Spitting Up

A small amount of spitting up is common to most babies and should not be thought of as abnormal.  It usually resolves with the first few months of infancy.  If spitting up seems excessive, occurs with every feeding, or is more forceful, consult your child’s physician.  As long as he/she is growing and developing well, is not having choking episodes or turning blue, and is not excessively irritable, spitting up is more of a nuisance than it is dangerous.  However, if any of these conditions are present, there are medications that can sometimes benefit an infant with this condition.  Recurrent projectile vomiting (vomiting that shoots out of the mouth) is abnormal and requires a medical workup.

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Sleep Problems

Sleep problems, and in particular, frequent night time awakenings are an extremely common frustration for parents of young children. Part of the answer lies in knowing what to expect from your child at certain ages. newborn will average two awakenings a night, usually for a feeding and a diaper change. By 2 months of age, they are down to one arising or none at all, and by 4 months of age, a majority of infants sleep through the night. Acute illnesses, such as a bad cold or ear infection can temporarily upset your child’s sleeping pattern. A 5-6 month baby who is not consistently sleeping a full night, or an older infant who develops night-time awakenings, is considered to be a self-trained poor sleeper, and therefore is also capable of being trained to sleep all night independently.


Unfortunately, the only method of any proven value in correcting poor sleepers involves allowing them to “cry it out” to some degree. Most young children who awaken in the night are simply hooked on a habit or association they require to get back to sleep (a bottle, rocking in your arms, etc.) and they are not too happy when those associations are broken. How do you do it? Put them in their crib awake; don’t rock them to sleep in your arms. If they cry at that time, or as they awaken and fuss later in the night, allow 10-15 minutes waiting periods before you step in. When you do go in, stay only for a moment and don’t get your baby out of the crib. The interval between each brief visit can be extended a little until your child drifts off to sleep. It will take an iron will and two to three nights for your infant’s bad habit to budge, but the method usually works and most parents feel it was well worth the effort.

If you’ve tried this technique without progress, or if there are other unusual features about your infant’s sleep patterns, be sure to bring up this issue at your child’s next preventative care visit. A helpful book on children’s sleep disorders is listed in the reference section.

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Sore Throat

A mild sore throat without fever can be treated with warm salt-water gargles, throat lozenges, or Chloraseptic spray. If your child has a sore throat, which persists over several days, or if fever is present, a visit with your physician is recommended.

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Seizures can be one of the most frightening events in a child’s life for his/her parents. Most parents are afraid that their child will stop breathing and die during a seizure. This is almost never the case. If your child should have a seizure, place the child on his/her back or side and turn his/her head to the side to prevent choking on stomach contents in case of vomiting. The tongue should be protected as best you can. Your physician should be notified immediately and it may be recommended that your child then be taken to the nearest emergency room.

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Newborn Rash

Most rashes in newborns are entirely normal and are of no concern. Small white bumps on an infant’s face and nose are called milia. These require no treatment. They will disappear in a month or so. Neonatal acne which resembles acne in older children occurs in infants due to maternal hormone stimulation. This, too, will fade with a little time. Birthmarks are common in babies, especially over the eyelids and over the back of the neck. These should be discussed at a routine office visit.

Bruise-Like Rash

Any purple or bruise-like rash which cannot be explained by simple bruising should be evaluated right away.

Diaper Rash

Diaper rashes are usually due to either irritation of the skin from a wet diaper (ammonia) or to a yeast infection in the diaper area. A yeast can grow on the skin in moist areas. When a diaper rash appears, try especially hard to keep the skin clean and dry. Change the diaper as soon as it is wet or soiled. It is a good idea to put zinc oxide ointment (Desitin) or Vaseline in those areas. If the rash is due to irritation from urine (ammonia), this treatment will be quite effective and the rash should resolve. However, if the rash does not improve with this treatment, contact your physician.


Eczema is a skin condition seen in allergic people, which causes the skin to be dry and sensitive. Sometimes, this can lead to a rash over most of the body which is scaly, red, itchy and sometimes even broken open or weeping. Eczema tends to occur in people with a family history of allergy (asthma, hay- fever, eczema, and/or itchy, watery eyes). The treatment of eczema is primarily directed at keeping the skin will hydrated. To do this, it is recommended that the mildest and least amount of soap possible be used. Examples of mild soap are: Dove, Tone, Purpose and Neutrogena. Soap washes away the normal oils of the skin and makes eczema worse. In addition to this, applying Moisturel or Eucerin lotion to the affected skin to further seal the skin from continued water loss can be helpful. If your child’s dry, sensitive skin continues to be a problem despite the above measures, you should contact your physician.

Hives and Allergic Rashes

Hives are red, raised rashes in various sizes, which are usually due to an allergic reaction. The rash seems to move to different areas of the child’s body. It is often associated with itching and sometimes with swelling of the hands and feet. The rash is usually not dangerous, but can be uncomfortable. Hives can be caused by anything that the child has eaten, breathed or come in contact with. Hives are almost never due to something that is new in the diet. Usually, the child has been exposed to the very thing that caused the hives sometime in the past with no reaction.

The treatment of hives is to remove what is causing the rash and make the child comfortable. Of course, to remove what is causing the rash requires that it be identified, which can be very difficult. Write down everything that your child had to eat or was exposed to during the 24 hour period prior to the break-out of the rash. If the hives recur, this should be done again. With each episode, the list should be compared to try to identify the agent responsible.

Benadryl should be given to your child. This will help resolve the rash and control the itching (see Dosing Guide). If your child develops a breathing problem associated with this rash (very rare), the child should be seen immediately.

Poison Ivy

If your child has come in contact with poison ivy or another irritant, it is important to wash the involved area thoroughly with soap and water to remove the poison ivy toxin. You should treat poison ivy (contact dermatitis) with three types of treatment to speed healing and comfort the child. First, cortisone medicine is quite effective in decreasing the inflammation due to poison ivy. Over-the-counter, 0.5% hydrocortisone cream or ointment (Cortaid) can be helpful. If the rash is particularly severe, you should contact your physician. A stronger cortisone cream or ointment or an oral form of cortisone may be prescribed. Elixir can be used to control itching (see Dosing Guide). Lastly, Calamine lotion and Aveeno baths are sometimes helpful for itching. As with other rashes that cause itching, you should trim your child’s nails to prevent scratching and scarring. You can not catch poison ivy by touching the rash of someone who has contracted poison ivy (contact dermatitis). Contact dermatitis is not contagious.

Rashes Due to Drugs

If a rash develops while your child is taking medication, the medication should be stopped and your physician notified. See section on allergy in this booklet.

Seborrheic Dermatitis(Cradle Cap)

Cradle cap is a red, scaly rash on the scalp and body of newborns and infants. This is caused by excessively oily skin. The use of baby oils can make it worse. Seborrheic dermatitis (cradle cap) is treated by removing the scales with an anti-dandruff shampoo such as Sebulex and scrubbing with a soft baby brush. If the rash on the body is particularly severe or if the cradle cap does not resolve with the dandruff shampoo, contact your physician.

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What are Pinworms?

Pinworms look like tiny white threads. They live in the intestines of children and adults which are infected with them. At night, they travel to the rectal opening and lay eggs on the outside of the skin. This causes tremendous itching of the child’s bottom and can cause restless sleep. You can check for pinworms by examining your child’s skin about the anal opening with a flashlight in the wee hours of the morning. Usually, the best time to check your child is around midnight. This infection is spread by passage of eggs from the infected person to others. Pinworms, however, represent no danger to your child.


Pinworms require treatment with medication to relieve the infestation. Your physician can check for pinworms during a routine office visit. When an infection is identified, all family members should be treated for the infection. At the time the family members are treated, underwear and bed linens should be changed and washed in very hot water. The house should also be vacuumed thoroughly. In addition to this, fingernails should be trimmed and the hands thoroughly cleansed. Each family member should use their own clean towel and washcloth. The above measures are necessary to rid the person and the home of pinworm eggs.

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Mouth Problems

What is Thrush?

Thrush is a yeast infection of young children which causes fever and white patches on the inner surface of the lips, gums and throat. It lasts a few days and can be uncomfortable for your child.


  1. Encourage fluids to ensure that your child stays well hydrated. Try to avoid carbonated beverages or fruit juices which will worsen discomfort. Milk, ice cream, pop-sickles and Jello are all good choices.
  2. Your doctor may need to evaluate and treat this problem.

For mouth injuries, see Teeth section.

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