Common Illnesses & Injuries

We have designed this page to answer general questions about common childhood health concerns and medications. If you have an urgent concern and the information provide here does not fit your child’s specific problem, please contact us by telephone at 865-483-5678 to speak to one of our nurses during normal business hours. After hours your call will be directed to one of the Children’s On-Call nurses who will return your call as soon as possible. For life-threatening emergencies (severe difficulty breathing, unconsciousness, seizures, or severe head injuries) call 911 immediately.

Mild abdominal pain in children is very common, and may be caused by viral illness, overeating, over-stimulation, or constipation. More severe abdominal pain, especially if accompanied by fever or vomiting, may be a sign of more serious illness such as appendicitis or urinary tract infections. Call the office for advice at 865-483-5678, if your child’s abdominal pain is severe and has persisted for longer than four hours, or fever/vomiting are present.

Constipation in infants and children refers to hard, painful bowel movements. Stools that are soft are normal, and may be as infrequent as every 2 or 3 days in normal, healthy infants and children. In toddlers and older children, constipation can usually be relieved by increased amounts of liquids in the diet, especially pear juice and prune juice, and by increased amounts of fruits and vegetables. For infants who have hard, painful stools, or in older children who do not improve with a change in diet, please call during office hours to talk with one of the nurses for further advice at 865-483-5678.

Excessive loss of body fluids through vomiting or diarrhea, combined with inadequate oral intake of fluids, can lead to dehydration in infants and small children. Signs of dehydration include infrequent urination (fewer than 3 times in 24 hours), dry lips and tongue, sunken eyes, and skin that has a “doughy” feel, or which remains tented up when gently squeezed between your thumb and forefinger. Lack of tears and saliva are also signs of dehydration. If you child appears to be dehydrated, please call the office for advice, at 865-483-5678.

Diarrhea is a common childhood condition usually caused by an intestinal virus. Frequent loose or watery stools may occur, accompanied by low-grade fever. If your child is otherwise well, taking fluids without vomiting and urinating at least once every eight hours, it is acceptable practice to continue feeding the child’s usual diet and expect the diarrhea to resolve in 3-4 days. In the toddler or older child it may be helpful to eliminate milk and other dairy products (which contain lactose) from the diet for a day or two. If diarrhea is accompanied by severe abdominal pain, high fever, or blood in the stool, please call the office at 865-483-5678.

Fever (any temperature above 100.4 degrees F) is usually a sign that your child’s immune system is responding to an infection of some kind. Most of these infections are cause by viruses and involve only mild signs of illness or discomfort. Most of these viral infections subside in 5-7 days, and for infants over six months of age and older children, on comfort care is necessary which includes fever-reducing medications.

If fever is accompanied by severe sore throat, headache, vomiting, diarrhea, rash, difficulty breathing, pain with urination, abdominal pain, or confusion, please consult those specific topics on this site or call to talk to one of our nurses at 865-483-5678.

Fever in an infant less than three months old may represent a serious infection. Call us immediately at 865-483-5678 for an urgent appointment. If we are not open please go to East Tennessee Children’s Hospital. Fever that appears after several days of cold symptoms may indicate a secondary bacterial infection-call us at 865-483-5678 to discuss your child’s symptoms and decide whether they need to be seen in the office.

Children often have headaches associated with viral infections, overheating, or mild dehydration. These headaches are usually brief and respond to comfort measures such as rest, fluids, and medications such as acetaminophen or ibuprofen. Headaches may also follow minor head injury and also respond to comfort measures.

If headaches are severe, or are accompanied by vomiting, fever, confusion, or stiff neck call our office as soon as possible at 865-483-5678 for advice. If your child develops a pattern of frequent or severe headaches, especially if they interfere with normal daily activities please call our office to arrange an evaluation.

The most useful medications for pain and fever are acetaminophen (Tylenol or Triaminic fever reducer) and ibuprofen (Motrin, Advil). However, we do not recommend the use of ibuprofen products prior to 6 months of age. The main difference between them is that acetaminophen should be given every 4-6 hours, and ibuprofen every 6-8 hours, which is more convenient at night.

Aspirin should never be used in children because of the risk of Reyes Syndrome, a rare and dangerous liver disease.

We do not recommend the use of over the counter cough and cold medicines in children less than 6 years of age because of the lack of benefit and the possibility of side effects.

Dosing guidelines:

Acetaminophen:
Infant drops (80mg per 0.8ml):
6-8 pounds:  0.4ml each 4-6 hours
9-11 pounds:  0.6 ml every 4-6 hours
12-17 pounds:  0.8 ml every 4-6 hours
18-23 pounds:  1.2 ml every 4-6 hours
24-30 pounds:  1.6 ml every 4-6 hours

Children’s Suspension (160 mg per teaspoon):
24-30 pounds 5 ml or 1 teaspoon every 4-6 hours

Follow dosing instructions on label for other weights

Ibuprofen (Advil, Motrin):
We do not recommend using Ibuprofen products prior to 6 months of age!
Infant drops (50mg per 1.25 ml)
11-17 pounds:   1 dropper=1.25ml every 6-8 hours
18-22 pounds:   11/2 dropper=1.875ml every 6-8 hours

Children’s Suspension (100mg per teaspoon)
11-17 pounds    2.5ml=1/2 teaspoon every 6-8 hours
18-22 pounds    3.8ml=3/4 teaspoon every 6-8 hours
23-30 pounds     5ml=1 teaspoon every 6-8 hours

Follow dosing instructions on label for other weights.

Most rashes in infants and children accompany mild vial infections and look like scattered red dots and bumps that are not itchy or painful. Rashes occasionally are a sign of a serious infection-specifically rashes that are purplish, do not disappear with pressure from a finger, and are accompanied by fever and/or headache. Call our office immediately at 865-483-5678 if you observe a purplish rash. Some rashes can be diagnosed over the telephone. If a rash persists for a week or more, or happens while on a medication please call to make an appointment to be seen.

Most sore throats in children are mild and are caused by viruses that last 3-4 days before resolving on their own. Comfort measures include cool liquids, bland foods, and appropriate doses of pain medications such as acetaminophen or ibuprofen. More severe infections in children over 12 months of age can be caused by the Streptococcus bacteria (“strep throat”). Clues that your child’s sore throat might be due to strep are sudden onset, headache, abdominal pain, enlarged tonsils, and pain that remains the same throughout the day. Typical cold symptoms such as runny nose and cough are usually absent. Occasionally a fine red bumpy feeling rash may occur under the arms, on the trunk and in the groin. If you suspect your child may have strep throat please call 865-483-5678 to make an appointment to be seen and tested.

Pain with urination is commonly accompanied by fever, frequent urination, and abdominal or back pain. These symptoms often indicate a urinary tract infection, and should be evaluated in the office within 24 hours. Call 865-483-5678 for an appointment during business hours and in the meantime comfort measures such as pain relievers and increase intake of fluids may be helpful.

Vomiting in children commonly occurs in the early stages of an intestinal viral infection and may also be a sign of food poisoning.  Vomiting may also be a sign of rare but serious conditions such as intestinal obstruction or appendicitis.  If your child is NOT vomiting green material (bile) and does NOT have a high fever or severe abdominal pain, it is safe to try comfort measures for the first six hours at home.  After the stomach is empty and hour child’s vomiting has ceased for two hours, begin rehydration using small amounts of clear liquids such as Pedialyte (our first choice for infants) or Gatorade.  Offer these every 5-10 minutes while your child is awake, gradually increasing the amounts.  If your child is breastfeeding you may resume nursing, but try limiting the duration and increasing the frequency of nursing.

If vomiting is bile-colored (lime-green) or persists for longer than six hours, or is accompanied by high fever, severe abdominal pain, or signs of dehydration, please call the office at 865-483-5678 to speak with one of the nurses.

When vomiting has ceased for 6 hours and your child is tolerating clear liquids, is should be safe to begin feeding your child small amounts of bland foods.  These can include rice, white bread, white potatoes, pasta, Jell-O, soy milk, or soy formula.  Observe this diet for 36-48 hours, and then resume your child’s regular foods.