DeKalb Clinic Specialties

Pediatrics

DeKalb Clinic's Pediatrics Department includes Dr. Suzanne R. Cook, Dr. John M. Kostrey, Dr. Heriberto Menendez, Dr. David Phillips. The links to the left will tell you about a few common infections in infants and young children. This information is not a substitute for proper pediatric care. If you child has any symptoms that concern you, call your DeKalb Clinic pediatrician at (815) 758-8671 Ext. 4500.

Signs of infection in an infant require prompt treatment in an infant less than 2 months of age, call your pediatrician right away if your child develops any of these symptoms:

• Poor feeding
• Poor color
• Listlessness
• Weak cry
• Rectal temperature of at least 100.4°F
• Breathing problems
• Unusual fussiness
• Sleeping more than usual
• Vomiting or diarrhea

Vaccines can protect against many infections, but you cannot immunize your child against every infectious disease. If you know the signs of the most common childhood infections, you are better prepared to help your sick child get well.

Bed-Wetting
What causes bed-wetting?
Wetting the bed at night (enuresis) is common and affects roughly 40% of 3 year olds. In many cases it is just a matter of the bladder not being fully developed to hold urine for the whole night or not waking up when the bladder is full.

Stress can also cause enuresis. If a child has experienced a big change such as moving, divorce, etc., then bed wetting can occur again even if they have been dry at night previously. It is very important to ask yourself if your child is happy, upset, nervous, or active.

If a pediatrician concludes that stress is not a factor, he or she may order some urine tests or x-rays of the bladder and kidneys. It is not common to find infections or other problems but sometimes it is necessary to see a pediatric urologist who specializes in these problems.

Most school children who still wet the bed have primary enures which means they never developed control over their bladder while sleeping. They have had this condition since birth and often at least one of the parents did too. Eventually, the child will outgrow it-usually at the same age the parent did.

How to deal with bed wetting
Make sure your child urinates before going to bed, and also limit the amount of fluids he or she drinks before bedtime.

There is a bed wetting device available from most pharmacies that has helped many children around the age of 7 or 8. When the device senses urine, the alarm goes off to wake the child so he or she can use the toilet. There is roughly a 75% cure rate, but children often have problems again when they stop using the device. This device is usually most helpful when children only have occasional wet nights.
Protect the mattress with a rubber cover to keep it clean.

Some pediatricians will recommend bladder stretching exercises. In this exercise, the child will wait as long as possible between urinations to increase the amount of urine the bladder will hold.

Bottle feeding: It is more common for babies who are bottle fed while laying down to get more ear infections than breast fed babies. By keeping the head above the stomach during feedings you can keep the eustachian tubes from getting blocked.

Even if treatment does not seem to work, nearly all children will outgrow bed-wetting by their teen years. Only 1% of adults have problems with bedwetting.

Support
Your child needs support during these times and also needs positive reinforcement. Never punish your child for wetting because they cannot control it and remember that they also want it to stop. Do not let other siblings tease or cause shame to the child. Bed-wetting is a normal condition and your child will eventually outgrow it.

Bronchiolitis
Bronchiolitis is a common disease of the lower respiratory tract. A specific virus called respiratory syncytial virus (RSV) may cause bronchiolitis. It is most common in the winter and mostly in children under 2 years of age. Bronchiolitis begins like a cold (runny nose and sneezing) and within days causes coughing, wheezing, and breathing trouble. This can also make it hard for the child to eat and often makes them uncomfortable and cranky. Mild cases, especially those with thick nasal mucus, may get some relief with a cool-mist vaporizer. A child who has a lot of trouble breathing may need to go to the hospital for oxygen, fluids or medication.

Chickenpox
Until today, chickenpox has been a disease with no prevention only treatment. Only recently has a vaccine against chickenpox been available to guard against the discomfort and possible complications the disease can cause.

What is it?
Chickenpox is one of the most common of all childhood diseases. It usually starts with a rash on the scalp and body and develops into hundreds of itchy blisters that eventually turn into scabs. Children often get a mild fever days before the rash appears. Usually chickenpox also causes coughing, irritability, loss of appetite, and headaches. It is also easily spreadable by direct contact with the sores or through air when an infected person sneezes or coughs. Because of how contagious it is, it is important for a child with chickenpox to stay home from school or day care while contagious 1 to 2 days before the rash starts and 5 days after. It is possible to for others to contract the disease and not show signs for another 10 to 21 days.

Colds
Symptoms include - watery eyes, sneezing, coughing, a stuffy, runny nose, mild fever and headache. These last about a week. Colds are caused by any of hundreds of viruses.

Relieve symptoms with:

• a cool-mist vaporizer:
• decongestants (consult your pediatrician before giving any kind of medication)
• lots of fluids
• contact your pediatrician with any of the following:
• • a fever remains after the first day or so, is higher than 100.4° (rectal), or goes up
• • symptoms seem to get worse after a week
• • your child has problems breathing or ear pain (child may rub, hold, or tug on ear) or sore throat

Conjunctivitis (Pinkeye)
Pinkeye causes painful or itchy, red eyes/eyelids. These require evaluation by your pediatrician. Pinkeye is often contagious and might mean your child has to stay out of school or day care. An eye irritation with high fever, sluggishness, or severe swelling around the eye can indicate a more serious infection.

Treatments may include:

• Eye drops prescribed by your pediatrician
• Warm, clean compresses

Croup
Noisy and labored breathing (stridor) and a cough that sounds like a seal's bark can make croup a scary illness for parents. The illness usually begins much more mildly with a runny nose and mild cough. There may or may not be a fever. Get advice from you pediatrician, but you can probably care for croup at home. In severe cases of croup, your pediatrician may recommend a hospital stay.

Relieve symptoms with:

• A cool-mist vaporizer, or turn on the hot water in your shower or bathtub and let the bathroom fill up with steam. Allow your child to breathe the steam for a few minutes but keep a close eye on your child so that he does not burn himself with the hot water. (Hold your child on your lap, and read a short story to pass the time.)
• Try to stay calm and keep you child calm to help him breathe easier.

Ear Infection
Children with colds can develop an earache. Younger infants cannot complain of earache, so be on the lookout for other signs. A small child may rub, hold, or tug on their ear. Fussiness, fever, or fluid draining from your child's ear may mean your child has an ear infection. These must be treated with medication by your pediatrician, especially to help prevent hearing problems.

Relieve symptoms with:

• Acetaminophen (in a dose recommended by your pediatrician, but never aspirin)
• Give your child all of their prescribed medicine, even if the symptoms go away
• Have your pediatrician check your child's ears again if they are not better within five days
• Help prevent ear infections by never smoking or exposing the child to second hand smoke

Febrile Seizures
What is it?
Febrile seizures usually occur at the onset of a fever. The child may stare oddly for a few moments and then stiffen, roll his or her eyes, and then start twitching. Breathing will be choppy and he or she will be unresponsive until it passes, usually less than a minute. Febrile seizures rarely occur more than once within a 24 hour period.

What do I do if it happens?

• Place your child on the floor away from all hard or sharp objects that the baby could grab and injure his or herself.
• Make sure to keep their head off to the side to avoid choking or swallowing any vomit or excess saliva
• Do not put anything in your child's mouth
• Contact your pediatrician

Recurring seizures
The likelihood of your child having febrile seizures depends on age. Children under 1 year have a 50% chance of having more while children over 1 year have only a 30% of them happening again.

Are they dangerous?
Although they can be scary to witness, febrile seizures are harmless. They do not cause brain damage, paralyses, retardation, or other conditions.

How to treat febrile seizures
Make sure to contact your pediatrician as soon as you notice the first seizure. Your pediatrician will examine your child to find the cause of the fever. It is more important to cure the fever than the seizure. Sometimes a spinal tap may be necessary to make sure there are no serious infections such as meningitis.

Generally, there is no preventative treatment for febrile seizures. For prolonged or recurring seizures, however, there may be possible treatments that your pediatrician will discuss with you. Acetaminophen and other fever reducing drugs will lower the fever, but do not prevent seizures.

It is important to remember that if your child has a febrile seizure, it is not dangerous or life threatening. If you are concerned about recurring seizures make sure to contact your physician.

Impetigo (Skin Infection)
Impetigo is suspected if a scratch turns into a crusted, yellow, oozing, sore surrounded by redness. Impetigo can spread quickly. It can also be contagious. This infection is most common in warm weather. Impetigo requires treatment with antibiotics and should go away quickly, consult your pediatrician.

Jaundice
What is it?
Jaundice occurs when the body produced too much bilirubin and the liver cannot break it down to get rid of it in the baby's stool. This is a very common condition in infants that usually goes away on its own. If it does not pass on its own, then it can be treated simply and quickly.

What is bilirubin?
Hemoglobin, which is found in red blood cells, turns into bilirubin when the red blood cells die. It is common for newborns to be affected because their livers are not yet efficient enough to remove it.

Is jaundice dangerous?
Very rarely is it dangerous, but if the bilirubin level in the blood gets too high it can be. This level varies depending on age and other medical conditions and can be tested through simple blood tests.

Warning signs
The most obvious symptom of jaundice is a yellowish change in skin color and/or the whites of the eyes. If you are not sure, gently press a fingertip on your child's nose or forehead. If the skin is white there is no jaundice, but if it is yellowish contact your physician to make sure the jaundice is not serious.

Treatment
Most times jaundice does not need treatment and will pass on its own. For high levels of bilirubin, a treatment involving special lights will help to alter it so the liver can more easily get rid of it. Sometimes this requires a few days in the hospital but sometimes pediatricians can treat babies with these lights at home.

More frequent feedings of breast milk can also help disperse the bilirubin in the stool. Water cannot cannot spread out the bilirubin because it does not pass through the stool.

In rare cases, special treatments may be required to remove the bilirubin. Blood exchanges have been done to give babies fresh blood and remove the bilirubin. Usually once jaundice passes, it does not occur again, but if your baby still appears to have jaundice make sure to talk to your pediatrician.

Jaundice is not a reason to be alarmed. Jaundice occurs even in healthy newborns and is usually not serious. If jaundice persists, contact your physician for treatment.

Pneumonia
Pneumonia is an inflammation of the lungs and can vary with severity depending on the cause. A child may have a cough, mild fever, and decreased appetite and energy or your child may suddenly have shaking chills, a high fever, difficult, rapid breathing, or other breathing problems. All cases of pneumonia require treatment from your pediatrician but only sever cases would require hospitalization.

Sinusitis
When your child has a cold, the sinuses around his nose often get stuffy and swollen. Sinusitis can develop after your child has had a cold for at least 10 days. Sinusitis requires antibiotic treatment from your pediatrician.

Signs of sinusitis include:

• Persistent nasal discharge
• Fever
• A cough during the day and night, that often gets worse at night
• Tenderness in the face
• Headaches

Strep Throat
Signs of strep include a sore throat, fever, headache, nausea or vomiting, and swollen glands in the neck. (If there is also a skin rash, the condition is called Scarlet Fever.) Since many viruses can cause the same symptoms as strep, your pediatrician will need to perform a test for strep. Strep requires antibiotic treatment and it is especially important to take all of the medicine or the infection may come back. If not treated, strep throat can also lead to rheumatic fever, kidney disease or a number of other health problems.

Sty
A tender, small swelling and redness on your child's eyelid are usually signs of a sty. This is an infection in a gland of the eyelid. To treat a sty, apply warm, clean compresses often. Let your pediatrician know if this does not work. He or she may then prescribe an antibiotic ointment or refer your child to an eye doctor who can drain the sty surgically. Sties are not contagious.

Urinary Tract Infection (UTI)
Urinary tract infections (UTIs) are found in children of any age and occur in the kidney or bladder. Treatment of an UTI includes taking an antibiotic for at least 5 days (important to finish all medication). X-rays and other tests may be needed to help determine the causes of the UTI.

Symptoms include:

• Fever
• Painful and frequent urination
• Vomiting
• Abdominal pain

Vomiting and Diarrhea
Illnesses that cause vomiting and diarrhea usually last only about a day or two, but in some cases they can last up to a week. To prevent more vomiting which can lead to dehydration, your pediatrician may tell you to not give food and fluid for a few hours. You can then give your child small sips of clear fluids, later followed by easy-to-digest foods. In cases of diarrhea, or frequent, loose, watery stools, you may need to stop feeding your child solid foods and milk for 12 to 24 hours. Instead give your child an oral electrolyte solution to prevent dehydration. You can buy this at your local drugstore. If your child's diarrhea does not clear up, your pediatrician may test for Giardia, a parasite often spread to children in day care or in rural areas. Giardia is treated with prescription medication. Dehydration is dangerous in children. If vomiting or diarrhea are severe or won't go away quickly, contact you pediatrician before dehydration occurs.

Signs of dehydration:

• Tired or have less energy
• Produce less urine or tears
• Have a dry mouth
• Have sunken eyes
• Soft spot on top of the head may become sunken in infants