Frequent Questions

Click here to see the recommended vaccines for children from birth to the age of 6 years.

For children older than 6 Years old, click here.

This information is best viewed here.

Our Health Care Providers can help patients and families before a trip, whether it is for a vacation, a medical mission, or a visit to relatives in other countries.

For brief trips lasting less than 3 weeks, preparation between 4 to 6 weeks in advance is preferable and adequate.  However, for prolonged visits and travel to exotic locations in developing countries, the trip preparation should begin at least 2 months prior to departure.  A pre-travel medicine consult with the patient and families include discussion about food and water, precautions to prevent travelers’ diarrhea, safety whie traveling, vacations and malaria prevention, and review and refills of current medications.

A pre-travel appointment is a great opportunity to make sure that the children are up to date with routine immunizations.  The vaccinations may be accelerated for children with imminent departures or those behind in routine immunizations.

The next step is to provide itinerary specific vaccinations such as immunizations against yellow fever, hepatitis A, typhoid fever, Japanese encephalitis, meningitis.  Our office can direct you to appropriate travel clinics for yellow fever and Japanese encephalitis vaccines as our office do not carry these.

Because country requirements and epidemiology of various diseases frequently undergo changes, the CDC (Centers for Disease Control and Prevention) recommends consulting up to date sources of information and checking with the appropriate embassy or consulate prior to departure.

Parents are advised to closely monitor their child for illnesses both during and after travel.  Any illness in a returned traveler needs a thorough evaluation and examination.

Our Providers can help children and families navigate through all this information and prepare for a safe, fun, and enjoyable trip.

We advise parents to call our office for pre-travel consultation as soon as travel plans and destination are decided.

WEBSITES:

International Society of Travel Medicine:  www.istm.org

Centers for Disease Control and Prevention:  www.cdc.gov/travel

It is essential that you know the requirements of your individual insurance plan. If your insurance requires a referral, please call our referral department at 703-729-7652 ext. 202. Leave the following information: child’s name, spelling the last name, date of birth, date and time of the appointment, specialist’s name and the phone and fax numbers.

Allow 3 business days (72 hrs) for processing or we cannot guarantee a referral prior to your appointment. If you require prior authorizations, allow 5 to 7 business days.

Once your referral is complete, we will fax a copy to the specialist and mail a copy to your home address.

DO NOT see a specialist or have a diagnostic procedure performed before your referral is complete. Insurance companies require referrals prior to seeing the specialist and they do not allow our staff to back date a referral after a visit has taken place.

Acetaminophen can be given up to every 4-6 hours for fever or pain.

Please see this attached document for dosing recommendations. Or click this link.

Motrin can be given up to every 6-8 hours for fever or pain.

Please see this attached document for dosing recommendations.

Vomiting and diarrhea have many causes, the most common of which are viral gastroenteritis and other viral illnesses.  Vomiting and diarrhea can be problems because they can lead to dehydration, especially in young infants.  Signs of dehydration include 1) mouth dryness, 2) decreased urination (or no urine in over 8 hours), 3) lack of tears, 4) sunken eyes, and 5) lethargy or irritability.

What you can do at home: Try oral fluid replacement at the onset of your child’s illness.  For children who are vomiting, you may need to start very slowly and work your way up to larger amounts of fluid gradually.  For example, you could start giving fluids at the rate of at 1 teaspoon every 5 minutes, and if your child is tolerating that amount, then increase to 2 teaspoons, then 1 tablespoon, then 1 ounce until he/she is able to tolerate larger amounts of fluid without vomiting.  The best fluid to use is Pedialyte, because it replaces the electrolytes your child is losing without making diarrhea worse.  Plain water has no electrolytes or sugar, so it is not the first choice when your child is dehydrated.  If you child has diarrhea, please avoid very sugary liquids such as juice and soda, which can make diarrhea worse.

When to seek medical help: Please call our office or the on call service if your child’s symptoms are not improving or are worsening over the next several hours so that we can further guide you.  If your child’s dehydration is severe and you cannot get enough fluid into your child orally, your child will likely need to go to the emergency room for IV rehydration.  In addition, you should go straight to the emergency room if you notice blood or bile in your child’s vomit.

Cough is a natural reflex that occurs in response to mucus or other irritants in the airways and lungs.  There are many causes for cough, such as common colds, croup, allergies, and asthma attacks.  Cough can be either acute (less than 2 weeks duration) or chronic (greater than 2 weeks duration).  If your child has had a chronic cough, you should make an appointment at our office to further discuss causes and treatment.  If your child has an acute cough, continue reading for tips on management.

What you can do at home: Nasal saline drops with suctioning in young infants can help to reduce postnasal drip, thereby helping with mucus-induced coughing.  Repositioning your child into an upright or sitting position can help reduce cough.  You can also try a humidifier or vaporizer in your child’s bedroom.  If your child has a history of asthma or wheezing, you can try using a nebulizer or inhaler breathing treatment.  If your child is uncomfortable, you can give Acetaminophen or Ibuprofen to reduce the pain.  If the cough sounds like a barking seal, the cause may be croup, and you can try letting your child breathe in cold air from the freezer or steam from a hot shower.  We do not recommend cough medicines as they suppress the body’s natural reflexes and can result in worsening.

When to seek medical help: Please call our office or the on call service if your child is having any associated breathing problems, such as wheezing or rapid breathing, or if the cough is continuous.  Please go straight to the emergency room or call 911 if your child has any more serious signs of respiratory distress, such as retractions (chest caving in, ribs sticking out, nostrils flaring), cyanosis (blue skin), or gasping.

Fever is defined as an elevated body temperature higher than 100.4 degrees Fahrenheit or 38 degrees Celsius (taken rectally).  The most common cause of fever is infection, either viral or bacterial.  The height of your child’s temperature is never as important as how your child looks and responds to you.

What you can do at home: If your child has a fever but otherwise looks good, you do not need to give medications.  Keep in mind that the fever may actually help fight off the infection.  If your child is acting sick (ie: fussy, uncomfortable, or sleepy), you may want to give a dose of Acetaminophen or Ibuprofen to reduce the fever.  Please refer to the dosage charts listed in this section for the proper doses of these medications for your child’s weight.  Be certain that you are not giving any other over the counter medications also containing either of these medicines as overdoses can happen.  If you suspect an overdose, please call Poison Control at 1-800-222-1222 immediately.  Never give your child aspirin for fever.

When to seek medical help: Please call our office or the on call service if your child has fevers lasting more than 72 hours, has temperatures higher than 104 degrees Fahrenheit, or has seizures associated with the fever.  Please go straight to the emergency room if your child is younger than 30 days old with rectal temperature >100.4 or is acting very ill despite medications to reduce the fever.  If your child was placed on antibiotics for a bacterial infection and continues to have fevers 48 hours later, you should call our office for an appointment to get your child rechecked.

Colic is defined as prolonged fussy periods of crying (at least 3 hours per day) for no obvious reason in a baby from birth to 3-4 months.  There is no known cause for colic, but it is thought to be due to a combination of a baby’s temperament, a baby’s response to stress (ie: overstimulation or understimulation), and parental responses to their baby’s cries.

What you can do at home: First look for other causes of crying, such as hunger or a dirty diaper.  When other causes have been ruled out, you can try other comfort measures such as tightly swaddling your baby, holding and rocking your baby, giving your baby a pacifier, or repositioning your baby on the side or stomach.  (Keep in mind that you should never let your baby sleep on his/her side or stomach).  You could also try a vibrating swing, carrying your baby around in a sling, or a warm bath.  For most babies, a combination of these techniques will help them to calm down.  Remember that intermittent crying, for up to 3 hours a day and which is consolable, is very normal during the first few months of life.

When to seek medical help: Please call our office or the on call service if your baby’s crying is inconsolable or if there are other symptoms associated with the crying (ie: poor feeding, vomiting, diarrhea, fevers).