“Pink eye” or conjunctivitis is when the white part of one or both eyes is a pink to red color. It can be caused by a virus, bacteria, trauma, or allergy. In viral pink eye the eyes are usually beefy red with a clear watery discharge. There is sometimes crust in the corner especially after waking. Sometimes there are other viral symptoms and fever. Bacterial pink eye can occur with no other symptoms or sometimes along with a bad cold. There is crusty gooey drainage that keeps coming back shortly after the eyes are cleaned. The outside of the eye may be slightly red or swollen from rubbing or irritation, but the inside of the eyes are always red. If an eye is red or painful check to see if there has been a history of trauma like a scratch to the eye. Allergic pink eye usually is in both eyes, usually itchy and irritated with tearing and puffiness. Medicines are needed for most cases of pink eye, but this rarely is an emergency. Warm compresses may help symptoms. You can make an office visit, or at times when medically appropriate, both during and after hours we may be able to call in medicine for your child. A $15.00 fee would apply if you choose that option.
Most sore throats that have associated cold symptoms and sometimes fever are viral in nature and will go away on their own. Strep is a bacterial infection, more common in winter and in school age kids. It is rare under age 2-3. There often is a known exposure, however many kids with a known exposure will not test positive for strep. Usually there are no other respiratory symptoms, but fever, headache, stomachache, vomiting and rash are often associated. The diagnosis requires a culture, after which if positive antibiotics are prescribed. It is not an emergency and can almost always wait until regular office hours to be diagnosed. Symptomatic care like Tylenol or Motrin for fever or pain, fluids, and throat lozenges may help your child feel better.
Many babies pull on their ears for comfort, as a habit, when they are teething, and occasionally when they feel ear pain. The only way to tell for sure is for the ears to be examined. Ear infections are more common after a few days of cold symptoms. There may or may not be a fever and often sleep is disrupted. Many ear infections will go away on their own , so we often wait a day or two before deciding if an antibiotic is needed. The first thing to do if your child seems uncomfortable is to give Tylenol or Motrin (over 6 months). If the child is more comfortable then he or she can be observed for a few days and if the symptoms persist seen in the office. More from the AAP about ear infections.
Rashes are very common. Many occur with associated viral symptoms, either during the illness or as the other symptoms disappear. Viral rashes are usually all over, red, flat or slightly raised bumps. Allergic rashes can appear out of nowhere. Rarely do we figure out what caused the rash, although if your child is taking a medicine and develops a rash the medicine should be stopped. Allergic rashes are often called hives– they are raised welts with a blotchy look and usually itch. Benadryl will often help the itching and minimize the rash. There are many other causes of rashes, most of which are not serious. Most rashes in well appearing children will go away on their own. Consider an office visit if it lasts more than 5-7 days. If a strange rash appears along with other more serious symptoms like fussiness, sleepiness, vomiting, high fever, pain and your child does not seem well call us right away.
Most diaper rashes start out as irritation from contact with urine or stool. If caught early and treated with exposure to air and a barrier cream like Desitin they usually resolve or come and go. If the area stays moist and irritated for a few days yeast often begins to grow, You will see scattered small red bumps or an area that comes together as a red patch with tiny bumps. Lotrimin or any OTC yeast cream can be applied 3 times/day along with the barrier cream. Call us if it does not respond, or if you see a rash with fluid filled or pus filled blisters or open sores.
It is easy to think babies and children have to have a BM every day. In fact there is no such rule! Many babies, especially breast fed babies can go many days without a bowel movement. Infants will squirm, grunt, grimace and squeal with bowel movements. This is normal and not a sign of constipation. Many toddlers and older children will hold stool, especially after having a larger, more uncomfortable bowel movement. We care more about the consistency of stools than about how often they occur. If the stools are soft and easy to pass there is nothing to worry about. If the stools are hard and the child seems uncomfortable we recommend increasing the amount of water, and for toddlers and older children increasing the fiber in the diet and scheduling regular toilet time. If your baby or child is having hard stools and seems uncomfortable call us during regular office hours for more information.