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Pediatric Care

Ear Infection

An ear infection can be unpleasant for anyone, especially a baby or toddler. Ear infections cause pain, irritability, and loss of appetite. Also, when your child has an ear infection, he or she will grab at the ears. Find out about the symptoms and solutions for pediatric ear infection.

Causes and Concerns

An ear infection (referred to as acute otitis media) occurs behind the eardrum in the middle ear. This type of illness is often called a middle ear infection. Many children, especially those under the age of 7 years, suffer from these types of ear infections. This type of illness causes pain and complications when left untreated. Because of a short Eustachian tube, children are more at risk.

In children, the Eustachian tube is horizontal, short, and soft. This tube should drain fluid from the eardrum area. When a child suffers from an allergy or even a cold, the tube swells and does not function properly. Air cannot get into the middle section of the ear, and this can create problems, as the air acts like suction cup and pulls in fluid. When the fluid becomes trapped in the middle ear, an ear infection develops. Once the fluid is trapped, bacteria and viruses can form which cause the infection.

Symptoms and Signs

There are a few different symptoms to look for if you believe your child is suffering from an ear infection. You may not even notice these, as signs of an ear infection are subtle in young children. The symptoms are:

  • Pulling or tugging at the ear
  • Holding the ear or scratching it
  • Irritability
  • Drainage from the ear that is thick and yellow
  • Fever
  • Ear Pain
  • Vomiting
  • Trouble sleeping
  • Trouble hearing
  • Loss of appetite

Solutions and Options

There are some things that you can do to avoid an ear infection in children. These are called preventive measures. You should keep the child away from areas where there is a lot of cigarette smoke, and you should not smoke around your child. Cigarette smoke can block the tube that goes to the ear, causing the child to get an ear infection. You can also prevent an ear infection by avoiding exposure to germs. Do not spend a prolonged period of time around a sick person, and always wash yours and your child’s hands.

There are two different way to approach treating an ear infection. Home treatment for an ear infection involves over the counter medication, such as Tylenol or Advil, to relieve the pain and decrease swelling. If you give a baby or small child these types of medicines, consult your doctor for the recommended dosage. If the symptoms persist, or the child develops a fever, you should consult a doctor.

Medical treatment for ear infections typically involves prescription antibiotics. If there is a risk of the child developing more serious complications, or if the child is extremely sick, the doctor may have to perform additional tests and treatment. In cases where the child has continuous ear infections, surgery may be performed to insert tubes into the ear to drain the fluid.

Tonsil Infection

A tonsil infection is also referred to as tonsillitis. Tonsillitis can happen to anyone at any age, and it is an inflammation of the tonsils (the lymph glands in the throat). Tonsillitis is typically caused from viruses or bacteria. Children occasionally get tonsil infections. Find out about the symptoms and solutions for a tonsil infection.

Causes and Concerns

Tonsillitis from bacteria and viruses occurs when the disease is transferred from person to person through the air, and it is highly contagious. In most cases, tonsillitis occurs from a viral source. Tonsillitis that is bacterial is often caused from Streptococcus bacteria (strep throat). This infection becomes a problem for the child if left untreated, as it leads to complications.

Symptoms and Signs

There are combinations of symptoms that occur with tonsillitis. The symptoms range from minor to severe, and the child can have just a couple symptoms or quite a few symptoms. These include:

  • Runny Nose
  • FeverHeadache
  • Sore Throat
  • Pain when Swallowing
  • White Patches on the Tonsils
  • Swollen Lymph Glands
  • Redness that appears on the Throat and Tonsils
  • Abdominal Pain
  • Coughing
  • Vomiting
  • Nausea

Solutions and Options

If you suspect that your child has tonsillitis, it is important to get it checked out by a pediatric throat specialist. The doctor will conduct a physical examination to verify whether or not the child has a tonsil infection. Since tonsillitis is contagious, it is important to seek medical care immediately. A doctor will diagnose tonsillitis based on the following:

  • Redness, swelling, discharge, or swollen glands
  • Inability to swallow, drooling, and muffled speech
  • Performing a swab test
  • Any abscesses on the tonsils

When treating tonsillitis at home, you can give the child over the counter pain medications such as Tylenol or Advil. These medicines will help with any associated fevers and throat pain. Gargling warm salt water in the back of your throat will also help ease the pain of your child’s sore throat. Treatment of tonsillitis medically is through antibiotics and sometimes even surgery. It is important to follow proper instructions for the medications and to give the correct dosage. If any abscesses form on the tonsils, the doctor may perform a procedure to drain this, open the airway, and to prevent infection. Surgical removal of the tonsils is required when a child has reoccurring tonsil infections in a given time period.

Tonsillitis can be prevented by following proper care. Encourage your child to wash his or her hands frequently to prevent the bacteria and viruses from spreading. If you know someone who has tonsillitis, it is recommended that you limit your interactions with them, as it can be spread through the air.

Also, it is essential to your child’s health to keep follow up appointments and checkups. Even if the symptoms go away completely, or you child feels perfectly fine, he or she must take all of the prescribed antibiotics. Once your child is on antibiotics, he or she is no longer contagious after 24 hours and can return to all normal activities. As with any other sickness, if your child starts to feel worse or the symptoms get worse, contact your doctor.

Airway Problems

In children, airway problems are commonly caused from reflux of undigested food and secretions from the stomach. This condition is often difficult to diagnose, as typical symptoms are not always clear in children. This condition is called laryngopharyngeal reflux (LPR) or gastroesophageal reflux (GER). Find out about the symptoms and solutions for airway problems.

Causes and Concerns

LPR and GER in children are similar to the adult forms of the condition. These airway problems occur when the lower esophageal sphincter relaxes. This can cause acid and digested food from the stomach to come back up into the mouth. Children are more prone to LPR and GER, because the meal volume tends to be larger than the gastric volume.

For young babies and infants, these airway problems occur from an undeveloped ring of muscle at the bottom of the esophagus. This muscle is a sphincter, and it keeps the fluid from coming back up into the throat, nasal cavity, and mouth. When it is not fully developed, it does not adequately function.

If LPR and GER are left untreated, they can cause serious complications. Reflux esophagitis, acquired from untreated airway problems, is an adverse effect of persistent GER or LPR. Pneumonia and respiratory problems develop and cause life threatening problems for the child. It is important to seek treatment for your child as soon as you suspect these problems.

Symptoms and Signs

For young babies, LPR and GER may not be evident, as symptoms and signs are not always so obvious. Consider bringing your child in to see one of our caring pediatric airway specialists if you notice any of the following:

  • Vomiting
  • Hoarseness
  • Breathing difficulties
  • Swallowing difficulties
  • Weight loss
  • Loss of appetite
  • Recurrent regurgitation
  • Abdominal pain
  • Sleeping problems
  • Respiratory problems

Solutions and Options

Believe it or not, LPR and GER are often left undiagnosed in children. Early diagnosis and treatment is the only way to prevent complications. The main goal of therapy is to provide relief for the child, to prevent complications, and to cure existing disease. In some cases, children may need to be put on medications to manage the airway problem symptoms.

If you suspect your child has LPR or GER, be sure to keep him or her in an upright position after each feeding for at least 30 minutes. Proper burping and mouth care are also important. Also, avoid giving young children spicy or fried foods, as these contribute to the problem.

Down Syndrome

Down syndrome is a genetic disorder which leads to cognitive impairment. People with Down syndrome have learning difficulties, low muscle tone, and distinctive facial features. It was not until 1959 that the cause of Down syndrome was actually found. Down syndrome is fairly common, occurring in 1 in 800 babies.

Causes and Concerns

Down syndrome is a disorder that occurs from an extra chromosome (chromosome 21). The extra chromosome can come from either parent, but it is typically inherited from the mother. It is unknown what actually causes an extra chromosome, but scientists do know that the mother’s age is a big factor. The only risk factor that is known for Down syndrome is the age of the mother at the time of conception. When a mother is older, the risk of Down syndrome increases exponentially.

Symptoms and Signs

When babies are born with Down syndrome they usually do not develop as fast as other children, and they typically do not reach the average height of other children their age. There are some common distinguishing features of those with Down syndrome. Some of these features include:

  • Small mouth
  • Small ears
  • Upward slanting eyes
  • Protruding tongue
  • Flattened nose

There are a number of medical conditions that can occur in people with Down syndrome. Around 50% of children with Down syndrome have heart defects. Children born with Down syndrome are at a higher risk for developing certain types of leukemia and testicular cancers. Common illness include: frequent ear infections, hearing loss, constipation, obesity, dementia, and seizures. Ear, nose, mouth, and throat symptoms for children with Down syndrome include:

  • Difficulty breathing
  • Coughing
  • Wheezing
  • Nasal drainage and congestion
  • Earache

Solutions and Options

Unfortunately, there is no treatment for Down syndrome at this time, even though there is an understanding of the genetic cause. Research is ongoing, as scientists are constantly investigating the disorder. If your child has breathing problems, ear infections, or throat conditions related to Down syndrome, consider an evaluation with one of our pediatric Down syndrome specialists.

When babies are born with heart defects and also gastrointestinal problems, they may have to undergo surgery at some point to try and correct the problem. Also, regular checkups and screenings with a Down syndrome pediatric healthcare provider helps cut down on complications. Additionally, physical therapy and other interventions improve the outcome for children with this condition.

Allergy and Sinus

Allergy and sinus problems can lead to sinusitis, upper airway infections, persistent allergies, and asthma in children. Asthma is a condition that can be life threatening for your child. There are many other causes of allergy and sinus problems in children. Find out about the symptoms and solutions for allergy and sinus conditions.

Causes and Concerns

Sinusitis is caused from infection of a viral or bacterial nature. When allergies are left untreated, children are at risk for developing this condition. Asthma occurs when the airways swell leading to breathing difficulties. Swelling and inflammation of the airways can make it difficult for air to get to and from the lungs. Flareups are called asthma attacks, and they occur when the airway becomes restricted, or when the lung components swell and become tight.

Some children only experience sinus and airway symptoms during allergy season, when the pollen count is high. Allergies are triggered by pet dander, cock roaches, mold, mildew, and pollen. Some children experience allergy symptoms on a regular basis from persistent allergies.

Symptoms and Signs

Sinus and allergy symptoms vary from child to child. If you notice any of these signs, consider consulting one of our pediatric allergy and sinus specialists. It is important to treat these symptoms early to prevent complications. Some of the symptoms include:

Itchy, watery eyesNasal drainage and congestionWheezingFatigue during physical activityCoughingTight feeling in the chestTrouble sleepingWheezingShortness of breath

Solutions and Options

Allergy and sinus problems can be diagnosed by a number of ways. Your child will first need to have an examination by the doctor to determine the possibility of asthma, sinusitis, upper respiratory infection, or persistent allergies. If the doctor suspects that your child has one of these conditions, he or she will conduct tests to further evaluate.

Allergy testing determines whether or not the symptoms are from a reaction to an allergen. Spirometry is a test for asthma, and it is conducted in children older than 5. It will measure how much air is flowing through the lungs and the pulmonary function. The doctor may also perform x-rays if a sinus or lung infection is suspected.

When the doctor determines the cause of your child’s allergy and sinus symptoms, he or she can then implement at treatment plan. Options include allergy desensitizing shots, medications, antibiotics, and breathing treatments. If your child has persistent allergy or sinus symptoms, it is an indication of an underlying medical condition.


Asthma in children is a condition that can lead to serious complications. Asthma can be diagnosed by a pediatric asthma specialist, and there are many treatment options available. Find out about the symptoms and solutions of asthma.

Causes and Concerns

Asthma is a condition that makes it hard for your child to breathe due to swelling and inflammation or the airway structures. Airways become tight and narrow during an asthma attack, leading to breathing difficulty as air is unable to pass through the lungs. Attacks can also range in severity from a minor to severe. While the cause of asthma is unknown, there are things that put your child at risk for developing this condition. These include:

  • Heredity: Usually runs in the family
  • Allergies: Associated with this condition
  • Environment: Pollution and other factors

Symptoms and Signs

If you suspect your child has asthma, you should consider scheduling an appointment with one of our caring pediatric asthma specialists. There are a few different symptoms related to asthma, and these can become worse at night and during allergy season. These include:

  • Coughing
  • Trouble sleeping
  • Wheezing
  • Fatigue during physical activity
  • Tightness in the chest
  • Shortness of breath
  • Loss of appetite
  • Weight loss

Solutions and Options

A doctor can diagnose asthma by examining the child and performing some tests. These tests will help the doctor determine the extent of the disease. Some of the tests are spirometry, X-rays, and allergy testing. Spirometry is a test that measures the air flow in and out of the child’s lungs. X-rays are often done to rule out infections. Also, allergy testing helps the doctor determine the allergen that is causing the symptoms.

Because asthma does restrict the airways, trouble breathing is a main symptom, and this can often scare the child. Asthma can be controlled long term, however, through the use of medications and an action plan. You track your child’s symptoms and progress through a chart, and report it to your doctor. It is typical for a child to be on a corticosteroid medication daily to help reduce the number and frequency of attacks.

Asthma can also be treated at the time of the attack. Asthma attacks are life threatening and require immediate medical attention. The doctor will prescribe a quick acting medication (albuterol) for your child to use during an attack.