Helpful Information for Parents
- Physical, Camp or School Forms Referral Forms
- Prescription Renewal
- After Hours Coverage
Have your child seen immediately if:
- The sick child is less than 2 months old and the fever is 101.5° or greater
- Your child is awake but unaware of his/her surroundings and febrile
- He/she has not urinated in over 12 hours
Fevers are a normal body’s reaction to infection. The body increases its temperature to fight infection and to protect itself from the intruding virus or bacteria. The fever helps rid the body of the infection, and is a sign the body is working properly. If the elevated temperature (101°-104°) is not causing discomfort, and the child is playing, eating and sleeping normally, there is no need to treat the fever. How the child looks or is acting (sick or normal) is more important than the height of the fever.
Treat your child’s fever at home if:
- The fever is above 101° and the child is uncomfortable.
- Treat with acetaminophen (Tylenol) or ibuprofen (Motrin or Advil) according to the dosing chart. Tylenol may be repeated every 4 hours, Ibuprofen every 6 hours.
- Infants 2 months or less should be seen immediately for fevers over 101.5°.
- If you choose to bathe or sponge the child, use lukewarm water. If shivers occur or the child becomes cold, increase the water temperature. (Shivering helps the body increase its temperature further.)
- Push fluids, dress the child lightly.
Bring your child in to be seen if:
- Infant age 3-6 months and fever is above 102°, or less than 102° and acts sick
- Child age 3-24 months and fever lasts more than 24 hours and child has no other symptoms.
- Parent feels child needs to be seen.
Colds, or Upper Respiratory Infections (URIs) are caused by a virus. The symptoms are congestion initially which is usually followed by a runny nose, cough, often a fever, sore throat, and or headache can be present as well.
Small infants have the most difficulty with colds because the congestion makes it difficult for them to suck. When congested, they cannot breath well through their nose while eating. They tire easily so often must be fed smaller amounts more frequently to keep up with their needs.
Colds can usually be cared for without a doctor’s visit, provided the fever lasts no more than 3 days, the nasal discharge lasts less than 2 weeks and the cough lasts less than 3 weeks. Young children can frequently get one cold after another and it becomes difficult to differentiate between the length of each symptom. Colds frequently precede ear infections, and ear pain usually warrants a doctor’s visit.
Cough and Cold Medication recommendations
Younger than 2 years: Tylenol can be used for discomfort or fever caused by a cold. Saline nasal drops can help clear thick drainage.
2-6 years: Tylenol for fever or discomfort of the cold. Encourage fluid intake such as water, soups, Gatorade. Milk is usually fine to drink as well.
Older than 6 years: Tylenol for fever or discomfort, encourage fluid intake of water, soups, Gatorade,. Cough drops can be helpful for daytime cough. Benadryl (small dose) can help sleep challenges. Multiple ingredient cough and cold medicines are discouraged due to over-dose risk.
Have your child seen now if:
- Your child is less than 2 months and the fever is greater than 101.5
- Your child is breathing rapidly, or having difficulty breathing not improved by clearing their nose.
Have your child seen soon if:
- Earache developed or ear drainage occurs.
- Nasal discharge is present more than 2 weeks.
- Cough persists more than 3 weeks.
- Fever persists beyond 4 days.
- Caretaker is concerned child is not recovering appropriately.
- Child should remain home from school while he/she has a fever. Frequent hand washing is essential throughout the illness.
Vomiting is usually caused by a stomach virus. Commonly, the illness starts with vomiting and progresses to diarrhea within 24-48 hours. Vomiting can be caused by more serious illnesses and the child may need to be seen in the office.
Have your child seem immediately if:
- Child’s vomiting is accompanied by a stiff neck and bulging fontanel (soft spot, in an infant)
- Child’s vomitus is blood or coffee-ground color
- Your child has had a recent head injury and has vomited more than twice
- Child is less than 3 months and vomiting is accompanied by a fever
- Child is less than 6 months and the vomitus is green or yellow
- Child has not urinated in more than 8 hours and is unable to hold anything down
- Parent is concerned the child is not improving
Home care for vomiting in children 1 or older:
- Allow the child’s stomach to rest 1-2 hours
- After resting, offer ½ ounce pedialyte every 10 minutes.
- If ½ ounce is tolerated 2-3 times without vomiting, increase the volume to 1 ounce and the interval to 15 minutes.
- Increase the volume and interval gradually, if vomiting occurs, resume at smaller volumes more slowly.
- If the child refuses pedialyte, you may alternate between flat soda (Not diet) and clear soup broth.
- Clear liquids can be offered for up to 24 hours, but advanced to a bland diet as the vomiting subsides.
*Home care for vomiting in children less than one year of age, please call our office or the nurse care line as the treatment varies more with symptoms. Also we like to follow the child’s weight closely in younger children when dehydration is possible.
*If vomiting lasts more than 24 hours more serious causes may be considered, so please call if vomiting persists.
Diarrhea is most commonly caused by a viral infection causing increased stool frequency and looseness of the bowel movements. The term diarrhea medically suggests more than 8 loose stools per day. Diarrhea is concerning as it can cause dehydration and younger children can become dehydrated quickly with serious diarrhea.
Have your child seen today if:
- Child has not urinated in more than 8 hours.
- Child has bloody stools.
- Child is less than one year and having 8 or more stools a day.
- Child has a high fever and/or persistent abdominal pain.
- Child has watery stools and unable to hold liquids down.
Infectious diarrhea can be caused by a virus, a bacteria as well as parasites. Viral diarrhea resolves without medication, bacterial and parasitic diarrhea may need medication to clear the illness. Diarrhea can also be caused by diet, food intolerance or other problems.
Home care for diarrhea to prevent dehydration*:
- Push fluid intake; avoid cow’s milk and all juice, sugary drinks and soda. Breastfed infants should continue breastfeeding during a diarrheal illness.
- Encourage BRAT diet for children over 4 months (bananas, rice, applesauce and toast). Feeding may result in more stools but less weight loss.
- Foods easily tolerated are dry cereal, crackers, noodles, clear soups, rice, carrots and bananas. Yogurt can be helpful.
- Loose stools can persist 1-2 weeks though the frequency should decrease.
- Wash your and the child’s hands frequently to avoid spread of the infection.
- If diarrhea frequency is concerning and/or urine output decreases, or urine is darker yellow, please make an appointment to have your child weighed in the office to evaluate for dehydration.
*Dehydration can occur quickly in young children. If diarrhea is accompanied by vomiting, frequent weight checks and evaluation in the office are necessary to assess your child’s fluid status.
Circumcisions, can be done in the office for male infants less than 2 weeks of age. (On occasion we will do them up to one month of age if the infant is small.) The decision to circumcise is a personal decision and one must weigh both social and medical factors into the decision.
If you have made an appointment to circumcise your infant, please do not feed him 2 hours prior to the appointment. Bring formula or mom, if the child breastfeeds, to feed the infant immediately after the procedure is completed. He will be hungry. We also ask that you avoid using powders or diaper ointment prior to the appointment.
The circumcision is done under local anesthetic and he is given Sweet-ease, a sugar solution to suck as a distraction during the procedure. The procedure usually takes approximately 10 minutes. Parents may observe or leave the room during the procedure, whichever they prefer.
If you have any questions regarding circumcision please don’t hesitate to ask.
Circumcision Procedure and Instructions
Before the procedure
- Stop feeding your baby 2 hours before the appointment.
- Pack a receiving blanket and formula, or mom should come to the appointment if infant is breastfed. He will want to feed immediately after the procedure.
- Please do not use ointments, creams or powders when changing his diapers prior to the procedure.
During the procedure
- The procedure will be described to you before it is done and you will have a chance to ask questions.
- The infant receives a local anesthetic block and is given a sugar solution to suck on during the procedure.
- Parents may stay in the room and observe (or not look) if they like, or they may wait outside or in the waiting room as they choose.
- The circumcision is done with a Plastibel and he will go home with a plastic ring in place which falls off as the site heals.
- The procedure takes 10-15 minutes and he may feed immediately afterwards.
After the procedure
- Keep the site clean. If stool gets on the circumcision site, clean it with soap and water.
- Apply Bacitracin to the circumcision with each diaper change
- He will get the circumcision wet each time he urinates; this is not a problem.
- The ring should loosen and then fall off in the same manner his belly button healed. Do not pull it lose if it is hanging but still attached as it will bleed.
- Call the office if you have any questions or concerns with the process.
Yuma Pediatrics’ Care Providers strongly believe in the safety and effectiveness of vaccines. We recommend that all children receive their vaccines according to Center for Disease Control and the American Academy of Pediatrics. If you have doubts, concerns or questions about the vaccines we will be happy to talk to you about them. We understand there are websites and literature available expressing the dangers of immunizations, but we feel the disease prevention the immunizations offer, far out weigh the minimal risks they may have. Rare reactions do occur and we should be notified in these cases so we can help your child avoid a recurrence in the future.
If your immunization philosophy is directly opposed to ours, we will have you sign a form stating vaccine refusal. We may ask you to seek medical care for your child where the physicians’ beliefs align with yours.
Please allow 5 days when requesting forms to be filled out. To ensure accuracy your child must have had a physical or well check within 1 year of completing the requested form. To expedite the process we ask that you fill out the “Parent Section” of all forms prior to the request.
Please contact your pharmacy for refills. The pharmacy will contact our office should doctor approval be necessary. Please allow 3 business days to process a request. Prescription renewal for controlled substances such as narcotics and stimulant medications such as Ritalin or Adderall cannot be faxed to the pharmacy or processed over the phone and therefore a prescription must be picked up at our office. In addition to refill medications for ADHD/ADD, your child must have an office visit every 6 months to monitor medication side effects.
One of our medical staff is available for consultation 24 hours a day, 7 days a week. During office hours, our medical assistants may offer recommendations for treating minor illness at home. After regular office hours, our Answering Service may direct your inquiries to the Nurse Care Line (1-800-336-2273) staffed by nurses of the Yuma Regional Medical Center. You may request to speak to any one of our Physicians at anytime during or after hours. Hospital admissions are managed by the Pediatric Hospitalist Group that specializes in hospital care.