Congratulations on the birth of your baby! A newborn can bring a whirlwind of activity and excitement to your life — and plenty of stress and fatigue. It is important to remember that caring for yourself is just as important as taking care of the baby. Get rest when you can, eat a healthy diet and don’t be afraid to set limits for friends and family wanting to visit. Remember, loving your child, common sense, and the ability to adapt to particular situations are the keystones to success. If a problem arises use the information below as a guide or give the office a call and one of our nurses will be happy to assist you with whatever you may need.
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Common Pediatric Conditions
- The Common Cold
What is the Common Cold?
The common cold (also known as nasopharyngitis, rhinopharyngitis, or a cold) is a viral infection of the upper respiratory tract which affects primarily the nose. Symptoms include coughing, sore throat, runny nose, sneezing, and sometimes a fever which usually resolve in seven to ten days, with some symptoms lasting up to three weeks. No cure for the common cold exists, but the symptoms can be treated. Over-the-counter cold remedies are not recommended for use in children under 6 years old. Children under 6 years old can use saline drops in the nose and acetaminophen or ibuprofen (not for use in children less than 6 months old) for pain or fever. Sleeping slightly elevated can also help ease breathing.How do you get it?
The common cold is caused by a virus. There are over 200 different viruses that are blamed with causing the cold. Since the common cold is caused by a virus, antibiotics will NOT get rid of it. Most colds resolve on their own in 7-10 days. Colds are spread most easily through the hands, primarily through touching the nose or eyes after hands have been exposed to a cold virus. The best thing you can do to protect yourself and your child is to wash your hands frequently, especially in the winter months when colds are most prevalent.
When to call us
Colds can sometimes turn into a bacterial infection. If your child is experiencing the symptoms below, please call us for an appointment.
- Cold symptoms lasting more than ten days without improvement
- A fever for three or four days in a row of 100.4 degrees or more
- Headache around the eyes.
What is constipation?
Constipation is one of the most frequent reasons children are brought to a pediatric office. It is a common cause of abdominal pain in children, while other times it presents with urinary symptoms. Sometimes this issue builds gradually over months and may take many weeks or months to completely resolve, while for others it has a more acute onset. The medical definition of constipation describes a stool that is hard, dry, large, or difficult to pass. Those stools may cause a child to strain, experience pain or even have small amounts of blood in the toilet from a fissure, or a small tear in the anus.Constipation in children usually occurs at three distinct points in time:
- After starting formula or processed foods (while an infant)
- During toilet training in toddlerhood
- Soon after starting school (as in a kindergarten)
After birth, most infants pass 4-5 soft liquid bowel movements (BM) a day. Breastfed infants usually tend to have more BM compared to formula-fed infants. Some breastfed infants have a BM after each feed, whereas others have only one BM every 2–3 days. By the age of two years, a child will usually have 1–2 bowel movements per day and by four years of age; a child will have one bowel movement per day.
How is constipation treated?
The treatment of constipation is dependent on the child’s age. For babies, you should speak with our office before initiating treatment. Sometimes we will use small amounts of juice, water, or glycerin suppositories. In older children and teens, we usually first recommend increasing water intake and high fiber foods. Some foods that may be helpful include beans, broccoli, apples, pears, and whole grain breads and cereals.
After trying dietary changes, if your child is still experiencing issues with their stool, we may recommend an over-the-counter stool softener. Please call our office for advice and questions about the use of over-the-counter medications.
- Attention-Deficit/Hyperactivity Disorder (ADHD)
What is Attention Deficit Hyperactivity Disorder (ADHD)?
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that is usually diagnosed during childhood and often persists into adulthood. It is the most commonly diagnosed behavioral disorder in children, and can cause significant problems with home, school, and social interaction. In the United States, 8-10% of children under age 18 will be diagnosed with ADHD at some time in their lives, typically during their grade school years.ADHD is classified into 3 different types:
- Predominantly Hyperactive-Impulsive Type. Behavior marked by hyperactivity and impulsivity, but not inattentiveness.
- Predominantly Inattentive Type. Behavior marked by inattentiveness, but not hyperactivity and impulsivity.
- Combination Type. A combination of hyperactivity/impulsivity and inattentive symptoms. This is the most common type of ADHD.
What are the symptoms of ADHD?
Symptoms of ADHD typically become apparent at a young age. According to the American Academy of Pediatrics, ADHD symptoms can first emerge in children as young as age 4.
A diagnosis of ADHD in children requires 6 or more symptoms that have persisted for at least 6 months.
Symptoms of inattention in children include:
- Often fails to give close attention to detail or makes careless mistakes
- Often has difficulty sustaining attention in tasks or play
- Often does not seem to listen when spoken to directly
- Often does not follow through and fails to finish tasks
- Often has difficulty organizing tasks and activities
- Often avoids or dislikes tasks requiring sustained mental effort
- Often loses things necessary for tasks or activities
- Is often easily distracted by extraneous stimuli
- Is often forgetful in daily activities
Symptoms of hyperactivity and impulsivity in children include:
- Often fidgets, squirms, or taps when sitting
- Often has difficulty remaining seated when required to do so
- Often runs about or climbs in inappropriate situations
- Has difficulty playing quietly
- Is often “on the go” and is unable to sit still for extended periods
- Often talks excessively
- Often blurts out answers to questions before they have been completed
- Has difficulty waiting for his or her turn
- Often interrupts or intrudes on others
In young preschool children, hyperactivity may be the initial sign of ADHD. As the child enters grade school, attention problems become more noticeable. During adolescence, hyperactivity usually diminishes, but issues with impulse control and inattention persist. Adolescents with ADHD often have problems with restlessness, and difficulty making and carrying out plans. Although some children (especially younger ones) without ADHD may exhibit similar behaviors at times, children with ADHD present with these symptoms for a longer period of time and in various settings.
How is ADHD treated?
There are quite a few different treatment options for children with ADHD. The best course of treatment is one that works for your child and your family. If you think that your child might have ADHD the best thing to do is call our office and set up a consultation with one of our physicians. At that time we can discuss your child’s individual symptoms and decide what the best choice would be. You can bring your child to this appointment or you can come alone for the initial discussion. Testing for ADHD can be done in our office for children over the age of 6 years. After starting treatment it will be necessary for the physician to recheck your child in about 3 months.
Please also note that some medications used to treat ADHD cannot be called into the pharmacy or e-prescribed for refills. It will be very important to call our office about 3-5 days prior to needing a refill to ensure we can get it to you.
Although it can be challenging to raise kids with ADHD, it’s important to remember they aren’t “bad,” “acting out,” or being difficult on purpose. And they may have difficulty controlling their behavior without the help of medication, behavioral therapy or other treatment options.
Additional Education and Parent Information
What are antibiotics?
Antibiotics are used to treat infections caused by bacteria. Bacteria are microscopic organisms, some of which may cause illness. Before bacteria can multiply and cause symptoms, the body’s immune system can usually destroy them. We have special white blood cells that attack harmful bacteria. Even if symptoms do occur, our immune system can usually cope and fight off the infection. There are occasions, however, when it is all too much and some help is needed. There is concern worldwide that antibiotics are being overused. Antibiotic overuse is one of the factors that contribute towards the growing number of bacterial infections, which are becoming resistant to antibacterial medications.How do you know if my child needs antibiotics?
The only way for us to determine if the illness your child is experiencing is caused by a bacterial infection is for us to examine your child. As pediatricians, we wish that every time your child was sick we could prescribe them something to make it go away fast, but the truth is most infections that cause children to become sick are caused by viruses. Prescribing antibiotics for infections that are not bacterial in nature will not help your child get better, and in fact, sometimes it could make them feel worse and could lead to resistant strains of common bacteria.
What you need to know:
It is important for children to receive all of the childhood vaccines as laid out by the American Academy of Pediatrics and the CDC.Below is the schedule that we have chosen to use to vaccinate the children in our practice. We use combination vaccines when applicable.
2 month: DTaP, HIB, Prevnar, Hep B, Polio and Rotavirus
4 month: DTaP, HIB, Prevnar, Hep B (only if not given at birth), Polio and Rotavirus
6 month: DTaP, Prevnar, Hep B, and Polio
9 month: Developmental screening. Lead/ tuberculosis screening after 6 months at every visit.
12 month: Hep A, HIB, and Prevnar
15 month: MMR and Varicella (chicken pox)
18 month: DTaP, Hep A, developmental screening
24 month: Developmental screening
30 month: Developmental screening
3 year: Lead/ tuberculosis screening
4 year: DTaP, Polio, MMR, Varicella (chicken pox), hearing and vision
5 year: Urine, TB/lead screening
Yearly visits after age 5 to discuss growth and development. Children ages 11-12 may receive a Tdap booster and Menactra (meningitis vaccine) and Gardasil (cervical cancer vaccine) at the family’s discretion.
Each time you visit our office you can expect questions about safety. Sometimes those questions will be about childproofing your home, other times we might ask about pets, or water safety. We are hoping to make you aware of some dangers that can exist inside and outside the home so that you can take every precaution to keep your children safe.Firearms in the home: If you choose to keep firearms in your home, it is important that they are locked up so that children cannot get to them easily. It is also recommended that they be stored separately from their ammunition so that if a child does get a hold of a firearm they are less likely to harm themselves or someone else.Water safety: It is important for children to have adult supervision while swimming or even playing near a swimming pool. Swimming pools in your backyard should have a fence with a gate that can be locked to prevent your children or someone else’s children from gaining access to the water unsupervised. Even if your child can swim, it is important that an adult supervises them.Bike safety: It is important that children wear a helmet every time they ride their bike or scooter. Head injuries are serious and avoidable by simply making sure they wear a helmet every time.Car seats and booster seats: It is Georgia LAW that all children be secured in a car seat or booster seat EVERY time they are in the car. For the most up to date information about height, weight and age requirements and recommendations please visit the American Academy of Pediatrics website.
- Sleep Cycles and Tips
Every living creature needs to sleep. It is the primary activity of the brain during early development. The sleep-wake cycle is regulated by light and dark and these rhythms take time to develop, resulting in the irregular sleep schedules of newborns. The rhythms begin to develop at about six weeks, and by three to six months, most infants have a regular sleep-wake cycle.
Newborns age 0-2 months:
At first, your new baby is on a 24-hour feeding and sleep-wake cycle. Newborns may sleep between 10 and 18 hours a day. They stay awake only 1 to 3 hours at a time.
Signs that your baby is becoming sleepy include:
- Eye rubbing
Sleep tips for newborns
Try putting your baby to bed sleepy, but not yet asleep.
To encourage your newborn to sleep more at night rather than during the day:
- Expose your newborn to light and noise during the daytime.
As evening or bedtime approaches, dim the lights, keep things quiet and reduce the amount of activity around your baby.
- When your baby wakes up at night to eat, keep the room dark and quiet.
Sleeping with a baby younger than 12 months may increase the risk of sudden infant death syndrome (SIDS).
Infants age 3-12 months:
By age 4 months, your child might sleep for up to 6 to 8 hours at a time. Between ages 6 and 9 months, most children will sleep for 10 to 12 hours. During the first year of life, it is common for babies to take 1 to 4 naps a day, each lasting 30 minutes to 2 hours.
Sleep tips for infants
When putting an infant to bed, make the bedtime routine consistent and pleasant.
- Give the last nighttime feeding shortly before putting the baby to bed. Never put the baby to bed with a bottle, as it can cause baby bottle tooth decay.
- Spend quiet time with your child by rocking, walking or simple cuddling
- Put the child in bed before he/she is deeply asleep. This will teach your child to go to sleep on their own.
When you lay your baby in bed, they may cry due to a fear of being away from you. This is called separation anxiety. Simply go in, speak in a calm voice, and rub the baby’s back or head. DO NOT take the baby out of the bed. Once your baby has calmed down, leave the room. Your child will soon learn that you are simply in another room.
If your baby awakens in the night for feeding, DO NOT turn on the lights.
- Keep the room dark and quiet. Use night lights, if needed.
- Keep the feeding as brief and low-key as possible. DO NOT entertain the baby.
- When the baby has been fed, burped and calmed, return your baby to bed. If you maintain this routine, your baby will become used to it and go to sleep on their own.
By age 9 months, if not sooner, most infants are able to sleep for at least 8 to 10 hours without needing a nighttime feeding. Infants will still wake up during the night. However, over time, your infant will learn to self-soothe and fall back asleep.
Sleeping with a baby younger than 12 months of age may increase the risk of SIDS.
Toddlers age 1-3 years:
A toddler will most often sleep for 12 to 14 hours a day. By around 18 months, children only need one nap each day. The nap should not be close to bedtime.
Sleep tips for toddlers
Make the bedtime routine pleasant and predictable.
- Keep activities such as taking a bath, brushing teeth, reading stories, saying prayers and so forth in the same order every night.
- Choose activities that are calming, such as taking a bath, reading or giving a gentle massage.
- Keep the routine to a set amount of time each night. Give your child a warning when it is almost time for lights-out and sleep.
- A stuffed animal or special blanket may give the child some security after the lights are turned out.
- Before you turn out the light, ask if the child needs anything else.
Preschoolers 3-5 years:
Preschoolers typically sleep 11-13 hours each night and most do not nap after five years of age. As with toddlers, difficulty falling asleep and waking up during the night are common. With further development of imagination, preschoolers commonly experience nighttime fears and nightmares. In addition, sleepwalking and sleep terrors peak during preschool years.
Sleep tips for preschoolers
- Maintain a regular and consistent sleep schedule.
- Have a relaxing bedtime routine that ends in the room where the child sleeps.
- Child should sleep in the same sleeping environment every night, in a room that is cool, quiet and dark – and without a TV.
school-aged children 5 years and older:
Children aged five to 12 need 10-11 hours of sleep. School-aged children become more interested in TV, computers, and the Internet all of which can lead to difficulty falling asleep, nightmares and disruptions to their sleep. Poor or inadequate sleep can lead to mood swings, behavioral problems such as hyperactivity and cognitive problems that impact on their ability to learn in school.
Sleep tips for school-aged children
- Teach school-aged children about healthy sleep habits.
- Continue to emphasize need for regular and consistent sleep schedule and bedtime routine.
- Make child’s bedroom conducive to sleep – dark, cool and quiet.
- Keep TV and computers out of the bedroom.
As with anything, if you have additional questions that are not covered here you are welcome and encouraged to contact our office for help with specific questions or problems. We are for you and your child.
- Growth & Development
Parents are always curious about how the infants, toddlers and even school-aged children are growing and developing with relation to their peers. Please use the resources below to find valuable information regarding normal growth and development. Please be aware that all children grow and develop at different rates and that just because one child does something at a certain age doesn’t mean that not doing that by a certain age is inappropriate. If you have any concerns about how your child is growing and developing or meeting milestones please feel free to contact the office to discuss your specific concerns.