A to Z Resources

Attention Deficit Disorder

Starting the conversation about ADD/ADHD with your doctor:

If you suspect that your child’s inability to focus, distractibility, impulsiveness, or academic performance is not up to the mark, it can be a sign of Attention Deficit Disorder (ADD) or Attention Deficit Hyperactivity Disorder (ADHD). We advise you to consult Dr. Alappan if you have any concerns about ADHD.

Related Websites

https://chadd.org/

https://www.healthychildren.org/english/health-issues/conditions/adhd/Pages/default.aspx

Abdominal pain

Severe abdominal pain, especially if accompanied by fever or vomiting, may be a sign of a more serious illness such as appendicitis or urinary infection.

Call us during office hours if your child:

• has burning or pain with urinating.
• has reflux or heartburn symptoms.
• has pain that doesn’t go away in a few hours.
• has pain that is due to constipation (hard bowel movements), and you are not sure how to manage the constipation.
• has pain and you’re not sure what is causing it or how to manage it.

If your child has severe abdominal pain lasting more than four hours, accompanied by a fever or vomiting, Go to the ER immediately.

Related Websites

https://www.mayoclinic.org/symptoms/abdominal-pain/resources/sym-20050728?p=1

Anxiety

Anxiety is a condition characterized by excessive fears and worries that are disproportionate to the situation and interfere with normal daily activities. Children often experience distress and negative thinking and may try to avoid situations that trigger their anxiety.

Physical symptoms such as headaches and stomach aches may also be present. If your child is experiencing anxiety, we can provide resources to help you as a parent. It is recommended that you schedule an appointment with Dr. Alappan to discuss this further and rule out any other underlying conditions such as learning difficulties or sleep problems.

Download from AAP

https://dmx299.a2cdn1.secureserver.net/wp-content/uploads/2022/02/Anxiety.pdf

Related Website

https://www.cdc.gov/childrensmentalhealth/depression.html

Asthma

If your child has been prescribed an asthma inhaler or nebulizer and you suspect they require it now, administer it first and then contact us. If your child has previously been diagnosed with asthma and has been prescribed an inhaler or nebulizer medication, it is important to closely monitor their symptoms and be prepared in case of an asthma attack. If you notice your child is experiencing symptoms such as wheezing, coughing, or shortness of breath, it is important to administer their prescribed inhaler or nebulizer as soon as possible.

After administering the medication, closely observe your child’s breathing and monitor their symptoms to ensure they are improving. If their symptoms persist or worsen, contact us as directed in the provided instructions.

It is important always to have your child’s prescribed asthma medication with you and to ensure that it has not expired. Additionally, make sure that you and your child understand how to properly use the medication and any accompanying devices, such as inhalers or nebulizers.

Related Websites

https://www.mayoclinic.org/diseases-conditions/childhood-asthma/symptoms-causes/syc-20351507

Behavior Problems

Behavioral symptoms can manifest in various ways, such as anger, irritability, arguing, defiance, vindictive behavior, or violating the rights of others or societal norms. It is essential to note that these symptoms may be indicative of other conditions, such as depression, anxiety, or ADHD. Therefore, it is advisable to seek the help of a qualified doctor who can evaluate these symptoms further and provide appropriate treatment. Feel free to contact us if your child is experiencing behavior problems.

Related Websites

https://www.123magic.com/positive-parenting-solutions/1-2-3-magic

https://www.cdc.gov/childrensmentalhealth/behavior.html

https://childmind.org/article/common-causes-of-behavior-problems-in-kids/

https://nhbh.org/resources

Colds

Colds are common and usually involve a congested or runny nose, a cough, and a low-grade fever.  Sore throats are also common as are mild headaches and decreased energy.  A fever with a cold usually starts within 2 days of the onset of cold symptoms, usually spikes 2 or 3 times a day, and usually lasts 2-4 days.

Helpful home care for colds includes:

• offering small amounts of liquids frequently to keep your child well-hydrated.
• using a cool mist humidifier (without medication added)
• let your child breathe in a steamy bathroom before bed.
• if your child is over three months old and has a low-grade fever or mild discomfort, you may give them Tylenol (acetaminophen) by this dosing and schedule.
• if they are over 6 months, you may use Ibuprofen (Advil, Motrin) for fever or mild discomfort with this dosing and schedule.
• an infant may need occasional nasal saline drops to help open a stuffy nose. Mix 1/2 teaspoon of table salt in 1 cup of warm water. Use a dropper to put one drop of salt water in one nostril. Wait a few seconds. Your child may sneeze the salt water and mucous out, or you may gently suction with a bulb syringe.  Repeat on the other nostril.
• we do not recommend cold or cough medicine for children under the age of 6 years because of the risks of side effects and because they usually don’t help very much.

Related Websites

https://kidshealth.org/en/parents/cold.html

https://www.healthychildren.org/English/health-issues/conditions/ear-nose-throat/Pages/Children-and-Colds.aspx

Constipation

Constipation in infants and children refers to hard, dry, and painful bowel movements. Stools that are soft are normal, even if the frequency is days apart.

For toddlers and older children, constipation is very common and often causes abdominal pain. It can also become a long-term condition if it is not recognized and managed. Constipation in children can often be relieved by increased amounts of water, fruits, and vegetables in their diet. Certain fruits such as prunes, apples, and pears are especially helpful, as are whole grains.

We encourage you to make an appointment to discuss any constipation concerns that are not quickly resolved by dietary changes. Dr. Alappan can confirm the diagnosis, make more specific dietary recommendations, and discuss whether stool softeners are recommended.

Download from AAP

https://dmx299.a2cdn1.secureserver.net/wp-content/uploads/2022/02/Constipation.pdf

Cough

A cough caused by a respiratory virus typically lasts 2-4 weeks and can either be dry or wet. The cough reflex helps to protect and clear the lungs.

• If your child has asthma or wheezing
• If your child has a tight, barking, hoarse cough with a raspy noise when breathing in

Although medicines to control the cough reflex don’t work and can have harmful side effects, there are ways to soothe the airway and throat to help your child feel more comfortable.

• try a cool mist humidifier in the bedroom.
• try letting your child breathe in steam from a steamy bathroom before bed.
• try letting your child over age 4 suck on sugar-free cough drops.
• try giving your child over age 1 one teaspoon of honey. You may mix it with one teaspoon of warm water.

Download from AAP

Children 0-5

https://dmx299.a2cdn1.secureserver.net/wp-content/uploads/2022/02/Cough-Age-0-5yr.pdf

Ages 6-21

https://dmx299.a2cdn1.secureserver.net/wp-content/uploads/2022/02/Cough-Age-6-21yr.pdf

Croup

Croup is a viral respiratory infection that can cause a hoarse, barking cough in young children. At night, the child may experience difficulty breathing due to a harsh sound known as stridor. This sound is caused by swelling of the tissue that lines the windpipe near the vocal cords. Wrapping the child in a blanket and taking them outside to breathe in cool air can often provide quick relief from stridor and difficulty breathing.

• If your child is having severe difficulty breathing even outside, call 911.
• If your child still has trouble breathing or significant noisy and labored breathing after being outside for 10 -15 minutes, your child may need steroids or other treatment and should go to the closest emergency room.
• If your child’s noisy, labored breathing is resolved outside, keep the air cool and moist with a humidifier or an open window and contact us.

Download from AAP

https://dmx299.a2cdn1.secureserver.net/wp-content/uploads/2022/02/Croup.pdf

Depression

Depression is a mood disorder that can cause a child to feel sad, hopeless, cranky, or tired. It can also lead to changes in sleep, appetite, and weight, and affects how a child feels, thinks, and acts. A child with depression may struggle with normal activities and feel that life isn’t worth living. If you are concerned that your child may be experiencing depression, it is a good idea to schedule an appointment with Dr. Alappan.

Related Websites

https://www.psychologytoday.com/us/therapists/ga/columbus?category=depression

https://nhbh.org/resources

Diarrhea

Diarrhea in children is often caused by a viral infection in the intestines, leading to frequent loose and watery stools, as well as a 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. Keep in mind that there is no effective, safe medicine to treat diarrhea in children. Extra fluids and diet therapy work best.

Related Websites

https://www.healthychildren.org/English/health-issues/conditions/abdominal/Pages/Diarrhea.aspx

https://www.webmd.com/children/diarrhea-treatment

Fever

Fever is a signal that your child’s immune system is reacting to some form of infection. You can use any thermometer to take their temperature if your child is over three months old. A digital thermometer placed under their arm is acceptable and will provide a temperature reading that is within half a degree of their core temperature. Ear thermometers can give readings that are several degrees higher than your child’s actual temperature, making them the least reliable option.

Fever in an infant under 3 months may represent a serious infection, so it is important to have an accurate temperature for these babies.  Use a rectal thermometer for infants under 3 months.  For an infant under 3 months with a fever (100.4° F rectal or 38° Celsius) contact us immediately.

Most infections causing fever are caused by viruses and involve only mild signs of illness or discomfort. The fever is part of the body’s response to fight off the virus and is not harmful.  Children will often have fever up to 104° F (40° C) with a viral illness.  Typically fevers due to a virus will spike up and down 2 or 3 times a day for 3-5 days.  Fever can make children not feel well and not look well. If your child is uncomfortable, we recommend that you use a fever-reducing medication (Tylenol or ibuprofen).

Related Websites

https://kidshealth.org/en/parents/fever.html

https://www.choa.org/parent-resources/everyday-illnesses/what-to-know-about-fevers-in-kids

Head Lice

If you suspect or know your child has head lice, please visit headlice.org for detailed help.

Potty Training

Need help with potty training? Visit Kids Health for a great video to help you and your child.

Sleeping Challenges

Being a parent, whether new or experienced, can be challenging. One of the most common challenges is helping your child get a good night’s sleep. If you’re facing such issues, we’ve got a great resource that can help both you and your child sleep better. Click here to access it and get started.

Downloads from AAP

https://dmx299.a2cdn1.secureserver.net/wp-content/uploads/2022/02/Back-to-Sleep-Tummy-to-Play.pdf’

https://dmx299.a2cdn1.secureserver.net/wp-content/uploads/2022/02/Good-Sleep-Habits.pdf

Related Websites

https://www.preciouslittlesleep.com/

Recommended Reading

• Sleeping Through the Night, by Jodi Mindell, PhD
• Healthy Sleep Habits, Happy Child, by Weissbluth, MD

Sore Throat

Most children experience mild sore throats caused by viruses, which usually resolve within 3-7 days. Treatment includes cool liquids, bland foods, and appropriate pain medication doses of ibuprofen or Tylenol.

Infections caused by the Streptococcus bacteria (also known as ‘strep throat’) can be more severe in children over 18 months. If your child experiences sudden onset, headache, abdominal pain, fever, enlarged tonsils (which may be red or have white patches), red palate (roof of the mouth), and enlarged, tender lymph nodes on either side of the neck (known as ‘swollen glands’), it could be due to strep throat. It is important to note that typical cold symptoms such as runny nose or cough may not be present. Occasionally, a fine red rash with a ‘sandpapery’ texture may appear under the arms or in the groin.

Related Websites

https://www.health.harvard.edu/blog/the-sore-throat-checklist-what-parents-need-to-know-202109132586

 https://www.cdc.gov/groupastrep/diseases-public/strep-throat.html

Upper Respiratory Viruses

See Colds

Vomiting

Vomiting is a common symptom among children during the early stages of an intestinal viral infection, also known as “stomach flu”. However, it can also be a sign of food poisoning or rare but serious conditions such as intestinal obstruction or appendicitis. It is important to keep an eye out for any other symptoms and seek medical attention if necessary.

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 giving them very slow, clear fluids as described below. The child may initially vomit several times in quick succession as the stomach empties.

After the child’s initial vomiting has stopped for about an hour, begin rehydration using small amounts (1 to 2 teaspoons) of clear liquids such as Pedialyte (our first choice for infants) or 1/2-strength Gatorade or water. Offer these every 5 to 10 minutes while your child is awake. Continue giving a teaspoon every five minutes even if your child still vomits every couple of hours or less. If your child is breastfeeding, you may resume nursing, but try limiting the duration and increasing the frequency of nursing.

When vomiting has stopped for eight hours, and your child is tolerating 2 ounces of clear liquids at a time, it should be safe to begin feeding your child small amounts of food. Foods that are well-tolerated include carbohydrates such as rice, white bread, white potato, pasta (except whole wheat), jello, rice milk, soy milk, or soy formula. Observe this diet for 24-36 hours, and then resume your child’s regular foods.

Related Websites

https://kidshealth.org/en/parents/vomiting-sheet.html

https://www.mayoclinic.org/symptom-checker/nausea-or-vomiting-in-children-child/related-factors/itt-20009075

Wheezing

See Asthma and Croup