Routine health supervision enhances the optimal physical, intellectual and emotional, and social growth of your child. It is very important that your child have regular well-child examinations, evaluations, and immunizations. The Pediatric Nurse Practitioner also sees babies and children for routine well-child and selected sick visits at the University Medical Center and 1^st Avenue offices.

Schedule for Well-Child Evaluations 

Schedule for Immunizations and Routine Lab Tests

The immunization schedule is somewhat flexible and may be individualized at times to meet your, and your child’s needs.

Age Immunization

Taking Your Baby Out Into Their New World

We know you are anxious to introduce your baby to your family and friends. But, the more people your baby has contact with, the greater the chance that your baby can become sick. Here are a few guidelines.

1. Do not take your new baby to public places, such as restaurants, stores, malls, church, etc., until your baby is 4-6 weeks old.

2. Avoid large family gatherings, either at your home or away from home, 
    until your baby is 4-6 weeks old.

3. Avoid having many visitors at your home until your baby is 4-6 weeks old.

4. Try to keep your baby away from anyone who is presently or has recently been sick
    (colds, flu, infections, etc.).

5. Do not be afraid to take your baby outside for walks or drives ... the fresh air is good for your baby.

    Dress the baby in the same amount of clothing that you would wear depending on the temperature.

FEVER

Fever is common with most childhood illnesses. Normal oral body temperature is about 98.6^oF. Rectal temperatures run about one degree higher and axillary (underarm) temperatures run about one degree lower. Morning temperatures may run about ½ degree lower and afternoon/evening temperatures run about ½ degree higher. This is normal.

Taking a Rectal Temperature

1. Using a thermometer (glass or digital) with a stubby bulb 

2. Place your infant on his or her stomach or back.

3. Shake down mercury in thermometer if using a glass thermometer

4. Put on disposable probe cover if using a digital thermometer

5. Lubricate bulb of the thermometer with Vaseline or A & D Ointment.

6. Put thermometer into rectum only until the bulb is completely covered.

7. Hold in place 3 minutes while holding your infant still. Do not leave infant.

8. Remove it and read it.

Taking an Axillary Temperature

1. Use either a rectal, oral, or digital thermometer.

2. Place your infant on his or her back.

3. If using a glass thermometer, shake down mercury.

4. Put a disposable probe cover on disposable thermometer.

5. Baby’s armpit should be dry.

6. Put the bulb of the thermometer in deepest part of baby’s armpit and hold baby’s arm snug against his or her body.

7. Hold in place 3-4 minutes.

8. Remove thermometer and read it.

Oral (slim and long bulb) Normal Oral Temperature 37.0^oC/98.6^oF
Rectal (round and short bulb) Normal Rectal Temperature 37.6^oC/99.6^oF

Reading A Glass Thermometer

1. Hold the thermometer at eye level. Turn it until you see the scale markings on the top and numbers on the bottom.

2. Bring it down slightly below eye level and turn it slowly. You will see a shining band.

3. Read the number at the end of the band, this is the temperature.

Care Of A Glass Thermometer

1. To clean a glass thermometer, draw it through a soapy cotton ball or tissue.

2. Rinse in cool water.

3. Shake it, so the temperature reading is less than 96^o.

4. Store in a safe place, out of the reach of children.

Methods To Control Fever

1. Slight elevations of temperature (100^o-101^o) are common with colds and other mild infections. This can usually be treated with aspirin-free preparations (acetaminophen, such as Tylenol, Tempra, Panadaol, etc.). (See the dosage chart below).

2. Dress the child loosely. Do not wrap in blankets or heavy clothing.

3. Give cool liquids frequently. This helps bring the temperature down and prevents dehydration.

4. For temps of 104^o or greater after acetaminophen is given, bathe the child in a tub of regular bath water. Use a washcloth and wash gently form head to toe. Do this for about 20-30 minutes, then recheck the temperature. Do not add alcohol to the water or have the temperature of the water too cool.

Call Us If Your Child:

1. is under 3 months of age and has an axillary temperature reading of 100^.4o or a rectal temperature greater than 101^.4o.

2. is not helped by the fever control measures listed above.

3. does not urinate for 8 hours or longer.

4. develops a rash with a fever.

5. is very drowsy or difficult to awaken.

6. has a seizure (stiffening of the arms, unusual shaking, or temporary loss of consciousness).

Acetaminophen Dosage:

PLEASE NOTE: This chart is for acetaminophen preparations supplied as:

Drops:    Each 0.8 ml dropper contains 80 mg (1.23 grains) acetaminophen.

Syrup:    Each 5 ml teaspoon contains 160 mg (2.46 grains) acetaminophen.

Chewables:    Each tablet contains 80 mg (1.23 grains) acetaminophen.

Adult Tablets:    Each tablet contains 325 mg acetaminophen.

If you are using another preparation, check the package directions, ask your pharmacist, or call the office for the specific dosage. If your child’s age and weight are on different lines, choose the dosage based on weight.

Dosage may be given every 4 hours as needed but not more than 5 times daily.

 Suctioning With Bulb Syringe

Suctioning mucus out of the baby’s nose makes it easier for the infant to breathe in and out. Only use suction when something is blocking the nose or mouth and baby is having difficulty breathing. Always use saltwater drops in nose when suctioning with bulb syringe. You can either buy saltwater drops (saline) or make your own by dissolving 1/4 tsp. table salt in ½ cup warm water. If you are unable to get the baby’s nose or mouth cleared and your infant is having difficulty breathing, call the office.

1. Position infant by turning head to the side being suctioned.

2. Squeeze the air out of the bulb.

3. Drop 1-2 drops of saltwater into a nostril with a medicine dropper.

4. Gently place the end of the bulb into a nostril.

5. Let air come back into the bulb. 
The suction will pull the mucus out of the nose and into the bulb.

6. Squeeze mucus out of the bulb onto a tissue.

7. Repeat on other nostril and mouth (position head to other side).

8. Gently wipe off the mucus around the nose with tissues to prevent skin irritation.

9. Wash the bulb syringe in cool soapy water. Squeeze the bulb several times to clean out the mucus. Rinse with clear water.

10. Discard any homemade saltwater after 24 hours.

You Should Call During Regular Office Hours If Your Baby Has:

1. a rash that looks pustular or infected - some rashes are common for infants and will pose no problem with your baby’s health

2. fever (temperature greater than 100^o in the first three months of life; 101^.4o in the first 3 months of life; 101 or greater after 3 months of age). 

3. weight loss or dehydration (dry mouth, no tears, sunken soft spot, decreased urination).

4. any signs of infection.

5. hard stools.

6. excessive tearing or drainage from the eyes.

7. excessive irritability, sleepiness, or poor feeding.

8. any other health concerns.