to the Pocatello Children’s Clinic! We believe that nothing is more rewarding than caring for children . As a parent, you know how exciting and sometimes challenging it can be . We are here to help . Every person in our office is dedicated to working just with children . It’s our specialty; we wouldn’t have it any other way . We provide comprehensive care for all children and adolescents . At the Pocatello Children’s Clinic, a pediatrician is always available to answer your questions or see your child 24 hours a day, 7 days a week . During regular office hours you can make appointments for well child care and sick visits . We reserve time every day for sick visits should your child need to be seen the same day . If you are unsure whether or not your child needs to be examined, you can ask to speak to a nurse before making an appointment . After hours, one of our pediatricians is available by phone at all times . We ask that you save calls about scheduling and other non-urgent issues until the next business day . If you have questions or concerns that cannot wait until morning, however, please call us . You should also call us before taking your child to the emergency room unless your child has a life-threatening condition . Many times a call to us can help you avoid costly emergency room visits . If your child does need to be seen at the hospital, we can arrange to meet you there . We also staff Portneuf Medical Center’s nursery and pediatric inpatient ward . If your child needs to be admitted to the hospital, there is a pediatrician from our clinic ready to care for him or her . In addition, pediatric sub-specialists from Primary Children’s Medical Center regularly work with our pediatricians and see patients in our clinic . Monday to Friday 8:00 a.m. to 9:00 p.m. and Saturday 8:00 a.m. to 12:00 p.m. — 3 — About this book We find that parents often have similar questions about the common illnesses children experience . We’ve written this book to: • Address some of the most frequent questions we are asked; • Help you understand why we believe well child care is so important and what you can expect at well child care visits; • Aid you and your child in getting the most out of being seen at the Pocatello Children’s Clinic . In its pages you’ll find advice and instruction on how to manage things like fever, vomiting and colds . Getting sick is part of growing up . But almost always kids get better, and moms and dads are the best medicine . The most important advice: Trust your instincts. And if you have questions, ask. That’s why we’re here. Think of this book as a quick guide . The internet and libraries provide extensive resources on the health and development of children . In fact, there is more information available than any one person could ever digest . Many of these resources offer parents sound advice . Some do not . We caution you to check the references of information you find and if in doubt, discuss it with us . We’ve obtained much of the information found in this book from trusted websites . You can access some helpful links on our website at: www.pocatellochildren.com — 4 — WELL CHILD CARE AND IMMUNIZATIONS Wellness means more than just not being sick. It involves healthy growth and development. We encourage regular visits with your pediatrician to address all aspects of your child’s health. In a typical visit, we’ll discuss past and on-going medical problems, your child’s development, and parenting advice. Parents are often interested in subjects such as diet, behavior and discipline, and safety issues. We’ll perform a full physical exam and age- appropriate screening tests. This is also a good time for you to ask us questions. During well child visits, children receive their immunizations, or “shots.” Immunizations have revolutionized the health of children in the past hundred years. Because of vaccines, children no longer die from many of the diseases our parents and grandparents dreaded such as polio, mumps, and measles. We believe that the benefits of vaccination far outweigh any risk. We immunize our own children. However, many parents have questions about vaccines, and we feel it is important to discuss your concerns and will do so during well child care visits. Below is a schedule of routine childhood immunizations. From time to time, new vaccines are added, and this schedule may change. We will inform you when changes are made. Health Supervision Visit Schedule with Immunization Schedule • 2 weeks - health supervision visit • 2 months - health supervision visit & Hib, DTaP and Polio, Hep B, Pneumococcal, Rotavirus • 4 months - health supervision visit & Hib, DTaP and Polio, Pneumococcal, Rotavirus • 6 months - health supervision visit & Hib, DTaP and Polio, Hep B, Pneumococcal, Rotavirus . Influenza vaccine annually in the fall . • 9 months - health supervision visit, catch-up immunizations if behind • 12 months - health supervision visit & MMR, Varicella, Hep A • 15 months - health supervision visit & DTaP, Hib, Pneumococcal • 2 years - health supervision visit & Hep A • 3 years - health supervision visit & Hep A (if needed) • 4-5 years - health supervision visit & DTaP, Polio, MMR, Varicella • Every few years - health supervision visit • 10-12 years - Tdap, Meningococcal and HPV — 5 — HOW DO VACCINES WORK? Vaccines work by preparing your child’s body to fight illness. Each immunization (given through a shot your child receives) contains either a dead or a weakened germ, or parts of it, that cause a particular disease. Your child’s body practices fighting the disease by making antibodies that recognize specific parts of that germ. This permanent or long- standing response means that if your child is ever exposed to the actual disease, the antibodies are already in place and his body knows how to combat it, so your child doesn’t get sick. This is called immunity (from www.kidshealth.org). FEVER Fever is a normal response to illness. Fevers, which we define as any temperature over 100.4°, do not harm children. Most of the time a fever can be managed by you at home. Occasionally it can indicate something more serious. The best way to take the temperature of a small child is by holding a thermometer in the rectum. An older child’s temperature should be taken in the mouth. Ear and armpit thermometers can offer a rough estimate of a child’s temperature but are often inaccurate. If your child is under the age of 3 months and has a fever, call us immediately. In older children, what’s more important than the temperature itself is how your child looks and is acting. Call us if your child has a fever and • looks very ill or is extremely fussy or drowsy • has a stiff neck or bad headache • the fever has lasted more than three days • the fever is higher than 104 degrees — 6 — What to do: While a fever alone will not hurt children, it can make them feel rotten . Here are some simple things you can do to make your child more comfortable . • encourage your child to drink plenty of fluids • dress your child in light clothing • sponge your child briefly (about ten minutes) with room temperature water, but never cold water or rubbing alcohol • let your child rest Tylenol(acetaminophen) and Motrin(Ibuprofen) are the best medicines for fever . Generic brands work just as well . Children should never take aspirin . But remember if you are thinking of giving any child younger than three months Tylenol for fever, you need to call us first . Here are some simple dosing guidelines . Heat exhaustion and heat stroke are very different from simple fever. If your child has a fever and has been in an overheated car or extremely hot environment, call us immediately. — 7 — DOSING INSTRUCTIONS Acetaminophen Tylenol or Store Brand Dosing Chart Doses may be repeated every 4 hours Consult your child’s physician Ibuprofen Motrin or Store Brand Dosing Chart Doses may be repeated every 6-8 hours 100 ½ tsp ¾ tsp — 8 — VOMITING AND DIARRHEA Children vomit. And they do it often. Fortunately, vomiting usually doesn’t last too long. Most of the time it is caused by viruses that pass quickly. Vomiting is often associated with diarrhea. Diarrhea generally lasts longer than the vomiting, sometimes up to two weeks. Like many other childhood illnesses, vomiting and diarrhea can often be managed by you at home. Here are some warning signs to watch for. Call us if your child is: • less than 3 months old • extremely uncomfortable with belly pain • vomiting blood or bile (bright green stomach content) • having diarrhea that is bloody or black and tar-like • vomiting everything and can keep nothing in his or her stomach • dehydrated What to do: Encourage your child to drink plenty of fluids, but don’t let them guzzle.