How often should my newborn urinate?

For the first 5 days, newborns should generally urinate as many times as they are days old.  For example, a one day old should urinate at least once a day, a two day old at least twice, and so forth.  By the time your infant is a week old, you will be an expert at changing diapers!  

How often should my newborn stool?

Newborns should stool at least once before they are 24 hours old (if not, you should call your pediatrician!).  At first, the stool will look dark and sticky.  As your newborn’s feeding improves, the stool will change to green and yellow, and they will stool more often. Let your pediatrician know if the stools look black and/or red after day 3 or 4 of life.  

How should I care for the belly button?

If the area on the cord gets dirty, use rubbing alcohol to clean it, otherwise you can leave the umbilical cord as is. You should expect the umbilical cord stump to fall off 1-3 weeks after birth.  Studies have shown that infections from the umbilical cord are rare, however you should call your pediatrician if there is any redness on the skin surrounding the umbilical stump or if fluid or blood leaks several days after the cord falls off (a little blood for a day or two after the stump falls off is normal).  

How often should my newborn take a bath?

Newborns do not need to be bathed that often!  As long as their diaper area is kept clean, they do not need to be bathed more than once or twice a week.  

How should I bathe my newborn?

Sponge bathe the baby as needed until the umbilical cord has fallen off and the belly button area is dry and healed.  After that, you can start giving your newborn tub baths.  

Should I circumcise my newborn son?

There are benefits to penile circumcision including a small decreased risk of sexually transmitted infections, urinary tract infections and penile cancer.  The downsides to circumcising include cost, discomfort from the procedure, and it may very rarely cause damage to the penis.  Ultimately the decision should be based on parental preference.  

How do I cut my newborn’s fingernails?

Babies can be born with long nails and they may scratch their face.  We suggest filing your newborn’s nails for the first few months—it is less likely to cause trauma than cutting.

What is a fever in a newborn?

Fevers in newborns need to be taken very seriously.  A fever is any temperature 100.4F (38 Celsius) or higher. Rectal temperatures are the most accurate and are the preferred method in newborns.  You can coat the end of the thermometer with a lubricant (like Vaseline) and insert about ½ an inch into the rectum.  If the temperature is 100.4 or higher in the first 3 months, call your pediatrician.  

Does my newborn need any water to drink?

There is no need to give your newborn water.  Formula and/or breast milk is all they need – in fact, you should not give your baby anything except formula or breast milk! Remember, breast milk and formula are over 90% water anyhow.  Water can be introduced around 4-6 months.  

Should I give my baby formula or breastfeed?

Pediatricians recommend breastfeeding if possible because breastmilk contains the exact nutrients your baby needs as well as substances to help fight infections. Not every woman is able to breastfeed, however.  If you are not able to breastfeed, don’t fret: children who are formula-fed turn out just fine!  

How often should my newborn be feeding?

Initially, your newborn should feed about 8-12 times a day (or every 2-3 hours). Most newborns will lose weight in the first few days of life as it takes about 2-3 days until a mother’s milk comes in).  Until your newborn has regained their birth weight, we suggest not waiting longer than 4 hours in between feeds.  

Should my baby sleep face down or face up?

Infants should be placed on their back to sleep (face up) to best prevent against Sudden Infant Death Syndrome (SIDS). When your infant is awake, try to give “tummy time” to help strengthen the head, neck and upper body. Remember, a newborn resting against your chest (and off the back of their head) even counts as tummy time!  

Should my newborn use a pacifier?

There are good things and bad things about using a pacifier.  Pacifiers may be a great way to soothe your baby and they have even been shown to decrease the risk of SIDS.  However, early use of pacifiers may interfere with breastfeeding, may slightly increase the risk of ear infections and may be a hard habit to break down the road.  If you do decide to give your infant a pacifier it may be best to wait until breast-feeding has been well established.  

Should my newborn take Vitamin D supplementation?

The AAP recommends a daily intake of vitamin D of 400 IU/day for all infants and children.  While breast milk is the recommended diet for infants, breast milk in itself does not supply infants with enough Vitamin D.  Most breastfed infants, however, are able to make enough vitamin D from routine sun exposure (especially where we live in sunny southern California!). Vitamin D supplementation is especially important for those who have limited sun exposure (for example, if you live in an area with cloudy weather) or for those who have darker skin. For infants who consume at least 32oz of a vitamin-D fortified infant formula each day, vitamin D supplementation is not necessary.

 Although there is no “right” way to introduce solid foods, here are general feeding guidelines to consider:

Safety

• For healthy full-term babies, food can safely be started between 4-6 months. To be sure your child is ready, your infant should have good head control and open his/her mouth when food is placed near the lips. • Start by offering a small amount of a single ingredient food and introduce one new food at a time • To be sure a food agrees with your baby, introduce a new food every 3 to 5 days • Keep foods pureed until about 8-10 months of age, at which time consider advancing to small pieces of dissolvable “finger foods” • As your child consumes more solid foods, be sure and offer water to drink • Avoid Raw honey (which can cause botulism) and cow’s milk until 1 year of age  

Keep the food healthy!

• Start with foods that are “grown from the ground”; such as fruits, vegetables, and legumes. Consider starting with pureed peas, sweet potato, applesauce, pears, bananas, avocado, beans, and lentils • avoid added sugar and salt • Follow your child’s cues–in general, offer food as long as they are leaning forward and opening their mouth to eat. Children will let you know when they are done by closing their mouths when food is offered. • The parent is responsible to offer quality food, and the infants determine the quantity of food!  

Offer a Variety of Foods

• Strong scientific evidence has shown that the early introduction of a variety of foods will help prevent allergies. Have you heard the theory that when kids roll around in dirt it helps build up the immune system? It is a similar concept to food tolerance. For example, introducing peanuts (in a mashed-up form to avoid choking of course!) between 4-6 months of age has been shown to prevent peanut allergies. • introduce dairy products and protein, such as soft tofu, fish, meat, and poultry

Have fun!

• A favorite saying we have is “Food under 1 is just for fun!” as the main calorie source in the first year is generally breast milk and/or formula • Feeding your infant is a great opportunity to explore and find enjoyment in eating • If your child does not show interest in a particular food at first, that’s okay! Research shows that it may take up to 15 exposures of new food until they are interested. It may take them time to be good eaters. • Include your baby in family mealtimes as this will help promote socialization and healthy habits

Is My Child Ready to Toilet Train?

The age when a child is ready to use the toilet depends on many factors. Most children are able to stay dry during the day by age two to four years. Staying dry at night may take months or years longer. Most experts agree that before starting toilet training, a child should be able to:

• Walk to the toilet
• Sit up on a potty toilet
• Stay dry for several hours or wake up dry after a nap
• Pull clothes up and down
• Communicate the need to go to the toilet
• Show interest in toilet training

*Note that if your child has trouble with constipation, we recommend getting the constipation under control before starting to toilet train

How long will it take to learn?

The average time it takes a child to learn to stay dry during the day is six months. Girls usually complete toilet training earlier than boys. Additionally, parents should also be prepared to start the toilet training process, as it will take time, emotional energy, involve accidents and setbacks. It can be hard to resist pressure from other parents, family members or teachers who may expect your child to be toilet trained by a certain age. Remember that toilet training is not a contest. Success with toilet training does not mean that your child is more intelligent or advanced than other children. Additionally having trouble with toilet training does not mean that your child is lazy, stubborn or a slow learner. Just keep in mind Dr. Matthew’s sage advice: “By the time they walk down the aisle (for marriage), they will be out of diapers!”.

How to Start Toilet Training?

Consider Dr. T Berry Brazelton’s child-oriented approach, where a parent follows the child’s cues and signs of readiness to advance toilet training.

• Decide what words you will use to describe toileting and try to be consistent; examples include “pee,” “poop,” “potty,” etc.
• Buy a potty chair with your child. In the beginning, a potty chair is easier for a child to use compared with the over-the-toilet seat
• The potty chair should be placed in a convenient location, such as the child’s playroom or bedroom. Easy access is important.
• Encourage the child to sit on the potty chair, full dressed, to look at books or play with toys
• After your child is comfortable sitting on the potty chair, encourage your child to sit on the chair without a diaper.
• Toilet flushing can also be frightening to children, so a child may first practicing flushing pieces of toilet paper or wave “bye-bye” to the feces
• Encourage the child to tell you when s/he needs to go. Watch for signs that your child needs to go, like squirming or holding the genitals.
• Be patient because it may take days or weeks before the child is successful. And remember that setbacks are common!
• Do not punish, threaten or speak harshly to the child if s/he has accidents or will not use the potty.
• Transition to cotton underwear—the child can transition from diapers to training pants (“pull ups”) or cotton underwear after at least one week of success using the potty. Children should not be rushed out of diapers. At this stage, they should return to diapers if they are unable to stay dry. Once the child has mastered the use of the potty chair, he or she can be transitioned to the regular toilet with an over-the-toilet seat and step stool.

Some tips to keep in mind….

• Keep a positive, loving approach to toilet training
• Keep the child in loose, easy-to-remove clothing during the training process
• Avoid battles over toilet training. If your child is not interested, take a break with stop toilet training for two or three months before trying again.
• Consider using a star or sticker chart to reward your child for both trying and successful toileting
• Avoid flushing the toilet while the child is on it; this can be frightening
• Avoid over-reminders
• Teach boys to urinate sitting first; teach them to urinate while standing after they have learned to have bowel movements in the potty chair
• Keep stools soft by offering plenty of high-fiber foods and water, and limiting dairy products to no more than three eight-ounce cups of milk per day.
• To avoid accidents, remind your child to use the toilet after first waking up in the morning and at other times throughout the day. Even after a child has been completely toilet trained, accidents can happen.

What are head lice?

Head lice are tiny insects that infest the hair on your head, your eyebrows and eyelashes. The eggs of head lice, called nits, tightly attach to individual hairs and live close to the scalp. Lice can spread easily, especially among school-aged children. Lice cannot jump or fly but are spread by direct head-to-head contact, sharing clothing such as hats or bedding, and sharing combs or brushes. Having head lice is not a result of poor cleanliness. And not to worry; head lice do not carry diseases.

What are the signs and symptoms of having head lice?

• extremely itchy scalp
• small red bumps on the scalp or neck
• tiny white nits on the hair close to the scalp that are difficult to remove
• crawling sensation on the head

Note: lice are easier to see in bright light and by parting the hair to see close to the scalp. They are also easier to see near the ears and the nape of the neck.

How is head lice treated?

Over-the-counter lotions and shampoos that have pyrethrin or 1% permethrin are often the first choice. A second treatment is often needed about a week later. Side effects of permethrin include burning, itching, red skin, or numbness to the scalp. Prescription-strength medications such as 5% permethrin, malathion lotion, or benzyl alcohol lotion are other products that may be used. It is very important that the nits are removed. This can be difficult because they cling tightly to the hair. Special nit combs are available at drugstores. You should do a second combing 7 to 10 days after the first. Nits may live for 2 weeks. Hats, scarves, coats and bedding should be washed in hot water and dried in a hot dryer. Combs and brushes should be washed and the room of the infected person should be vacuumed.

Are there any natural treatment options?

There is no clear scientific evidence that lice can be treated by home remedies such as olive oil, but there is some evidence that they may be suffocated by Cetaphil cleanser. Tea tree oil is another potentially helpful natural remedy. Hopefully an effective, natural treatment will become available!

How can head lice be prevented?

Children should be careful not to share hats, combs, or brushes with others. For more information on Head Lice

1. Centers for Disease Control and Prevention: www.cdc.gov/parasites/lice/
2. American Academy of Dermatology: www.aad.org

The Common Cold: What to do?

Although common, colds can be very distressing for families.  In the United States, adults average about three colds per year, and children have colds about 6-8 times per year! Unfortunately, there’s no cure for the common cold, a viral infection that can’t be treated with antibiotics. Typically, a cold will run its course in a week or two, and children will usually get better on their own, without medication.  Symptoms from colds, such as cough and fever, can be distressing for families. It is helpful to remember that coughs are a normal symptom of a cold and help the body clear the mucus out of the airway and protect the lungs. Fever also helps the body fight off an infection and does not always need to be treated (Fever is defined as a temperature greater than 100.4 F).

What can we expect a typical cold to be like?

Most colds start with a sore throat and a stuffy nose, followed by other symptoms like cough, watery eyes, and a mild fever.  The flu tends to be more severe than a cold, typically with a higher fever, chills, body ache. These symptoms come on suddenly. When can my child return to school? Once your child is fever-free for 24 hours without medicine, she can usually return to school.  If your child returns to school and still has a runny nose, remind your child to throw away all used tissues and to wash her hands with soap. If my child has a fever, when should they see the doctor?

• A fever in an infant 3 months or younger
• A fever lasting more than 2 days
• Blue lips
• Difficulty breathing, including wheezing, fast breathing, the ribs showing with each breath or shortness of breath
• Not eating or drinking, with signs of dehydration (such as decreased urination)
• Excessive crankiness
• Excessive sleepiness
• Persistent ear pain
• If the cough lasts for more than three weeks
• If the child’s cold symptoms are getting worse after 1 week of illness

How can I help my child with a cold?

• Give your child plenty of fluids
• For infants with a stuffy nose, use saline or saltwater drops/spray to loosen mucus. Then clean the nose with a bulb syringe or other suction tool designed for infants.
• Place a clean cool-mist humidifier in your child’s room to help with congestion. This can help moisten the air and decrease the drying of the nasal passages and throat.
• One teaspoon of honey at bedtime may help relieve nighttime cough (don’t give honey to children younger than a year)
• For a sore throat, have your child gargle with warm salt water–dissolve a teaspoon of salt in a cup of warm water. You can also try liquids and foods that are soothing to the throat, such as warm tea, or cold drinks.
• Acetaminophen (Tylenol) or ibuprofen can help reduce fever, aches and pains.

Can I give my child over the counter (OTC) medications for their cough and cold symptoms?

• The FDA doesn’t recommend over-the-counter (OTC) medicines for cough and cold symptoms in children younger than 2 years old.  Although both over-the-counter and prescription medicines are available to treat cough and cold symptoms, most children will get better on their own.
•  For older children, some non-prescription medicines can help relieve the symptoms of a cold—but won’t change the natural course of the cold or make it go away faster.  It is advised to use medications only when the symptoms are too uncomfortable or make it difficult for the patient to breathe or sleep.
• Some cough and cold medicines also have side effects, such as slowed breathing, especially in infants and young children, so it’s important to know when your child needs medication and the correct dosage of the medication.
• Prescription cough medicines containing codeine or hydrocodone are not indicated for use in children. Caregivers should also read labels on OTC cough and cold products, because some might contain codeine.
• It can be tempting to give your children pain relievers, decongestants and other medications for a cold. But often it’s best to fight this common illness with rest and care.

https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm422465.htm Graph describing length of cold symptoms.  Notice how with the average cold, most symptoms have improved after 1 week.  Also worth noting, the average cough can linger beyond 2 weeks!

Temperature Basics What is a true fever? A fever is defined as a temperature equal to and greater than 100.4° Farenheit or 38° Celcius. What is the “normal” body temperature? The mean normal temperature is generally considered to be 98.6 ° F or 37° C.   Normal body temperature can change with age, the time of day, level of activity as well as other factors.  For example, infants have higher average “normal” temperatures, with an average of 99.5° F or 37.5° C as they have higher metabolic activity.  Temperature also varies with time of day, with a morning low and a late afternoon/early evening peak. Where is the best place to take a temperature?

• The most common sites to take a temperature are the rectum, mouth, and axilla (armpit), eardrum or forehead.  The best method depends on the age of your child and the method that easiest for the caregiver and your child.

• Rectal temperatures are the most accurate (the “gold standard”).  Oral or eardrum temperatures are accurate if done properly, and a good choice when children are old enough to cooperate.  Axillary (armpit) and forehead temperatures are the least accurate, but can screen for fevers.
• If a child 3 months old or younger has a fever (100.4°F and greater), they need to be evaluated by a doctor immediately.  If the axillary temperature is over 99.0°F, check it again by taking a rectal temperature to get the most accurate measurement.

How do you take a rectal temperature?

• Have your child lie stomach down on your lap
• Apply petroleum jelly to the end of the thermometer and to the opening of the anus
• Gently insert thermometer into the rectum  about ¼ inch. Never force it past any resistance.

How do you take an axillary temperature?

• Place the tip of the thermometer in a dry armpit
• Close the armpit by holding the elbow against the chest
• If you are uncertain about the result, check it with a rectal temperature

How do you take an oral temperature?

• Be sure your child has not had a recent cold or hot drink
• Place the tip of the thermometer under the tongue and toward the back
• Have your child hold it in place keeping the mouth closed. If your child is “mouth breathing” this will report a lower temperature.
• Oral temperatures are hard to do accurately if your child has a lot of nasal congestion.
• If there are any questions, please do not hesitate to ask!

Dr. Matthew answers common questions about childhood food allergy prevention and why he recommends Ready, Set, Food!. He is a member of the scientific advisory board for Ready, Set, Food! Learn more about Ready, Set, Food!’s pediatrician-recommended approach and why 150+ pediatricians and allergists recommend Ready, Set, Food! here.

In your 40 years of experience, what trends have you witnessed with respect to food allergies?

When I finished my residency in pediatrics in 1979, food allergies were rare and there was very low awareness. Now 1 in 13 children suffer from food allergies (in California, it’s 1 in 11) and unfortunately, I’ve seen that same troubling trend in my own practice. In addition, my 1 year old grandson suffers from multiple food allergies, and I’ve seen the toll it takes on the entire family.

How can parents help their children prevent food allergies?

The British Society for Allergy and Clinical Immunology (BSACI), American Academy of Pediatrics (AAP), National Institutes of Health (NIH), and American Academy of Allergy, Asthma & Immunology Foundation (AAAAI) are now recommending that parents introduce highly allergenic foods starting as early as 4-6 months of age, with recent studies on childhood food allergy prevention supporting that early introduction can help decrease the risk of allergy to that specific food by 67-80%. I think it’s important for any parents of infants to understand the following:

• Starting as early as 4-6 months of age, earlier introduction may be more effective at reducing the risk of food allergies. Parents should not delay as studies suggest that delaying introduction may put your child at a greater risk for developing food allergies.
• Studies also suggest sustained exposure is critical and just as important as early introduction, meaning parents must continue allergen exposure multiple times a week for several months.

How do your recommendations change (if at all) if the baby has eczema?

Babies with eczema are at the highest risk, specifically with more than a 3X increased risk of food allergies. In fact, two of the three recent clinical studies were especially focused on infants with eczema and the new NIH guidelines on peanut introduction are specifically for infants with eczema to help reduce the risk of developing peanut allergies. If a baby has mild to moderate eczema, I still recommend introducing potential allergenic foods at 4 months. However, if they have severe eczema, I always refer them to an allergist for a skin-prick or allergy testing. If they are cleared for allergies, then I continue to recommend early allergen introduction as supported by the new FDA recommendations.

Do you think eating allergenic foods while breastfeeding is enough to prevent allergies?

No. There has not been enough conclusive evidence that eating allergenic foods while breastfeeding has a protective effect, however, eating them also doesn’t increase the risk of developing an allergy. Therefore, according to recent studies, early allergen introduction in infants has been proven to be the most effective at preventing food allergies and is still recommended regardless of a mother’s diet while breastfeeding. Do you have any advice for parents that are nervous about introducing allergenic foods? It’s normal for parents to be nervous about giving their babies potentially allergenic foods, but in the three clinical trials with early introduction starting at 4 months with over 2,000 babies there were zero cases of anaphylaxis or hospitalizations. I recommend that parents introduce the smallest amounts possible of each food before gradually increasing dosage, similar to the approach taken by Ready, Set, Food! If they show any signs of sensitivity (e.g. rash, itching), I tell them to stop immediately and consult an allergist for testing.

Why do you recommend Ready, Set, Food! at every 4 month visit?

I tell parents that the most important thing is for them to introduce allergenic foods early and often, but since most families find that challenging to do on their own I recommend Ready, Set, Food! because it is:

• Easy to use – Mixing in with a bottle of breastmilk or formula makes it easy for parents to follow the studies and begin early and sustained allergen introduction starting at 4 months of age
• Evidence-based – With dosage based directly on the landmark clinical studies to help significantly reduce the risk of developing food allergies
• Organic and All Natural – Contains only organic, non-GMO peanut, egg, and milk with no additives or added sugar.

Learn more about how Ready, Set, Food! makes it easy to follow the guidelines to reduce your child’s risk of developing food allergies here. Interested in receiving a free intro pack ($24 value)? Claim this special offer for Oak Park Pediatrics families and get your head-start towards an allergy-free future here. ———————————- All health-related content on this website is for informational purposes only and does not create a doctor-patient relationship. Always seek the advice of your own pediatrician in connection with any questions regarding your baby’s health. These statements have not been evaluated by the Food and Drug Administration. Products are not intended to diagnose, treat, cure or prevent any disease. If your infant has severe eczema, check with your infant’s healthcare provider before feeding foods containing ground peanuts.

What do you tell parents about food allergy prevention?

Parents often tell me they’re not worried about food allergies because it’s not in their family. This is a common misconception – over 50% of kids with food allergies have no family history. Many parents are also nervous to offer their baby potentially allergenic foods like peanut, but we now know that avoidance is not the correct recommendation and could be attributed to the rise in food allergies. The link between early exposure to allergens and low allergy rates was first observed in Israel, where infants are fed peanut very early on and peanut allergies are rare (0.17% prevalence as compared to 1.7% in the UK and 1.4% in the US). This observation was confirmed in three clinical trials (the LEAP, EAT, and PETIT studies), where infants who were fed peanut, egg, and milk starting at 4-11 months had a 67-80% reduced risk of developing allergies to those foods. Based on these studies and new national guidelines, I recommend parents introduce peanuts, eggs, and milk into their baby’s diet starting around 4-6 months and continuing to feed these foods for several months.

If my baby is older than 6 months, is it too late introduce allergens?

No. Although earlier exposure is recommended, starting as late as 11 months of age has shown to also be effective in reducing risk. Although many parents worry that a younger baby will have a reaction, research shows that allergic reactions are much less severe in younger infants than in toddlers and older children, so there is no reason to delay.

Is eating peanut, egg and milk while breastfeeding enough to prevent food allergies?

This is a question that many of my parents ask but unfortunately no, breastfeeding is not enough. While breastfeeding has many benefits and I encourage moms to eat these allergenic foods while nursing, current research suggests it is not enough to prevent allergies. That’s why national medical guidelines still recommend that early and sustained introduction starting at 4-6 months regardless if a mother is exclusively breastfeeding as it is the most effective way to prevent allergies.

Do your recommendations changes for an infant with eczema?

No. In fact, approximately 30% of babies with eczema will develop food allergies, so early allergen introduction is particularly important for this high-risk group. National medical organizations such as the British Society for Allergy and Clinical Immunology (BSACI), American Academy of Pediatrics (AAP), National Institutes of Health (NIH), and American Academy of Allergy, Asthma & Immunology Foundation (AAAAI) recommend that parents of babies with eczema begin allergen introduction starting at 4 months, and it is extremely important to not delay introduction in this group. That being said, if your baby has severe eczema, current guidelines recommend they get allergy tested prior to introduction.

Why do you recommend Ready, Set, Food!?

I’ve been recommending early allergen introduction, but I was concerned about choking, dosage, and how parents would manage sustaining exposure for several months. I recommend Ready, Set, Food! because of its:

1. Controlled dosage to maximize safety and efficacy — Ready, Set, Food! uses the same dosage as the studies with a stepwise approach (introducing one food at a time) per pediatric guidelines. Since a lot of parents wonder how much to feed and how often, this product takes out all of that guesswork. Simply put, it is the safest way to introduce peanut, egg, and milk to your baby.
2. Ease to start early and SUSTAIN exposure – It’s common for parents to delay allergen introduction because their baby is not ready to eat solid foods at 4 months of age. Ready, Set, Food! allows parents to start early by mixing in their pre-measured packets to their baby’s bottle of breastmilk or formula. In addition, a lot of parents will give their baby peanuts only once or twice, but this is not enough – they need to be fed 2-3 times a week for several months to reduce the risk. And, their daily packet system makes that easy.
3. All-natural, non-GMO and organic ingredients: Ready, Set, Food! is made of only real, organic foods and nothing else – just peanut, egg, and milk – with no added sugars or preservatives.

Learn more about how Ready, Set, Food! makes it easy to follow the guidelines to reduce your child’s risk of developing food allergies here. Interested in receiving a free intro pack ($24 value)? Claim this special offer for Oak Park Pediatrics families and get your head-start towards an allergy-free future here.

How is an outer ear infection treated?

Ear drops are the preferred medication to help treat outer ear infections, also known as “swimmers ear”.  The ear drops are usually a combination of an antibiotic (to treat the bacterial infection) and steroid (to help reduce pain and inflammation in the ear canal). 

If my child starts to feel better after being on drops, it is okay to stop the medication early?

Be sure to finish all the medicine, even if you feel better after a few days.

Are there any tips for giving my child ear drops?

When you use ear drops, your child should:

• Lie on his side or tilt his head with the affected ear facing “up” or towards the ceiling. 
• Make sure the ear drops go into the ear canal (it helps to pull the outer ear away from the body as the drops go in)
• After the ear drops are in the ear canal, stay in the same position for 20 minutes 

Are there any other medications that may be helpful?

Motrin or Tylenol may be used to relieve pain

What else should I do during treatment?

It is important to keep the inside of your ear dry while the infection heals. You should not swim for 7 to 10 days after starting treatment. But you can take a shower. To keep the ear dry during a shower, put some Vaseline on a cotton ball, and then put the cotton ball in your outer ear, covering the opening of your ear canal. 

When should I call my health care professional?

If symptoms are not better 2 days after starting treatment, call your doctor

Can an outer ear infection be prevented?

Reduce your chances of getting an outer ear infection by not sticking things in your ears, or cleaning inside your ears. The inside of the ears do not usually need to be cleaned. It is normal to have some ear wax in your ears, as it is a natural way to protect the ear canal. 

Bedwetting Tips!

Nighttime bedwetting, or “nocturnal enuresis’, is common, and as a general rule it improves with time.   Daytime bladder control is usually achieved by four years of age.  Nighttime bladder control is not expected until five to seven years of age. About 15% of 5 year olds and 10% of 7 year olds still bedwet at least once a week.  Nighttime bedwetting is twice as common in boys as it is in girls.  In almost all cases, nocturnal enuresis resolves without any intervention. There is also a genetic tendency toward nighttime bedwetting. When one parent has a history of nighttime bedwetting, about 50% of the children will also experience nighttime bedwetting.   Remember that bedwetting is very common, and that the child is not doing it on purpose! As Dr. Matthew likes to say, “By the time your child walks down the wedding aisle, he will be peeing on the potty”.   Here are some tips to get closer to nighttime dryness:

1. Have your child urinate often during the day (five to seven times total) and just before going to bed. This will keep the bladder from “over-distending” during the day to help keep your child dry at night.
2. High sugar drinks should be avoided, especially toward the end of the day.
3. Try giving your child fluids mainly during the first half of the day, and less so toward the end of the day (try to restrict fluids after 5pm)
4. Make sure your child is not constipated.
5. Your child should urinate before going to sleep at night.
6. Motivational therapy (for example, a star chart) may help as a first intervention for younger children (between five and seven years).  Examples of motivational therapy; give a sticker for each dry night, and after 7 dry nights the child can get a prize!
7. If motivational therapy does not help, consider a bedwetting alarm. (We recommend the “Malem Ultimate Bedwetting Alarm”, which uses sound and vibration to wake even the deepest sleepers).