Sick-Child Care

• Bronchiolitis is an infection of the respiratory tract. It is usually caused by viruses.
• Bronchiolitis often lasts for 1-2 weeks.
• The virus infects the tiny airways called bronchioles and they become inflamed and filled with mucous.
• It usually affects babies and young toddlers most significantly. Parents may notice cough, runny nose, fever, and wheezing or difficulty breathing.
• Some children with bronchiolitis may have difficulty eating and drinking and staying well hydrated.
• You can help your child at home by using nasal saline drops and suctioning their nose.
• Running a vaporizer or humidifier may help as well.
• Make sure your baby is staying well hydrated. It helps to suction his/her nose before feeds if he/she is having difficulty eating.

Some babies with bronchiolitis can get very sick! It is important to call your doctor if you notice any of the following:

• Difficulty breathing (breathing very fast, using their belly muscles or neck muscles to help them breath)
• Difficulty drinking or dehydration (fewer wet diapers, little or no tears with crying, dry mouth)
• Increased lethargy
• Persistent fever

• Common colds are caused by viruses.
• Symptoms include sore throat, headache, congestion, runny nose, and cough.
• Colds are very contagious the first 3-4 days after symptoms begin.
• Colds can last 1-2 weeks; sometimes a little longer.
• To help with congestion in little ones, you can use nasal saline in the nose and run a humidifier in the child’s room. For babies you can suction out their nose, especially before feeds. For children over one, you can try honey to help with a sore throat and cough.
• Children may not want to eat as much, and that is ok, as long as they are drinking enough to stay hydrated (50% of their normal liquid intake).
• Over-the-counter cough and cold medicines are not recommended in children under 6. For babies over 1 you can try a product such as Zarbees, which is honey.
• For older children if you do give them medicines, it is important not to mix multi-symptom cough and cold medicines. Be careful because many of these medicines contain Tylenol - so always read the ingredients. Cough and cold medicines will not change the course of the cold. Studies have shown that they often don’t provide much relief outside of improved sleep.
• Antibiotics do not fight colds, so your doctor may not prescribe them to avoid overuse of antibiotics or developing a resistance.

Call your doctor if you notice:

• Difficulty breathing or shortness of breath
• Dehydration
• Fever for more than 3 days

For infants under 2 months call your doctor immediately (even during the night) if there is a fever of 100.4 degrees Fahrenheit or higher at any time. If your infant is under 6 months and has a fever for more than one day, call your doctor.

• Warts are lesions on the skin caused by the human papillomavirus family (HPV)
• They are often small, round bumps. They are often seen on fingers, feet, face, and knees.
• Warts are passed from person to person or from contaminated surfaces.
• Warts may go away on their own or may last several months to years.
• You can treat warts using over-the-counter treatments (salicylic acid/Compound W). If you use an over-the-counter treatment such as salicylic acid, it is also important to soak the wart in warm water and gently exfoliate the dead skin cells between treatments.
• Your doctor may also freeze the wart using liquid nitrogen.
• After warts are removed, they often return.
• Try to prevent your child from scratching or picking at warts as they may spread them.

Call your doctor if you notice:

• Over-the-counter treatments are not helping warts
• Warts are painful
• Signs of infection

Symptoms of COVID-19, which is caused by the SARS-CoV-2 virus, range from mild to severe and generally begin 2-14 days after being exposed to the virus. Someone with these symptoms may have COVID-19:

• fever and chills
• a cough
• shortness of breath or difficulty breathing
• muscle or body aches
• headache
• fatigue
• new loss of taste or smell
• sore throat
• congestion or runny nose
• nausea or vomiting
• diarrhea

If you are concerned about your child's symptoms, call your pediatrician right away.

The COVID vaccine is recommended for nearly everyone age 6 months and older. Staying up to date on recommended immunizations, including the COVID vaccine, is the best way for your child to stay healthy and thrive. Call your pediatrician to make an appointment.

What to do if your child has covid:

• Follow any guidelines set by your child's school or daycare for quarantining and mask wearing for returning to school to prevent spread.
• Separate your child with COVID-19 from others as much as possible.
• Call ahead before visiting your pediatrician's office. This will help them take extra steps to keep other people from getting infected or exposed.
• Avoid sharing personal household items.
• Monitor symptoms. In children, the goal should be to improve their overall comfort, monitor their activity, look for signs of serious illness, and make sure they drink enough liquids. Call your doctor or 911 right away if the illness gets worse.

Learn more on recommendations on the Centers for Disease Control and Prevention website:

• Isolation and Precaution Guidelines
• Vaccine Recommendations

• Croup is caused by a virus that causes swelling in a child’s airway.
• Children with croup will have a “barky cough” (like a seal’s bark). They also can have a raspy voice or a high-pitched squeaking sound when they inhale (stridor).
• They can develop runny nose and fever.
• For children with mild croup, you can treat their symptoms like you treat a common cold. Some children may need steroids or a breathing treatment from the doctor.

Call your doctor if you notice:

• Noisy, squeaky sounds when your child is breathing
• Difficulty breathing
• Dehydration (no tears when crying, dry mouth, little urine output)
• Fever for more than 5 days

• Eczema is a skin rash. It is caused by a defect in the skin barrier, as well as allergens and irritants.
• Children with allergies or asthma are more prone to eczema.
• Many babies have eczema that can improve as they get older; however, for some people eczema is a chronic disease.
• Eczema is treated with moisturizers and sometimes steroid ointments.
• Emollient moisturizers (such as petroleum jelly or ointments) are effective when applied after bathing.
• Avoidance of lotions and soaps with fragrances is important.

Call your doctor if you notice:

• Eczema is not improving with the use of moisturizers
• The rash has yellow crusting or signs of infection

• Hand, foot, and mouth is a viral infection that can cause blisters in the mouth, on the hands, and on the feet. There may also be a rash in the diaper area or elsewhere on the body.
• These blisters can be painful or they may itch.
• Children often have fevers with hand, foot, and mouth disease.
• Hand, foot, and mouth is contagious. Children should stay home until they are fever free for 24 hours and their rash stops spreading.
• Keeping children hydrated is important. Pain and fever can be managed with Ibuprofen or Acetaminophen.

Call your doctor if you notice:

• Dehydration (dry mouth, no tears with crying, fewer wet diapers)
• Fever for several days
• Irritability

• Ear infections are caused by viruses or bacteria infecting the middle ear (the space behind the ear drum).
• Children with ear infections may have ear pain, fever, fussiness, or difficulty sleeping.
• If there is enough pressure from fluid buildup behind the ear drum, the eardrum may rupture, and occasionally drainage may be seen.
• Ear infections are common when there is infection or inflammation of the upper respiratory tract, such as what is seen with common colds. They are more common in the first few years of life.
• Middle ear infections are often treated with antibiotics.
• Sometimes, in older children, your doctor may advise that you “wait and see” how your child’s ear pain progresses over a few days. Ear infections caused by viruses often improve on their own.

Call your doctor if you notice any of the following:

• Symptoms of an ear infection
• Persistent pain or fever after 2-3 days of antibiotic treatment
• Pain or discomfort after a course of treatment for an ear infection

• Molluscum are skin bumps caused by a virus.
• They are small, shiny bumps with tiny indents in the middle. They are generally skin colored, but may become red.
• Molluscum is spread through physical contact.
• Molluscum will often go away on its own. It may take several months to years. If the lesions are bothersome, you can talk to your pediatrician about topical treatments.
• The lesions may become angry and red before they start to self-resolve and go away. This is a sign that your body is starting to fight the virus.
• If your child’s molluscum is becoming red or irritated, you may cover it with Vaseline or a band-aid.
• Call your doctor if you think molluscum is becoming infected.

• Otitis externa is commonly referred to as Swimmer’s ear, which is an infection of the ear canal or outer ear.
• Swimmer’s ear happens most often in the summertime when swimming is common. However, scratching the ear canal, eczema, or using cotton swabs can increase the risk of otitis externa.
• Children with swimmer’s ear have ear pain. They can also have pain when the outer part of the ear is pulled or pressure is applied to their cheek. Sometimes, there can be drainage from the ear.
• Over-the-counter ear drops that are dilute acetic acid (vinegar) or alcohol can be used in children who get frequent swimmer’s ear to help prevent it. These drops should not be used as treatment.
• Acetaminophen or Ibuprofen can help with pain.
• Swimmer’s ear is usually treated with antibiotic drops, with or without a steroid component added to the drops.

Call your doctor if:

• You think your child has swimmer’s ear
• If your child has been using antibiotic drops for more than 2-3 days without relief

• “Pink eye”, or conjunctivitis, is an infection or inflammation of the thin covering of the white part of the eye.
• It can be caused by viruses, bacteria, allergies, or irritants.
• Pink eye is contagious, whether caused by a bacteria or virus.
• For pink eye caused by bacteria, your doctor will prescribe antibiotic drops.
• If you suspect your child pink eye due to allergies, it is ok to use over-the-counter allergy medicines.

Call your doctor if you notice:

• Pink eye is not improving on its own
• Increasing pain in the eye
• Redness or swelling of the eyelid
• Changes in vision

• Ringworm is caused by fungus. The same fungus may cause jock itch or athlete’s foot.
• Ringworm often starts as a scaly, red patch or bump. Over time it may grow and the center area may be clear.
• Ringworm in the hair may cause large, boggy areas with hair loss.
• Ringworm is passed by close physical contact.
• Ringworm on the skin is treated with topical creams such as clotrimazole, which are sold over the counter.
• If ringworm is in your scalp, it will need to be treated with oral medications.

Call your doctor if you notice:

• Ringworm is not improving with over-the-counter treatment
• Ringworm is spreading despite treatment
• You notice ringworm in the scalp

• UTIs occur when bacteria get into the bladder or kidneys.
• Children may have fever, pain with urination, increased urination, accidents, belly pain, fever, or fussiness.
• UTIs are more common in children who have an abnormal urinary tract, poor hygiene habits, constipation, or a family history of UTIs.
• If you think your child has a UTI, he/she needs to see his/her doctor.
• The doctor will check their urine and prescribe antibiotics if needed. It will be important for your child to drink plenty of fluids.

Call your doctor if you notice:

• Symptoms of a UTI
• Fever for more than 2 days after starting antibiotics for UTI
• Vomiting and or your child cannot stay well-hydrated
• Abnormal lethargy

• A variety of things can cause vomiting and diarrhea. Often, these symptoms are caused by viruses.
• Vomiting and diarrhea caused by a virus may start with nausea and vomiting, followed by 3-5 days of crampy abdominal pain and diarrhea. A fever may be present as well.
• It is important to keep children hydrated. If children cannot keep food down, it is ok to give fluids such as Pedialyte in frequent, small sips.
• If children can tolerate food, it is ok to allow them to eat normally.

Call your doctor if you notice:

• Diarrhea that lasts a week and is not slowing down
• Bloody diarrhea
• Bad abdominal pain
• Fever for more than a day
• Inability to drink fluids
• Signs of dehydration (no tears with crying, dry mouth, fewer wet diapers, excessive sleepiness)