Tag Archives: causes

Abdominal Pain

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Definition:

* Pain or discomfort located between the bottom of the rib cage and the groin crease.

* The older child complains of a stomachache.

* The younger child should at least point to or hold the abdomen.

Causes:

* Indigestion: Indigestion or overeating causes many mild stomachaches.

* Gastroenteritis: A viral infection of the intestines causes stomach cramps as well as vomiting or diarrhea.

* Food Poisoning: Severe vomiting or diarrhea lasting fewer than 12 hours is often caused by bacterial overgrowth in unrefrigerated foods.

* Constipation: The need to pass a stool causes lower abdominal cramps.

* Strep: Strep throat causes up to 10% of acute abdominal pain.

* Serious Causes: These include appendicitis, kidney infections, and intussusception. Suspect appendicitis if pain is low on the right side, the child walks bent over, the child won’t hop or jump, and the child prefers to lie still.

* Stress: The most common cause of recurrent stomachaches is stress (commonly called the “worried stomach”). More than 10% of children have them. These children tend to be sensitive, serious, conscientious, even model children. This can make them more vulnerable to the normal stresses of life, such as changing schools, moving, or family disagreements. The pain occurs in the pit of the stomach or near the belly button. The pain is mild but real.

Call 911 Now (Your Child May Need an Ambulance) If: Not moving or too weak to stand

Call Your Doctor Now (or in Alberta, Canada call 780-408-LINK) If:

* Your child looks or acts very sick

* You suspect poisoning with a plant, medicine, or chemical

*Unable to walk or walks bent over holding the abdomen

* Pain mainly low on the right side

* Pain or swelling in the scrotum or testicle (male)

* Could be pregnant (female)

* Severe pain anywhere

* Constant pain (or crying) present longer than 2 hours

* Blood in the stool or vomiting blood

* Vomiting bile (bright yellow or green)

* Recent injury to the abdomen

* Child is younger than 2 years

* Fever above 104°F (40°C) and not improved 2 hours after fever medicine

Call Your Doctor Within 24 Hours (Between 9:00 am and 4:00 pm) If:

* You think your child needs to be seen

* Mild pain that comes and goes (cramps) lasts longer than 24 hours

* Fever is present

Call Your Doctor During Weekday Office Hours If:

* You have other questions or concerns

* Abdominal pains are a recurrent chronic problem

Parent Care at Home If: Mild abdominal pain and you don’t think your child needs to be seen

Home care advice for mild abdominal pain:

1. Reassurance:

* A mild stomachache can be caused by something as simple as gas pains or overeating.

* Sometimes a stomachache signals the onset of a vomiting or diarrhea illness from a virus (gastroenteritis). Watching your child for 2 hours will usually tell you the cause.

2. Rest: Encourage your child to lie down and rest until feeling better.

3. Clear Fluids: Offer clear fluids only (eg, water, flat sofy drinks, half-strength Gatorade). For mild pain, offer a regular diet.

4. Prepare for Vomiting: Keep a vomiting pan handy. Younger children often refer to nausea as a stomachache.

5. Pass a Stool: Encourage sitting on the toilet and trying to pass a stool. This may relieve pain if it is caused by constipation or impending diarrhea. (Note: for constipation, sitting in warm water may relax the anus and help release a stool.)

6. Avoid Medicines: Any drug (especially ibuprofen [eg, Advil]) could irritate the stomach lining and make the pain worse. Do not give any pain medicines or laxatives for stomach cramps. For fever above 102°F (39°C), acetaminophen (eg, Tylenol) can be given.

7. Expected Course: With harmless causes, the pain is usually better or resolved in 2 hours. With gastroenteritis (stomach flu), belly cramps may precede each bout of vomiting or diarrhea and last several days. With serious causes (eg, appendicitis), the pain worsens and becomes constant.

8. Call Your Doctor If:

* Pain becomes severe

* Constant pain present longer than 2 hours

* Mild pain that comes and goes present longer then 24 hours.

* Your child becomes worse

9. Worried Stomach, Extra Advice:

* Help your child talk about events that trigger abdominal pain and how to cope with these triggers next time.

* Help your child worry less about things he can’t control.

* Teach your child to use relaxation exercises (relaxing every muscle in the body) to treat the pain. Lie down in a quiet place; take deep, slow breaths; and think about something pleasant. Listening to CDs or audiotapes that teach relaxation might help.

* Teach your child the importance of getting adequate sleep.

* Make sure that your child doesn’t miss any school because of stomachaches. Stressed children have a tendency to want to stay home when the going gets rough.

* CAUTION: Your child should have a complete medical checkup before you conclude that recurrent stomachaches are caused by worrying too much.

Based on recommendations/advice in “My Child is Sick; Expert Advice for Managing Common Illnesses and Injuries”, 14th Edition, by Barton D. Schmitt

Hives

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Definition: An itchy rash made up of raised pink spots with pale centers

Symptoms

* Raised pink bumps with pale centers (welts).

* Hives look like mosquito bites.

* Sizes of hives vary from ½ inch (12 mm) to several inches (cm) across.

* Shapes of hives are variable and change repeatedly.

* Itchy rash.

Causes:

* Widespread hives usually are caused by a viral infection. They can also be an allergic reaction to a food, a drug, an infection, an insect bite, or other substances. Often the cause is not found. Hives from foods usually resolve in 6 hours.

* Localized hives are usually caused by skin contact with plants, pollen, food, or pet saliva. Localized hives are not caused by drugs, infections, or swallowed foods.

Call 911 Now (Your Child May Need an Ambulance) If:

* Difficulty breathing or wheezing

* Hoarseness or cough with rapid onset

* Difficulty swallowing, drooling, or slurred speech with rapid onset

* Severe life-threatening allergic reaction in the past to similar substance

Call Your Doctor Now (Night or Day) If:

* Your child looks or acts very sick

* Hives began after a bee sting, medicine, or high-risk food (eg, peanuts, fish), and no previous reactions

* Child younger than 1 year with widespread hives

Call Your Doctor Within 24 Hours (Between 9:00 am and 4:00 pm) If

* You think your child needs to be seen

* Severe hives (eg, eyes swollen shut, very itchy) not improved after second dose of Benadryl

* Fever or joint swelling is present

* Abdominal pain or vomiting is present

Call Your Doctor During Weekday Office Hours If:

* You have other questions or concerns

* Hives interfere with school or normal activities after taking Benadryl every 6 hours for more than 24 hours

* Food suspected as cause

* Hives have occurred 3 or more times and cause is unknown

* Hives last more than 1 week

Parent Care at Home If:

* Hives with no complications and you don’t think your child needs to be seen

Home care advice for hives:

1. Localized Hives

* For localized hives, wash the allergic substance of the skin with soap and water.

* If itchy, massage the area with a cold pack or ice for 20 minutes.

* Localized hives usually disappear in a few hours and don’t need Benadryl.

2. Benadryl for Widespread Hives

* Give Benadryl 4 times per day for widespread hives that itch (no prescription needed)

* If you only have another antihistamine at home (but not Benadryl), use that.

* Continue Benadryl 4 times per day until the hives are gone for 12 hours.

* Contraindication: Child is younger than 1 year (Reason: Benadryl is a sedative). Give your doctor a call for advice.

3. Food-Related Hives

* Foods can cause widespread hives.

* Sometimes hives are isolated to just around the mouth.

* Hives from foods usually are transient and gone in less than 6 hours.

4. Cool Bath: Give a cool bath for 10 minutes to relieve itching (CAUTION: Avoid causing a chill). Rub very itchy areas with an ice cube for 10 minutes.

5. Remove Allergens: Give a bath or shower if triggered by pollens or animal contact. Change clothes.

6. Avoid Allergens: If you identify a substance that causes hives (eg, a food), help your child avoid that substance in the future.

7. Contagiousness

* Hives are not contagious

* Your child can return to child care or school if the hives do not interfere with normal activities.

* If the hives are associated with an infection, your child can return to school after the fever is gone and your child feels well enough to participate in normal activities.

8. Expected Course: Hives from a viral illness normally come and go for 3 or 4 days, then disappear. Most children get hives once.

9. Call Your Doctor If :

* Severe hives persist after second dose of Benadryl

* Most of the itch is not relieved within 24 hours on continuous Benadryl

* Hives last more than 1 week

* Your child becomes worse

Based on recommendations/advice in “My Child is Sick; Expert Advice for Managing Common Illnesses and Injuries”, 14th Edition, by Barton D. Schmitt

Crying

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Definition:
Excessive crying, irritability, or fussiness in a child 3 months or older.
Child is too young to tell us or show us the cause for his crying. Crying is the only symptom.
If your child is crying from an illness or physical symptom, use that symptom checker instead of this one.

Causes:
Not caused by hunger—by this age, you should be able to recognize hunger. Main Cause: Coming down with an illness. Other Common Causes: * Overtired, stressed, whining, tantrums, and separation anxiety. * Always consider pain as a possible cause of persistent fussiness or crying. Inconsolable crying may be the only symptom initially in a young child with an ear infection or even appendicitis. * Painful causes include earache, blocked nose from a cold, sore throat, mouth ulcers, raw diaper rash, metal ulcer on tip of penis, constipatio, and hair wrapped around toe (take off socks and check).

Call 911 Now (Your Child May Need an Ambulance): If Not moving or very weak

Call Your Doctor Now (or in Alberta, Canada call 780-408-LINK):

* IF Your child looks or acts very sick

* Stiff neck or bulging soft spot

* Possible injury (especially head or bone injury)

* Very irritable, screaming child for longer than 1 hour

* You are afraid you or someone might hurt or shake your baby

* Your child cannot be comforted after trying this advice for 2 hours

* Crying interferes with sleeping for longer than 2 hours

Call Your Doctor Within 24 Hours (Between 9:00 am and 4:00 pm)

* If you think your child needs to be seen

* Pain (eg, earache) suspected as cause of crying

Call Your Doctor During Weekday Office Hours

* If you have other questions or concerns

* Mild, off-and-on fussiness (acts normal when not crying) continues more than 2 days

* Excessive crying is a chronic problem

Parent Care at Home If mild fussiness present fewer than 2 days and you don’t think your child needs to be seen

Home Care Advice for Mild, Consolable Crying:

1. Reassurance: Most infants and toddlers become somewhat irritable and fussy when sick or overtired. Crying tells us your child is not feeling well. If the crying responds to comforting, it’s probably not serious.

2. Comforting: Try to comfort your child by holding, rocking, or massaging her

3. Sleep: If your child is tired, put him to bed. If he needs to be held, hold him quietly in a horizontal position or lie next to him. Some overtired infants need to cry themselves to sleep

4. Undress Your Child: Sometimes part of her clothing is too tight or uncomfortable. Also check her skin for redness or swelling (eg, insect bite)

5. Discontinue Medicines:

* If your child is taking a cough or cold medicine, stop it

* The crying should stop within 4 hours

* Antihistamines (eg, Benadryl) can cause screaming and irritability in some children

* Pseudoephedrine (decongestant) can cause jitteriness and crying

6. Expected Course: Most fussiness with illnesses resolves when the illness does. Most fussiness caused by stress or change (eg, new child care) lasts less than 1 week

7. Call Your Doctor If:

* Constant crying lasts longer than 2 hours

* Intermittent crying lasts more than 2 days

* Your child becomes worse

Based on recommendations/advice in “My Child is Sick; Expert Advice for Managing Common Illnesses and Injuries”, 14th Edition, by Barton D. Schmitt