Note: These guidelines are only for children who are 2 months of age or older and are fully vaccinated with no chronic medical illnesses. Please call Dr. Hirsch or go to the ER if your child is under 2 months old and has a fever (rectal temperature of 100.4 Fahrenheit or 38 Celsius). Also this handout is meant to provide general guidance and should not be used as a substitute for more detailed advice that can be given over the phone or at an appointment. If you have any significant or ongoing concerns, please call the office.
My infant/toddler has a fever. What should I do?
If you say the fever is not harmful, why do you recommend TREATING THE FEVER?
What should I expect after I treat the fever, and when do I need to worry?
How do I treat the fever?
What else do I need to know about treating fevers?
Ibuprofen (Motrin , Advil, other generic brands)
may be given every 6 – 8 hours
Important note for children over age 6 months: Ibuprofen works significantly better and lasts longer for children and should always be given instead of acetaminophen. |
|||
Weight | Ibuprofen
Milligram Dosage |
Ibuprofen
Infant Drops 50mg/1.25ml |
Ibuprofen
Children’s Liquid 100mg/5ml (Note: 1 tsp = 5 ml) |
12 – 17 lbs | 50 mg | 1 dropper
(1.25 ml) |
½ tsp
(2.5 ml) |
18 – 23 lbs | 75 mg | 1 ½ dropper (1.875 ml) | ¾ tsp
(3.75 ml) |
24 – 35 lbs | 100 mg | N/A | 1 tsp
(5 ml) |
36 – 47 lbs | 150 mg | N/A | 1 ½ tsp
(7.5 ml) |
48 – 59 lbs | 200 mg | N/A | 2 tsp
(10 ml) |
60 – 71 lbs | 250 mg | N/A | 2 ½ tsp
(12.5 ml) |
72 – 95 lbs | 300 mg | N/A | 3 tsp
(15 ml) |
Acetaminophen (Tylenol, other generic brands)
may be given every 4 – 6 hours |
||
Weight | Acetaminophen
Milligram Dosage |
Acetaminophen
Infant and Children’s Liquid 160mg/5ml (Note: 1 tsp = 5 ml) |
9 – 11 lbs | 60 mg | 1/3 tsp
(1.875 ml) |
12 – 17 lbs | 80 mg | ½ tsp (2.5 ml) |
18 – 23 lbs | 120 mg | ¾ tsp (3.75 ml) |
24 – 35 lbs | 160 mg | 1 tsp (5 ml) |
36 – 47 lbs | 240 mg | 1 ½ tsp (7.5 ml) |
48 – 59 lbs | 320 mg | 2 tsp (10 ml) |
60 – 71 lbs | 400 mg | 2 ½ tsp
(12.5 ml) |
72 – 95 lbs | 500 mg | 3 tsp
(15 ml) |
PDF HANDOUT: Everything You Need Know About Treating Fever and Dosage Instructions
Note: These guidelines are only for children who are fully vaccinated with no chronic medical illnesses. Please call Dr. Hirsch or go to the ER if your child is under 2 months old and has a fever (rectal temperature of 100.4 Fahrenheit or 38 Celsius). Also this handout is meant to provide general guidance and should not be used as a substitute for more detailed advice that can be given over the phone or at an appointment. If you have any significant or ongoing concerns, please call the office.
How do I know if my child has a cold, and what exactly is a cold?
How long will the cold last?
Will my child need antibiotics to treat the cold?
Can I give my child cold medications?
Okay, so I understand that my child will not benefit from antibiotics or cold medications, but he is really having a tough time with sleeping and feeding! Is there anything I can do to make him feel better?
Stuffy nose/nasal congestion – Please use the Nosefrida suction device with saline drops as often as needed day and night. To use the Nosefrida on older infants or toddlers, you will often need a helper or a blanket wrap around the torso to hold the child still while you remove the mucous. To use the saline drops, lay your child down on a carpeted surface and tilt his chin up a little. Put 1-2 drops of saline in a nostril and then after a few seconds you can suction the mucous out. Note that you can purchase or make normal saline nosedrops by mixing 1/2 teaspoon of table salt in 8 ounces of water. The salt water can be dripped with an eye dropper or wet cotton ball. Hirsch Pediatrics can also give you several vials of saline at no cost if needed.
Cough – Children over 1 year old can be given 1 teaspoon of honey at bedtime and as needed. Also keeping the air in your child’s bedroom moist with a humidifier is helpful. For middle of the night coughing fits, you can try bringing your child into a humid room like a bathroom that is steamy from hot water running. It is common for small children to vomit after coughing fits.
Fever/fussiness/ear pain/sore throat – Children 6 months and older should be given ibuprofen. Children from 2-5 months can be given acetaminophen as needed. Please visit the Hirsch Pediatrics website for a handout on dosage instructions. Using these medications can be particularly helpful at bedtime.
Difficulty sleeping – Fortunately the sleepless nights will improve, though it may take several nights. It is helpful to sleep on an incline whether this means holding your infant in your arms for a few nights or using pillows for your toddler.
When should I make an appointment to see Dr. Hirsch?
When do I need to really worry and go to the ER immediately?
When can my child go back to school or daycare, and when is my child still contagious?
How can I prevent my child from catching a cold?
PDF HANDOUT Everything You Need To Know About Treating Cold and Cough and Congestion
Note: These guidelines are only for children who are fully vaccinated with no chronic medical illnesses. Please call Dr. Hirsch or go to the ER if your child is under 2 months old and has a fever (rectal temperature of 100.4 Fahrenheit or 38 Celsius). Also this handout is meant to provide general guidance and should not be used as a substitute for more detailed advice that can be given over the phone or at an appointment. If you have any significant or ongoing concerns, please call the office.
What is “pink eye” (also known as conjunctivitis)?
Does my child have pink eye?
So now I think my child has pink eye. What should I do?
Is “pink eye” contagious and when can my child go back to daycare/school?
When are prescription eye drops for pink eye helpful?
How do I get a prescription for eye drops?
What if I need a prescription for eye drops after-hours?
When does my child need an appointment for pink eye?
What is the prescription eye drop?
How can I keep conjunctivitis from spreading in my house?
My child may have seasonal allergies so is it possible the pink eye is from allergies?
PDF HANDOUT Everything You Need to Know About Treating Pink Eye and Conjunctivitis
Note: These guidelines are only for children who are fully vaccinated with no chronic medical illnesses. Please call Dr. Hirsch or go to the ER if your child is under 2 months old and has a fever (rectal temperature of 100.4 Fahrenheit or 38 Celsius). Also this handout is meant to provide general guidance and should not be used as a substitute for more detailed advice that can be given over the phone or at an appointment. If you have any significant or ongoing concerns, please call the office.
Why is my child vomiting?
How long will the vomiting last?
How do I treat the vomiting?
When can my child go back to school or daycare?
How do I know if my child is dehydrated?
When do I need to worry?
Hirsch Pediatrics Vomiting Protocol
Step 1: Do not give any solids or milk products.
Step 2: Begin hydration with Pedialyte. You can also use diluted juice or juice mixed into the Pedialyte if your child will not take Pedialyte. Do not give water by itself (especially to infants) as this does not have the necessary electrolytes and calories. For infants that breast feed only and will not take a bottle, you can try to breastfeed for shorter periods of time every 2 hours.
Step 3: Give the following small amounts of Pedialyte every 20 minutes:
Important note: Even though your child may be very thirsty and want more fluid, it is important to start with the recommended small amount to get the vomiting under control.
Step 4: After 2 hours of no vomiting, you can gradually increase the amount of fluids.
Step 5: After 8 hours of no vomiting, you can offer your child small amounts of bland foods (i.e. rice, apple sauce, toast, soup).
Step 6: After 24 hours of no vomiting, you can resume a regular diet.
** Note: If at any step along the way, your child vomits again then wait 20 minutes and return to step 1. It is common for children to look well and seem better but then start vomiting 1-2 days later when they eat too much.
Is constipation common in children?
What are some of the ways that constipation presents in children?
If I do not treat my child’s constipation, will it just work itself out as my child gets older?
Can I use dietary changes instead to treat constipation?
What dose Dr. Hirsch recommend to treat mild constipation?
Is it safe to give my child Miralax every day for several months (or longer)?
How does Miralax work?
Will my child become “addicted” to Miralax?
I have been using Miralax but I think my child is still is very constipated. What should I do now?
My child is having intense bouts of abdominal pain. What should I do now?
How do I know when my child is not constipated?
When my child is no longer constipated, when can I stop the medications?
What can I do to encourage good stool habits that may expedite the process of weaning medications as well as encourage long-term success?
What if we have tried the above interventions and my child is still constipated?
When is a referral to a specialist indicated?
Hirsch Pediatrics is excited to announce our Asthma Quality Initiative (QI), launched in 2015 in collaboration with Children’s National Health System. The goal of this QI is to identify and track all children in Hirsch Pediatrics with a history of asthma or recurrent wheezing and to optimize your child’s care through the use of “best practices” described by Children’s and national guidelines.
Please see below important links with videos and documents that are useful for our QI as well as your child’s “asthma team appointment.”
Hirsch Pediatrics Asthma QI Welcome Letter
Asthma Diagnosis and Management (Extensive Handout Written by Dr. Hirsch)
Allergy Management (Additional Handout Written by Dr. Hirsch)
Two Great Videos Showing “What is an Asthma Flare?”
KidsHealth Video (2:26)
Children’s Hospital Asthma Clinic (1:34)
“Why Use a Spacer with an Inhaler?” Diagram
Asthma Assessment Questionnaire: Pediatric Asthma Control and Communication Instrument (PACCI)
Note: This brief 12 question survey can be completed online before your appointment Hirsch Pediatrics CHADIS account. To access the PACCI, select “asthma/wheezing” for appointment type after logging in to CHADIS.
Stepwise Approach to Managing Asthma
Video Showing Effective Spacer Use (2:49)
Asthma Action Plan Templates (customizable):
Age 0-4 Asthma Action Plan
Age 5-11 Asthma Action Plan
Age 12 and older Asthma Action Plan
Basic Asthma Action Plan for Maryland
Two Great Websites with Asthma Information:
KidsHealth Asthma Control Center
Asthma Care Guidelines (from University of Michigan Health System)
How do I know if I child has allergies?
rhinitis), itchy/watery/swollen eyes (allergic conjunctivitis), and cough.
What time of year are allergies worse?
What medications can I give my child?
What else can I do besides medications to help my child?
When should I see an allergy specialist?
Car Travel –
Your car trip may take a lot longer. Plan on taking a break at least every 1 and 1/2 hours unless the baby is sleeping–then stop as soon as your baby wakes up.
Air Travel –
You may notice that your ears “pop” with pressure changes during takeoff and landing. Fortunately, though this temporary discomfort may be felt by a baby, it is usually very mild and does not require any special preparation. In fact, the next time you fly and feel your ears pop, you will notice that most babies are still calm and comfortable. If your baby does show significant discomfort, you can try feeding since sometimes swallowing helps equalize the air pressure. Note: It is safe to fly even when your child has a cold.
Hotels –
Though you can reserve a crib at most hotels, many families find it much easier to bring your own “pack n’ play” when travelling. Bring a few familiar items that the baby has in his crib at home (such as rattles or stuffed animals). Note: If your baby is used to sleeping in his/her own room, you may need to sit quietly out of sight while your baby is falling asleep. You can even sit in the bathroom and read while you wait.
Travel Immunizations and Medications –
Certain special vaccines are necessary to prevent diseases you might be exposed to during travel to other parts of the world. These vaccines include typhoid fever, yellow fever, meningitis, and Japanese encephalitis. If you are going to a part of the world where malaria is common, you may need to take medicine to prevent malaria.
To get up-to-date travel information on travel immunizations and medications, please review the following two resources at least 2 months prior to travel:
Centers for Disease Control and Prevention (CDC) via the Traveler’s Health Hotline at 1-877-FYI-TRIP or online at http://www.cdc.gov/travel
Travel Health Online: http://www.tripprep.com
Note: If you still have questions or will need a travel vaccine, please schedule an appointment with a specialty travel clinic. Travel clinics are very common in the DC area. The following clinic is located ½ mile from Hirsch Pediatrics.
Travel Advisory and Immunization Clinic
15005 Shady Grove Road, #450
Rockville, MD 20850
tel 301-738-6420