Leg & Arm Problems

If your child refuses to use his/her arm or leg completely, you should contact your physician. A limping child who has no fever and is not in much pain should be evaluated if the limp has failed to disappear after 24 hours. Of course, any swelling, redness or pain in the joint, associated with fever, is a cause for immediate concern and the physician should be notified.

In-toeing and out-toeing when a youngster walks is a common problem and should be discussed at a routine check-up visit.

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Kidney & Urinary Problems

Any symptom suspicious for urinary tract infection, including painful urination, urinary frequency or urgency should be evaluated by your physician.

Other common types of urinary problems involve irritation of the urethra. This occurs especially in girls who take bubble baths or add soapy substances to their bath water. It is generally recommended that substances such as bubble baths, dish washing liquid, bath oil, bath beads or additives be avoided.

If your child develops problems with night-time or even daytime wetting (enuresis), please consult the section on bed wetting.

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Jaundice

What is Jaundice?

Jaundice refers to a yellow tint of the skin usually due to liver immaturity in newborns or liver disease in older children. In these conditions, bile pigments accumulate in the blood stream and are deposited in the skin. It is the liver’s job to rid the body of these bile pigments. The liver of a newborn infant is not mature enough to do this job hence the bile pigments accumulate and the child can become jaundiced. Usually by five days of life, the infant’s liver is mature enough to take care of the bilirubin load. Most all babies develop some degree of jaundice which is a little more pronounced in breast fed babies. It is rarely a cause for concern. If jaundice develops in the lower legs and/or feet or lasts more than five days, call your physician for an appointment.

Jaundice which develops after the newborn period can be due to liver disease. All such children who develop jaundice should have a routine office visit to check this.

Sometimes, young children who eat a lot of yellow vegetables (carrots and squash) develop a yellowish tint to their skin, but not in the whites of the eyes. This is known as carotenemia and is not truly jaundice. It is harmless, requires no treatment and resolves with age.

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Itching

Itching due to insect bites, rashes and chickenpox can be treated with Benadryl Elixir (per package instructions; for dosing for children less than 6 years of ago please contact your physician for dosing instructions). This can be given every four hours as needed. It is also a good idea to trim fingernails to protect the skin from scarring.

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Impetigo

What is Impetigo?

Impetigo is a minor superficial infection of the skin. It is common during the summer months and is characterized by yellow, weeping sores which are usually located on the face, arms and legs. Impetigo is usually due to Strep or Staph infection.

Treatment

Washing the sores daily with soap and water, thus removing the crusty lesions.

Applying Neosporin topical antibacterial ointment to the sores.

If the areas are particularly bad, you should contact your physician. Sometimes, oral antibiotics are necessary to completely resolve the infection.

Other measures can be taken to make your child more comfortable. These include keeping the fingernails trimmed and giving Benadryl for itching (see Dosing Guide).

Sores with surrounding angry-looking red areas or red streaks should be seen by your physician.

If your child has more than one sore, make an appointment with your physician

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Headache

Headache is not as common in children as in adults. Any recurring headache or headache associated with vomiting, poor coordination or other symptoms should be evaluated by your physician. Mild infrequent headaches can be treated with acetaminophen or ibuprofen. Headaches associated with fever and a stiff neck are potentially serious and should be evaluated by your physician right away.

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Head Injury

Most head injuries in children are relatively minor and are seldom severe enough to justify the hours that parents spend worrying about them.

Symptoms

There are a variety of signs and symptoms to watch for following a head injury during the first 24 to 48 hours. You should observe your child for the following symptoms and report them to your doctor as instructed.

Severe Symptoms

  1. If your child loses consciousness, you should immediately contact the physician.
  2. Drowsiness. Most children will become drowsy after a head injury and sleep. It does no harm for your child to fall asleep. In fact, this is very common.It is important, however, to make sure that your child can be fully aroused. It is a good idea to awaken your child every three to four hours during the night after a bad blow to the head. If you have difficulty in waking your child, you should report this to your doctor.
  3. Any convulsion or seizure following head trauma should be reported to the doctor.
  4. Double vision or other visual problems should be reported to the physician.
  5. Unequal pupils should be reported to the doctor.
  6. Weakness in one arm or one leg should be reported to the doctor. Any limp or staggering which persists more than a few minutes after the head injury should be reported.
  7. Any abnormal leakage of fluid from the nose or ears should be reported.
  8. Vomiting. Vomiting is common following even minor head trauma. If it persists more than twice following the trauma, you should report this to the doctor.
  9. If your child develops slurred speech or is unable to speak, you should contact the doctor.
  10. Headache. This is a common symptom after head injury. If it persists or becomes increasingly severe, you should notify your doctor.

If your child exhibits none of the above, then it is very unlikely that your child has sustained a significant head injury. A hematoma (a collection of blood under the skin at the site of the head trauma) or “goose egg,” as some parents call them, is not serious unless they are huge (size of a baseball). This problem will resolve on its own.

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