HEAD OR BRAIN

Cradle Cap


Definition

  • A scaly rash on the scalp that starts in newborns
  • Symptoms of Cradle Cap
  • Yellow scales and crusts attached to the scalp
  • Occurs in patches
  • Scales can be greasy or dry
  • Not itchy or painful
  • Begins in the first 2 to 6 weeks of life
Cause of Cradle Cap Cradle cap is probably caused by hormones from the mother. These hormones cross the placenta before birth. The hormones cause the oil glands in the skin to become overactive. They then release more oil than normal. Dead skin cells normally fall off. The extra oil causes these cells to "stick" to the skin. These cells form yellow crusts and scales on the scalp. When To Call Call Doctor or Seek Care Now
  • Baby under 1 month old with tiny water blisters or pimples in a cluster
  • Your child looks or acts very sick
Call Doctor Within 24 Hours
  • Baby under 1 month old with any water blisters or pimples
  • You think your child needs to be seen
  • Call Doctor During Office Hours
  • Raw rash behind the ears
  • Rash spreads beyond the scalp
  • Cradle cap gets worse with treatment
  • Cradle cap lasts longer than 12 months
  • You have other questions or concerns
Self Care at Home Mild cradle cap Care Advice What You Should Know About Cradle Cap: Cradle cap is a common skin condition of newborns. It's caused by overactive oil glands in the scalp. It's harmless and will go away on its own. But it takes time. Here is some care advice that should help.
  • Shampoo Daily:

Wash the hair with an anti-dandruff shampoo (such as Head and Shoulders). Do this twice a week. No prescription is needed. Note: The daily use of anti-dandruff shampoo isn't approved until after 2 years old. But, using it twice a week is fine. On the other days, wash the hair with baby shampoo.
  • Scalp Massage:

While the hair is lathered, massage the scalp with a soft brush. You can also use a rough washcloth or your fingers for 5 minutes. Don't worry about hurting the soft spot.
  • Baby Oil:

If the scalp has thick crusts (scales), put some baby oil on the scalp. Do this for 15 minutes before shampooing to soften the crusts. Wash all the oil off, however, or it may worsen the cradle cap. (Reason: The oil blocks the oil glands on the baby's scalp.) Do not use olive oil. (Reason: may increase the growth of yeast) Cradle cap lotions for loosening up the scales are also available without a prescription. Apply the lotion 15 minutes before shampooing.
  • Steroid Cream:

If the rash on the scalp is red and irritated, use 1% hydrocortisone cream. An example is Cortaid. No prescription is needed. Put this on once a day. After 1 hour, wash it off with soap and water. Do this for 7 days or less.
  • Expected Course:

Cradle cap will eventually go away on its own between 6 and 12 months of age. Usually, it doesn't cause any symptoms (such as pain or itching). Therefore, treatment is optional. It is mainly done for cosmetic reasons. Shampoos, lotions and brushing will reduce the thickness of the scales. They will usually make them go away sooner.
  • Return to Child Care:

Cradle cap cannot be spread to others. Your child does not need to miss any child care.
  • Call Your Doctor If:

Gets worse with treatment Lasts over 12 months of age You think your child needs to be seen And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.




Crying Baby - Before 3 Months Old


Definition A baby less than 3 months old is crying and you don't know why Crying is the only symptom The type of frequent crying called colic is included For crying with an illness or other symptom, go to that care guide Causes of Unexplained Crying Hungry Baby. The most common reason babies cry is because they are hungry. They stop crying at the onset of feeding. By the end of the feeding, they are happy. Sleepy Baby. The second reason babies cry is they need sleep. They need their parent to put them in a comfortable position. It may be swaddled and on their back. Then they fuss a little and fall asleep. Fed Too Much. Some babies cry because of a bloated stomach from overfeeding. Unlike gas, too much milk can cause discomfort that lasts a short time. Caffeine. Caffeine is a stimulant that can cause increased crying and trouble falling asleep. Breastfeeding mothers need to limit their caffeine intake. Clothing. Being too hot or too cold can make a baby cry. So can clothing that is too tight. Dirty Diaper. Stool is very irritating to the skin. If not cleaned off, it can cause pain and burning. Colic. Colic is the main cause of recurrent crying during the early months. All babies have some normal fussy crying every day. When this occurs over 3 hours per day, it's called colic. When they are not crying, they are happy. Pain (Serious). Painful causes include an earache, mouth ulcers, or a raw diaper rash. An ulcer on tip of penis may also cause pain and crying. These babies cry a lot and are not happy when they are not crying. They need to see a doctor to make a diagnosis. Fever in this age group is serious until proven otherwise. Shaken baby syndrome is a concern. Myths About Causes of Crying Not Due to Gas. Gas passing through normal intestines does not cause pain or crying. All crying babies pass lots of gas. Their stomachs also make lots of gassy noises. The gas comes from swallowed air. The gas is normal. It does not become trapped nor cause any pains. That's why burping a baby doesn't help the crying. Blaming gas is a myth. Definition of Colic A lot of crying once or twice per day Usually consolable when held and comforted Acts normal (happy, contented) between bouts of crying The baby is getting enough to eat and is not hungry The baby is not sick Onset most often before 2 weeks of age Usually goes away by 3 months of age (sometimes up to 4 months) When To Call Call 911 Now Not moving or very weak You think your child has a life-threatening emergency Call Doctor or Seek Care Now Age less than 1 month old and looks or acts abnormal in any way Age less than 12 weeks old with fever. Caution: do NOT give your baby any fever medicine before being seen. Bulging or swollen soft spot Swollen scrotum or groin Vomiting Cries when you touch, move or hold your baby Could be an injury Nonstop crying lasts more than 2 hours. (Your baby can't be consoled using this Care Advice). Will not drink or drinks very little for more than 8 hours Not alert when awake ("out of it") You are afraid someone might hurt or shake your baby High-risk child (such as with heart or brain disease) Your child looks or acts very sick You think your child needs to be seen, and the problem is urgent Call Doctor Within 24 Hours Not gaining weight or seems hungry New crying but your baby can be consoled. (Your baby will stop crying, but cause of crying not clear) You are worn out from all the crying You think your child needs to be seen, but the problem is not urgent Call Doctor During Office Hours Your baby has never been checked for excessive crying Crying started after 1 month of age Crying occurs 3 or more times per day You have other questions or concerns Self Care at Home Normal crying in all babies Colic (Excessive crying in a well baby who can be consoled) Care Advice What You Should Know About Crying: Normal Crying: All babies cry when they are hungry. Also, the normal baby has 1 to 2 hours of unexplained crying each day. It is scattered throughout the day. As long as they are happy and content when they are not crying, this is normal. Colic: Some babies are very hard to comfort. Some babies also cry a lot (over 3 hours per day). If growing normally and have a normal medical exam, the crying is called colic. Remind yourself that colic is due to your baby's temperament. It has nothing to do with your parenting or any medical disease. Here is some care advice that should help both types of crying. Feedings: For formula-fed babies, feed if more than 2 hours since the last feeding. For breast-fed babies, feed if more than 1½ hours since the last feeding. Be careful not to feed your baby every time she cries. Some babies cry because of a bloated stomach from overfeeding. Let your baby decide when she's had enough milk. (For example, she turns her head away.) Don't encourage your baby to finish what's in the bottle. Caffeine. If breastfeeding, decrease your caffeine intake. Limit your coffee, tea and energy drinks to 2 servings per day. That's 2 cups or 16 ounces (480 mL). Hold and Comfort for Crying: Hold and try to calm your baby whenever he cries without a reason. Hold your baby flat to help them relax and go to sleep. Rock your child in a rocking chair, in a cradle or while standing. Many babies calm best with rapid tiny movements like vibrations. Place in a windup swing or vibrating chair. Take for a stroller ride, outdoors or indoors. Do anything else you think may be comforting. Examples are using a pacifier, massage, or warm bath. Swaddle your Baby in a Blanket for Crying: Swaddling is the most helpful technique for calming crying babies. It also keeps your baby from waking up with a startle reflex. Use a big square blanket and the "burrito-wrap" technique: Step 1: Have the arms inside and straight at the sides. Step 2: Pull the left side of the blanket over the upper body and tuck. Step 3: Fold the bottom up with the knees a little flexed. Safe swaddling keeps the legs in a straddle position. Step 4: Pull the right side over the upper body and tuck. Caution: Don't cover your baby's head or overheat your baby. Caution: Stop swaddling when your baby shows signs of rolling over. Age limit: 4 months. Read the book (or view the DVD),"The Happiest Baby on the Block". Both products are authored by Dr. Harvey Karp. It is the best resource on how to calm fussy babies. White Noise for Crying: Swaddling works even better when paired with a low-pitched white noise. Examples are a CD, vacuum cleaner, fan or other constant sound. Caution: Avoid making white noise too loud. Reason: risk of hearing damage. Keep the white noise on any time your baby is crying. When your baby is awake and not crying, keep your baby unwrapped. Turn off the white noise. Reason: So she can get used to the normal sounds of your home. (For details, view Dr. Karp's DVD.) Falling Asleep on their Own: Often babies cry because they need to sleep. If over 2 hours have passed since the last nap, this probably is the reason. You have tried different ways to comfort your baby. You fed him recently. Nothing you do seems to help your baby relax. So, now, it's time to get out of the way. Swaddle your baby. Place him on his back in his crib. Turn on some white noise or soothing music. Then, leave the room. Let your baby fuss until he falls asleep. For some overtired babies, this is the only answer. Encourage Nighttime Sleep (Rather Than Daytime Sleep): Try to keep your child from sleeping too much during the daytime. If your baby has napped 2 hours or longer, gently wake him up. Play with or feed your baby, depending on his needs. This will lessen the amount of time your baby is awake at night. Warning: Never Shake a Baby It can cause bleeding on the brain. Severe brain damage can happen in a few seconds. Never leave your baby with someone who is immature or has a bad temper. If you are frustrated, put your baby down in a safe place. Call or ask a friend or relative for help. Take a break until you calm down. What to Expect: The right technique should start to reduce the crying. You may have to try several things before finding the best method. The crying should start to decrease to about 1 hour per day. Colic gets better after 2 months of age. Most often, it is gone by 3 months. Call Your Doctor If: Your baby starts to look or act abnormal Cries nonstop for more than 2 hours Your child can't be consoled using this advice You think your child needs to be seen Your child becomes worse And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.




Crying Child - 3 Months and Older


Definition A child more than 3 months old is crying and you don't know why Your child is too young to tell you why Age: Most of these children are younger than 2 years old Crying is the only symptom For crying with an illness or other symptom, go to that care guide Causes of Unexplained Crying New Illness. Coming down with an illness is the main physical cause. Young children cry about being sick, even if they don't have any pain. Physical Pain. Painful causes include earache, sore throat, mouth ulcers, or a raw diaper rash. A sore on the penis or constipation may also cause pain or crying. Behavioral Causes. Most crying means the child is upset about something. Crying can occur when a young child is separated from his parents. Other examples are crying with tantrums or when overtired. This guide detects many babies with sleep problems. Crying always occurs during re-training programs for bad sleep habits. Some preverbal children cry any time they want something. Hunger. After the early months, most parents can recognize hunger and feed their child. If they don't, the child may cry. Cold Medicines. Drugs like Sudafed can also cause crying. Note: FDA does not advise cough and cold medicines for children under 4 years. Myths About Causes of Crying Not Due to Teething. Teething may cause some babies to be fussy. But, in general, it does not cause crying. Not Due to Gas. Gas passing through normal intestines does not cause pain or crying. When To Call Call 911 Now Not moving or very weak You think your child has a life-threatening emergency Go to ER Now Stiff neck (can't touch chin to the chest) Bulging or swollen soft spot Swollen scrotum or groin Won't move an arm or leg normally Cries when you touch or move your child Screaming child and can't be consoled Call Doctor or Seek Care Now Could be an injury Nonstop crying lasts more than 2 hours. (Your child can't be consoled using this Care Advice) You are afraid someone might hurt or shake your child Will not drink or drinks very little for more than 8 hours Not alert when awake ("out of it") Your child looks or acts very sick You think your child needs to be seen, and the problem is urgent Call Doctor Within 24 Hours You think pain (such as an earache) is causing the crying New crying but your child can be consoled. Cause of crying is not clear. You think your child needs to be seen, but the problem is not urgent Call Doctor During Office Hours Mild, off-and-on fussiness without a cause lasts more than 2 days Crying is a frequent problem You have other questions or concerns Self Care at Home Mild fussiness without a cause is present less than 2 days Normal protest crying Temper tantrum crying Sleep problem crying Care Advice Mild Fussiness of Unknown Cause What You Should Know: Your child is crying and fussing more than normal. But, if acting normal when not crying, the cause is probably not serious. He could be coming down with an illness. Most often, that will become clear in a day or so. He could be reacting to some changes in your home or child care setting. See if you can come up with some ideas. At times, children can also go through a "clingy phase" without a reason. If the crying stops with comforting, it's not serious. Here is some care advice that should help. Comfort Your Child: Try to comfort your child by holding, rocking, or massage. Talk in a quiet, calm voice. Undress Your Child- Check the Skin: Sometimes, part of the clothing is too tight. Loosen it. Also, check the skin for redness or swelling (such as an insect bite). Stop Any Over-the-Counter Medicines: If your child is taking a cough or cold med, stop it. The crying should stop within 4 hours. Allergy meds like Benadryl can cause screaming in a small number of children. Also, may cause some children to be more fussy than normal. Drugs that lessen congestion like Sudafed can cause crying. The FDA does not approve any of these drugs for children under 4 years old. Sleep - Take a Nap: If your child is tired, put him to bed. If he needs to be held, hold him quietly in your arms. Sometimes, lying next to him will comfort him. Some overtired infants need to fuss themselves to sleep. Warning: Never Shake a Baby It can cause bleeding on the brain. Severe brain damage can happen in a few seconds. Never leave your baby with someone who is immature or has a bad temper. If you are frustrated, put your baby down in a safe place. Call or ask a friend or relative for help. Take a break until you calm down. What To Expect: Most fussiness with illnesses goes away when the illness does. Fussiness may be due to family stress or change (such as new child care). Fussiness due to this cause lasts less than 1 week. Call Your Doctor If: Nonstop crying lasts more than 2 hours Crying with an illness gets worse Mild crying lasts more than 2 days You think your child needs to be seen Your child becomes worse Normal Protest Crying What You Should Know: Normal children cry when they don't get their way. Normal children cry when you make changes in their routines. Crying is how young children communicate in the first years of life. Crying can mean, "I don't want to." This is called normal protest crying and is not harmful. Do not assume that crying means pain. Call Your Doctor If: Crying becomes worse Your child does not improve with this advice You have other questions or concerns Temper Tantrum Crying What You Should Know: Crying is the most common symptom of a temper tantrum. Temper tantrums occur when your child is angry or trying to get his way. This is likely the cause of the crying if it occurs at these times. All kids have some temper tantrums, starting at about 9 months of age. Tips for Dealing with Temper Tantrums: Ignore most tantrums (such as wanting something the child doesn't need). Don't give your child an audience. Leave the room. For tantrums from frustration (such as when something doesn't work), help your child. For tantrums that involve hitting or throwing objects, put in timeout. Leave your child there until he calms down. Don't give in to tantrums. No means No. Be a good role model. Do not yell or scream at others (adult tantrums). Call Your Doctor If: Crying becomes worse Your child does not improve with this advice You have other questions or concerns Sleep Problem Crying What You Should Know: Sleep problems can cause crying. Suspect this if most of your child's crying occurs in his crib or bed. The crying mainly occurs when you put him down for naps and at night. Also, suspect a sleep problem if your child acts normal during the daytime. Sleep problems are common in childhood. Tips for Treating the Sleep Problem: Re-train your child to be a good sleeper at bedtime and naptime. Place your child in the crib "sleepy but awake." Once placed in the crib, don't take your child out again. If needed, visit your child every 10 minutes or so until asleep. For waking at night, it's fine to hold your child until calm. Do all of this in a loving way with a calm voice. Never feed until asleep. Always stop before asleep. Never sleep in the same bed with your child. Call Your Doctor If: Crying becomes worse Your child does not improve with this advice You have other questions or concerns And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.




Dizziness


Causes of Dizziness Main Cause. Usually due to reduced blood flow to the brain for a short time. It can be triggered by many normal events: Standing too long in one place. Reason: This causes pooling of blood in the legs. Standing up suddenly. Reason: This causes sudden drop in blood pressure. Dehydration. This can be from losing fluids and/or from not drinking enough fluid. Low Oxygen (such as when running and out of breath). Reason: Lower than normal oxygen levels can't meet body's needs for a short time. Too Much Sun or Hot Tub Use. Reason: Increased sweating causes fluid loss. Sweating from Sports or Hard Work. Reason: Sweating causes fluid loss. Fasting. Skipping a meal causes low blood sugar. Fever Motion Sickness. Main symptoms are dizziness and nausea. Viral Syndrome. Patients with viral illnesses (e.g., colds, flu) often say they are a bit dizzy. This is never the only symptom. It may relate to weakness from being sick. Vertigo (Serious). In addition to dizziness, the child complains that the room is spinning. They can't walk if they have vertigo. True vertigo is very rare in children. It's usually caused by middle ear disease. Symptoms of Dizziness Feeling dizzy or light headed Feeling unsteady with slight loss of balance Feeling "woozy" or not thinking clearly May also have brief blurring of vision Dizziness Scale Mild: walks normal Moderate: interferes with normal activities such as playing, school or sports Severe: can't stand, needs support to walk, feels like passing out now When To Call Call 911 Now You think your child has a life-threatening emergency Go to ER Now Severe dizziness (unable to walk, requires support to walk) Follows bleeding. Exception: small amount and dizzy from sight of blood. Passed out (fainted) and not caused by prolonged standing Acts or talks confused Poisoning suspected (usually 8 months to 4 years old) Drug abuse suspected (especially if psych. problems and more than 8 years of age) Severe headache Child complains of heart pounding differently Too weak to stand and not caused by prolonged standing Call Doctor or Seek Care Now Dehydration suspected. No urine in more than 8 hours, dark urine, very dry mouth and no tears. Dizziness caused by heat exposure, prolonged standing, or poor fluid intake. It's not gone after 2 hours of rest and fluids. Your child looks or acts very sick You think your child needs to be seen, and the problem is urgent Call Doctor Within 24 Hours Passed out (fainted) and caused by sudden or prolonged standing Moderate dizziness (interferes with normal activities) present now. Exception: dizziness caused by heat exposure, prolonged standing, or poor fluid intake. Fever lasts more than 3 days Ear pain or congestion You think your child needs to be seen, but the problem is not urgent Call Doctor During Office Hours Mild dizziness (normal walking) lasts more than 3 days Dizziness is a frequent problem You have other questions or concerns Self Care at Home Sudden or prolonged standing caused the dizziness Poor fluid intake caused the dizziness Mild dizziness from unknown cause present less than 3 days Care Advice Dizziness from Sudden or Prolonged Standing What You Should Know: Standing up quickly is the most common cause of dizziness. This type of dizziness only lasts a short time. Getting out of bed is when it usually happens. Prolonged standing in one place is another common cause. Not drinking enough fluids or eating enough salt always makes it worse. Here is some care advice that should help. Standing - Pump Legs: In the mornings, sit up for a few minutes before you stand up. This will help your blood flow stay steady and adjust before you stand up. With prolonged standing, contract and relax your leg muscles. Reason: This helps pump the blood back to the heart. Sit down or lie down if you feel dizzy. Salt - Increase Intake: Most people with this type of dizziness (due to standing) don't get enough salt. Try to eat some salty foods (potato chips or pretzels) every day. Fluids - Drink More: Drink several glasses of fruit juice, other clear fluids or water. This will improve your child's fluid status and blood sugar. If the weather is hot, make sure the fluids are cold. Lie Down: Lie down with feet up for 1 hour. Reason: This will increase blood flow to the brain. Prevention: Extra water and salty foods during sports or hot weather Regular mealtimes and snacks Enough sleep and rest What to Expect: With treatment, the dizziness usually goes away in 1 to 2 hours. Call Your Doctor If: After 2 hours of rest and fluids, still feels dizzy Your child passes out (faints) You think your child needs to be seen Your child becomes worse Dizziness from Poor Fluid Intake What You Should Know: Not drinking enough fluids and being a little dehydrated probably caused the dizziness. It should go away with drinking fluids and resting in a cool place. This is always made worse during hot weather. Too much sun exposure can also increase the body's need for fluid. Here is some care advice that should help. Fluids - Drink More: Drink several glasses of fruit juice, other clear fluids or water. This will improve your child's fluid status and blood sugar. If the weather is hot, make sure the fluids are cold. Cool Off: If the weather is hot, use a cold pack or washcloth to the forehead. Taking a cool shower or bath will help even more. Lie Down: Lie down with feet up for 1 hour. Reason: This will increase blood flow to the brain. Prevention: Extra water and salty foods during sports or hot weather Regular mealtimes and snacks Enough sleep and rest What to Expect: With treatment, the dizziness usually goes away in 1 to 2 hours. Call Your Doctor If: After 2 hours of rest and fluids, still feels dizzy Your child passes out (faints) You think your child needs to be seen Your child becomes worse Dizziness from Unknown Cause What You Should Know: Dizziness that goes away is a harmless symptom. It's usually due to not drinking enough water during sports or hot weather. It can also be caused by skipping a meal or too much sun. Sometimes, it's part of a viral illness. Here is some care advice that should help. Lie Down: Lie down with feet up for 1 hour. Reason: This will increase blood flow to the brain. Fluids - Drink More: Drink several glasses of fruit juice, other clear fluids or water. This will improve your child's fluid status and blood sugar. If the weather is hot, make sure the fluids are cold. Cool Off: If the weather is hot, use a cold pack or washcloth to the forehead. Taking a cool shower or bath will help even more. Prevention: Extra water and salty foods during sports or hot weather Regular mealtimes and snacks Enough sleep and rest What to Expect: With treatment, the dizziness usually goes away in 1 to 2 hours. Mild dizziness with a viral illness may last 1 or 2 days. Call Your Doctor If: After 2 hours of rest and fluids, still feeling dizzy Mild dizziness lasts over 3 days Your child passes out (faints) You think your child needs to be seen Your child becomes worse And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.




Fainting


Definition Fainting is sudden brief loss of consciousness with falling down A return to being awake and alert happens within 1 minute Also called passing out or blacking out Fainting Basics Fainting is a brief loss of consciousness. Normal awareness returns in less than 1 minute if the person is allowed to lie down. If standing, the person falls to the ground. If sitting, the person slumps over. The medical name for fainting is syncope. Fainting happens in 15% of healthy teens. Simple fainting doesn't occur before age 6. It is not common before age 10. Causes: In teens, 98% is simple fainting. Less than 1% have heart problems. In older adults, serious causes are much more common. Cause of Simple Fainting: Decreased blood flow to the brain. Risk Factors: mild dehydration, fasting, hot weather, lack of sleep, recent illness, change in altitude. Most fainting is harmless. There is a risk of a head or face injury from sudden falling. Simple Fainting (Benign Fainting): Types Standing too long in one place before fainting is the most common type. The medical name is orthostatic or postural syncope. Happens at church, graduations, weddings or at events when standing a long time. More common if one keeps the knees "locked." This pools the blood in the leg veins. A person who stands long enough in one place will faint. Standing up quickly (often after lying down) before fainting is a less common cause. Often this just causes a person to feel dizzy for a short time. More common in the morning after not eating or drinking during the night. Sudden stressful feelings before fainting. This is called vasovagal syncope. Seeing a badly injured person or pet can trigger fainting. Other examples are seeing someone vomit, bleed or pass a stool. Also, stressful events such as speaking or performing in public can cause fainting. Sudden physical pain before fainting such as getting a shot or a blood test. Having slivers or stiches taken out can also trigger fainting. The stress of the event may cause the fainting rather than the pain itself. Warning Signs For Simple Fainting Dizziness (light-headed), blurred vision, nausea, sweating, feeling cold. These last for 5 to 10 seconds before passing out. The person may look pale just before passing out. Serious Causes of Fainting Cardiac syncope. Any fainting that happens during exercise needs a heart work-up. This cause is rare in children. Blood loss - large amount or bleeding inside the body Concussion or head injury Sudden drop in blood sugar. Mainly happens in people with diabetes. Poisoning Drug or alcohol abuse Seizure When To Call Call 911 Now Still passed out or hard to wake up after 2 minutes Caused by choking on something Fainted suddenly after medicine, allergic food or bee sting Trouble breathing and not a breath-holding spell Bleeding large amount You think your child has a life-threatening emergency Go to ER Now Talking or acting confused for more than 5 minutes Feels too dizzy to stand after drinking fluids Fainted during exercise Heart is beating too fast Chest pain Muscle jerking or shaking during fainting Call Doctor or Seek Care Now Followed a head injury Followed a belly injury First fainting spell Passed out for more than 1 minute after laying down Dehydration suspected. No urine in more than 8 hours, dark urine, and very dry mouth. Fainted 2 times in one day Age less than 10 years Cause of fainting is unknown (Not if cause is long standing, sudden standing, pain or stressful event) Your child looks or acts very sick You think your child needs to be seen, and the problem is urgent Call Doctor Within 24 Hours You think your child needs to be seen, but the problem is not urgent Call Doctor During Office Hours Simple fainting from long standing, sudden standing or pain is a frequent problem You have other questions or concerns Self Care at Home Simple fainting and now alert and feels fine Prevent simple fainting Care Advice Fainting Treatment What You Should Know About Simple Fainting: Fainting is common and happens in 15% of teens. Standing too long in one place is the most common cause of fainting. It's caused by blood pooling in the legs. Standing up quickly after lying down can cause anyone to feel dizzy. If your child doesn't sit down when this happens, he may faint. These are normal types of fainting. Simple fainting doesn't cause any long-term problems. Here is some care advice that should help. Lie Down: Lie down flat with the feet up for 10 minutes. Reason: This will increase blood flow to the brain. Simple fainting is due to a sudden drop in blood flow to the brain. Caution: Getting up too soon can cause your child to faint again. Drink Some Water: Give your child a large glass of water. Reason: to increase blood volume. Do this before he stands up again. Offer fruit juice if your child hasn't eaten breakfast yet. Reason: also raises blood sugar. In hot weather, drink extra water to stay hydrated. Ease Stress: If fainting was due to stress or fear, help your child talk about what happened. Talk about what scared them. Try to calm your child with a soothing voice. Comfort them. Tell them they are safe and you will protect them. What to Expect: Most children with a simple faint are alert within 2 minutes. They feel normal after lying down for 10 minutes. They are able to stand without feeling dizzy. Call Your Doctor If: Still feeling faint or dizzy after 15 minutes Passes out again on the same day You think your child needs to be seen Your child becomes worse Prevent Simple Fainting When Dizzy, Lie Down or Sit Down: Most fainting can be prevented. Learn the early warning signs for fainting. They are feeling dizzy, blurry vision, and nausea. If you feel these warning signs, lie down right away. If you can only sit, put your head down by your knees. You only have 5 - 10 seconds to prevent fainting and falling down. Move Your Leg Muscles: If long standing in one place is needed, tighten and relax your leg muscles. Do this a few times each minute. This will pump the blood back to your heart. Caution: never stand with your knees locked. For long sitting in one place, move your feet and legs every few minutes. When getting out of bed, sit on the edge for a few minutes before standing. If you feel dizzy, lie down again. If getting out of a hot tub or bath, go very slowly. Extra Water and Salty Foods: If you tend to faint, extra water and salt are key. Drink extra fluids every day. Your goal is 8 cups (2 liters) per day. You may need more during sports or hot weather. Add some salty foods to your diet. Too little salt in your diet also isn't healthy. It can cause low blood pressure. Call Your Doctor If: Fainting is a frequent problem You have other questions or concerns And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.




Fever


Definition An abnormal high body temperature Fever is the only symptom. Your child has a true fever if: Rectal (Bottom), Ear or Forehead temperature: 100.4° F (38.0° C) or higher Oral (Mouth) temperature: 100° F (37.8° C) or higher Under the arm (Armpit) temperature: 99° F (37.2° C) or higher Caution: Ear temperatures are not accurate before 6 months of age Caution: Forehead temperatures must be digital. Forehead strips are not accurate. Causes of Fever Overview. Almost all fevers are caused by a new infection. Viruses cause 10 times more infections than bacteria. The number of germs that cause an infection are in the hundreds. Only a few common ones will be listed. Viral Infections. Colds, flu and other viral infections are the most common cause. Fever may be the only symptom for the first 24 hours. The start of viral symptoms (runny nose, cough, loose stools) is often delayed. Roseola is the most extreme example. Fever may be the only symptom for 2 or 3 days. Then a rash appears. Bacterial Infections. A bladder infection is the most common cause of silent fever in girls. Strep throat is also a common cause of unexplained fever. Sinus Infection. This is a problem caused by a cold. The main symptom is the return of fever after it has been gone for a few days. The sinus congestion also changes to sinus pain. Color of nasal discharge is not very helpful for making this diagnosis. Vaccine Fever. Fever with most vaccines begins within 12 hours. It lasts 2 to 3 days. This is normal and harmless. It means the vaccine is working. Newborn Fever (Serious). Fever that occurs during the first 3 months of life can be serious. All of these babies need to be seen as soon as possible. The fever may be due to sepsis (a bloodstream infection). Bacterial infections in this age group can get worse quickly. They need rapid treatment. Meningitis (Very Serious). A bacterial infection of the membrane that covers the spinal cord and brain. The main symptoms are a stiff neck, headache and confusion. Younger children are lethargic or so irritable that they can't be consoled. If not treated early, can suffer brain damage. Overheated. The fever is usually low grade. Can occur during heat waves or from being overdressed. The temp becomes normal in a few hours after moving to a cooler place. Can also occur during hard exercise. Fever goes away quickly with rest and drinking extra fluids. Not Due to Teething. Research shows that "getting teeth" does not cause fevers. Fever and Crying Fever on its own shouldn't cause much crying. Frequent crying in a child with fever is caused by pain until proven otherwise. Hidden causes can be ear infections, kidney infections, sore throats and meningitis. Roseola: Classic Cause of Unexplained Fever in Young Children Most children get Roseola between 6 months and 3 years of age. Cause: human herpes virus 6 Rash: pink, small, flat spots on the chest and stomach. Rash is the same on both sides of the body. Then spreads to the face. Classic feature: 2 or 3 days of high fever without a rash or other symptoms. The rash starts 12 to 24 hours after the fever goes away. The rash lasts 1 to 3 days. By the time the rash appears, the child feels fine. Normal Temperature Range Rectal. A reading of 98.6° F (37° C) is just the average rectal temp. A normal low can be 96.8° F (36° C) in the morning. It can change to a high of 100.3° F (37.9° C) late in the day. This is a normal range. By mouth. A reading of 97.6° F (36.5° C) is just the average mouth temp. A normal low can be 95.8° F (35.5° C) in the morning. It can change to a high of 99.9° F (37.7° C) late in the day. This is a normal range. When To Call Call 911 Now Not moving or too weak to stand Can't wake up Trouble breathing with bluish lips or face Purple or blood-colored spots or dots on skin You think your child has a life-threatening emergency Go to ER Now Stiff neck (can't touch chin to the chest) Age less than 1 year and soft spot bulging or swollen Hard to wake up Had a seizure with the fever Call Doctor or Seek Care Now Trouble breathing Great trouble swallowing fluids or spit Not alert when awake ("out of it") Acts or talks confused Age less than 12 weeks old with any fever. Caution: do NOT give your baby any fever medicine before being seen. Fever over 104° F (40° C) Shaking chills (shivering) lasting more than 30 minutes Nonstop crying or cries when touched or moved Won't move an arm or leg normally Dehydration suspected. No urine in more than 8 hours, dark urine, very dry mouth and no tears. Pain or burning when passing urine Weak immune system. Examples are: sickle cell disease, HIV, cancer, organ transplant, taking oral steroids. Your child looks or acts very sick You think your child needs to be seen, and the problem is urgent Call Doctor Within 24 Hours Age 3-6 months old with fever Age 6-24 months old with fever that lasts more than 24 hours. There are no other symptoms (such as cough or diarrhea). Fever lasts more than 3 days Fever returns after being gone more than 24 hours Recent travel outside the country to high risk area You think your child needs to be seen, but the problem is not urgent Call Doctor During Office Hours You have other questions or concerns Self Care at Home Fever with no other symptoms and your child acts mildly ill Care Advice What You Should Know About Fever: Having a fever means your child has a new infection. It's most likely caused by a virus. You may not know the cause of the fever until other symptoms develop. This may take 24 hours. Most fevers are good for sick children. They help the body fight infection. Use the ranges below to help put your child's level of fever into perspective: 100° - 102° F (37.8° - 39° C) Low grade fever: helpful, good range. Don't treat. 102° - 104° F (39 - 40° C) Average fever: helpful. Treat if causes discomfort. Over 104° F (40° C) High fever: causes discomfort, but harmless. Always treat. Over 106° F (41.1° C) Very high fever: important to bring it down. Rare to go this high. Over 108° F (42.3° C) Dangerous fever: fever itself can be harmful. Treatment for All Fevers - Extra Fluids Fluids alone can lower the fever. Reason: being well-hydrated helps the body give off heat through the skin. Offer your child extra water or other fluids by mouth. Cold fluids are better. Until 6 months old, only give extra formula or breastmilk. For all children, dress in 1 layer of light weight clothing, unless shivering. Reason: also helps heat loss from the skin. Caution: if a baby under 1 year has a fever, never overdress or bundle up. Reason: babies can get over-heated more easily than older children. For fevers 100°-102° F (37.8° - 39°C), fever meds are rarely needed. Fevers of this level don't cause discomfort. They do help the body fight the infection. Exception: if you feel your child also has pain, treat it. Fever Medicine: Fevers only need to be treated with medicine if they cause discomfort. Most often, that means fevers above 102° F (39° C). Also use for shivering (shaking chills). Shivering means the fever is going up. For fevers above 102° F (39° C), give an acetaminophen product (such as Tylenol). Another choice is an ibuprofen product (such as Advil). Goal of treatment: Bring the temperature down to a comfortable level. Most often, the fever meds lower the fever by 2° to 3° F (1 - 1.5° C). They do not bring it down to normal. It takes 1 or 2 hours to see the effect. Do not use aspirin. Reason: Risk of Reye syndrome, a rare but serious brain disease. Do not use both acetaminophen and ibuprofen together. Reason: Not needed and a risk of giving too much. Sponging With Lukewarm Water: Note: Sponging is an option for high fevers, but not required. It is rarely needed. When to Use: Fever above 104° F (40° C) AND doesn't come down with fever meds. Always give the fever medicine at least an hour to work before sponging. How to Sponge: Use lukewarm water (85 - 90° F) (29.4 - 32.2° C). Sponge for 20-30 minutes. If your child shivers or becomes cold, stop sponging. Other option: You can also make the water warmer. Caution: Do not use rubbing alcohol. Reason: Can cause a coma. Return to School: Your child can return to school after the fever is gone. Your child should feel well enough to join in normal activities. What to Expect: Most fevers with viral illnesses range between 101° and 104° F (38.4° and 40° C). They may last for 2 or 3 days. They are not harmful. Call Your Doctor If: Your child looks or acts very sick Any serious symptoms occur such as trouble breathing Fever goes above 104° F (40° C) Any fever occurs if less than 12 weeks old Fever without other symptoms lasts more than 24 hours (if age less than 2 years) Fever lasts more than 3 days (72 hours) You think your child needs to be seen Your child becomes worse And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.




Hair Loss


Definition Hair loss in patches or throughout the scalp The missing hairs can be broken off or just fall out The medical term for hair loss is alopecia Causes Common causes of hair loss are listed below. Most don't usually require medical treatment. Ringworm of the Scalp. This is the main cause of patchy hair loss that needs medical treatment. Your child's doctor will prescribe a medicine to treat ringworm of the scalp. It's taken by mouth. Newborn Hair Loss. The hair of many newborns falls out during the first few months of life. This baby hair is replaced by permanent hair. Rubbing or Friction. Babies can rub off a patch of hair on the back of the head. This most commonly occurs in infant 3 to 6 months old. It is a result of friction during head-turning against a firm surface. Examples are crib mattresses, playpens, and infant seats. The hair grows back once the baby starts sitting up. Also called friction alopecia or pressure alopecia. Repeated or severe friction can cause hair loss at any age. Tight Hair Styles. If hair is pulled too tight, it will eventually break. Mostly seen with tight braids, pony tails or dreadlocks (especially corn row styles). Hair can also be lost because of vigorous hair-brushing or back combing. Hot hairstyling tools can also cause hair damage. Also known as traction alopecia, mechanical alopecia, or "hair abuse." Twisting or Pulling Out the Hair. This is a nervous habit called trichotillomania. Frequent twisting of the hair results in broken hairs of different lengths. The missing hair occurs in patches of different shapes. This creates bald spots. Rarely, it can include plucking of the eyebrows or eyelashes. Can occur with nail biting, lip biting or sucking, and sore picking habits. In older children, may be associated with OCD. Stress. Hair follicles are very sensitive to physical or emotional stress. The hair begins to fall out about 3-4 months after a severe stress. Reason: Hair follicles are very sensitive to physical or emotional stress. Examples are a high fever, severe illness or surgery. Also, an emotional crisis or a crash diet can be triggers. In pregnant teens, the stress can be childbirth. After hair stops shedding, the hair will slowly grow back. This can take 6 to 8 months for all the hair to grow back. The whole cycle takes about 12 months. This type of hair loss is called telogen effluvium. When To Call Call Doctor or Seek Care Now Your child looks or acts very sick You think your child needs to be seen, and the problem is urgent Call Doctor Within 24 Hours Scalp is red and very swollen in area of hair loss You think your child needs to be seen, but the problem is not urgent Call Doctor During Office Hours Scabs or crusts are present in the hair Ringworm of the scalp suspected. (Round patch of hair loss with scales, rough surface, redness or itching) Broken hairs from tight hair style and pimples are present in scalp Patch of hair loss and cause not known Widespread hair thinning and cause not known Hair loss from nervous habit of twisting the hair (needs counseling) Hair loss is a chronic problem Normal hair loss suspected, but doesn't grow back within 6 months You have other questions or concerns Self Care at Home Newborn normal hair loss in infancy Hair loss on back of head from chronic rubbing and friction Hair loss from tight hair style Widespread hair thinning follows a major stress about 3 months ago Care Advice Newborn Normal Hair Loss in Infancy What You Should Know About Newborn Normal Hair Loss: Newborns are born with varying amounts of hair. The baby hair of many newborns falls out during the first 6 months of life. Hair loss peaks at 3 months old. The mother may also lose some of her hair at this time. This baby hair is then replaced by permanent hair. The normal hair comes in between 6 and 12 months. This shedding phase in newborns is always normal. Hair loss is not caused by shampoos. Call Your Doctor If: Hair does not grow back by 12 months old You have other questions or concerns Hair Loss on Back of Head from Chronic Rubbing and Friction What You Should Know About Rubbing Off Hair on Back of Head: Babies can rub off a patch of hair on the back of the head. This most commonly occurs in infant 3 to 6 months old. The hair loss is from friction during head-turning against a firm surface. Examples are crib mattresses, playpens, activity mats and infant seats. The hair grows back once the baby starts to sit up. This may take 6 to 12 months. Can also occur in any bedridden child (e.g., severe cerebral palsy). Treatment for Hair Loss from Friction and Too Much Time on Back: After 1 month old, give your baby more tummy time. Caution: Tummy time should always occur under adult supervision. Reason: Risk of suffocation until child reaches an age when can turn over. Tummy time has many benefits. It will help the back of head become more rounded and less flat. It will also build up strength in shoulder muscles. Call Your Doctor If: Hair does not grow back by 6 months after learning to sit You have other questions or concerns Hair Loss From Tight Hair Style What You Should Know About Hair Loss from Tight Hair Style: Symptoms: Broken hairs are seen at the hairline or where the hair is parted. It's usually the same on both sides of the head. Cause: If hair is pulled too tight, it will eventually break. This gives a frizzy look from hairs broken off at various lengths. Examples: It's most commonly seen with tight braids, pony tails or dreadlocks. Hair can also be lost because of vigorous hair-brushing or back combing. Hot hairstyling tools can also cause hair damage. Can also occur during exercise while wearing head phones. Hair loss is not caused by shampoos. Treatment of Broken Hairs from Tight Hair Style: Change the hair style to one that doesn't put tension on the hair. If that is not acceptable, loosen the ponytail or braids. These hair styles are at risk if they feel tight or cause any pain. Outcome: If tight hair styles are avoided, the hair will return to normal. Warning: If tight braiding continues over 10 years, permanent hair loss can occur. Pimples in the Hair and on the Scalp: Cause: Most pimples are caused by blocked hair follicles. Treatment: Stop using any ointments or oils in the hair. Reason: they block the hair follicles. Stop any hair style that puts tension on the hair. Reason: damages the hair follicle and makes it prone to infection. Wash any ointment or greasy pomade off the scalp with soap and water. Antibiotic Cream: Apply an antibiotic cream to the pimples. Do not use ointment. Use it 2 times a day for 3 days. No prescription is needed. Outcome: Most pimples will clear up in 3 days. Call Your Doctor If: Hair does not grow back by 6 months after hair style changed You have other questions or concerns Widespread Hair Thinning Following Major Stress About 3 Months Ago What You Should Know About Hair Loss after Stress: Symptoms: Lots of hair is noticed in a comb or brush. The hair falls out from all parts of the scalp. This leads to major thinning of the hair, but no bald spots. Cause: Severe stressful event. Hair follicles are very sensitive to physical or emotional stress. Examples are a high fever, severe illness or surgery. Also, an emotional crisis or a crash diet can be triggers. In pregnant teens, the stress can be childbirth. Hair loss is not caused by shampoos. Time Frame: The hair begins to fall out about 3-4 months after a severe stress. It continues to fall out excessively over the next 3 or 4 months. After hair stops shedding, the hair will slowly grow back. This can take 6 to 8 months for all the hair to grow back. The whole cycle takes about 12 months. There's no way to hurry the process. The hair growth cycle needs to run its course. Here is some care advice that should help.