Dr. Shannon L. Stevenson, DO

Absolutely. Give her some regular stool softner, miralax is okay for kids. ¼ - 1 adult dose daily. Titrate dose to get a bowel movement daily. Ask your pediatrician to be sure he or she is okay with it since they know her history, they may have other suggestions.

Miralax is safe. You can give up to 5 adult doses at his age in 20-30 oz of Gatorade over the course of an hour or so to do a “clean out” if you feel like it’s to that point. Or you can just do 1/2 an adult dose in 8-10 oz Gatorade with plenty of water throughout the day daily x 2-5 days until effect is achieved.

If constipaton is a chronic problem, should prob talk to your doctor about a regular stool softener daily for a period of time to prevent this from coming back. The colon gets stretched to accommodate repeatedly large stool volumes and thereby can perpetuate constipation if daily bowel movements are not maintained for a period of 3-6 months after a prolonged period of recurrent constipation.

For really tough to treat diaper rashes, I recommend a combination that you make yourself.

It is EQUAL PARTS Hydrocortisone ointment 1%, Clotrimazole cream 1% and Bacitracin (NOT NEOSPORIN!), all available over the counter.

Use it 2-4 times daily (with MOST diaper changes). Any cause of rash would be treated with this combination.

No more than 7 days of use without improvement before you seek counsel from your provider.

If it is working, limit use to 14 days at a time, again seeking counsel of your provider if the rash returns or is not fully resolved thereafter.

Sleep is complicated because it involves a lot of factors. Most often these are environmental. Talk with you primary care clinic/team about where your daughter sleeps (own bed or family bed), what the environment is like (sounds, light, temperature), and what your general schedule for her day is (wake time, meals and snacks, nap time - ? if taking naps -, and bed time) and what is her "bedtime routine." These are generally the most important factors to promoting sleep in children, the routine and schedule being the MOST important. Your clinic can help you adjust things as needed to promote better sleep.

If you have addressed all these and your daughter is still not sleeping appropriately then she needs to see a sleep specialist to look for more rare causes of sleep issues. Lack of sleep does have a modest affect on growth in the long term.

Strep throat is treated with antibiotics to prevent secondary issues such as rheumatic heart disease and scarlet fever, the former being the main concern as it can cause damage to the heart valves that is lifelong. Our body can generally clear the infection without antibiotics and the incidence of rheumatic fever is dramatically lower in industrialized nations versus non industrialized. The most likely reason for this is access to antibiotics but also not all strep infection causes rheumatic heart disease or scarlet fever.

So the answer to your question is no, "medicine" is not always necessary to "treat" strep infection, but I would consider the prevention of the other conditions in your decision on whether to treat your child with antibiotics.

You are completely right, fever is an immune response. Fever is a sign of an infection, most commonly caused by a virus, and it is our body's mechanism to make the environment (our body) uninhabitable to the virus or bacteria. Viruses and bacteria have adapted to infect us at our normal body temperature (one of the reasons why humans are not susceptible to ALL viruses and bacteria) so our body raises the temperature as a way to kill the invader.

Most often I tell people that if the fever is not preventing the patient (adult or child) from functioning - eating, drinking, sleeping - and is not causing significant distress - in the case of children this would manifest by being cranky, inconsolable - then do no suppress the temperature until it reaches closer to 103.5F.

An exception to this would be in a child with KNOWN febrile seizures, generally treating the seizure if important until they outgrow this condition which is something you should discuss with your personal physician as far as at what age you can stop avid fever suppression.

Fever typically lasts 3-5 days in most infections with the highest temperature on day 3, this is especially true in VIRAL infections. Depending on the age of your child, strep swabs can be positive due to being a carrier and not active infection. So it may be that your child has a viral infection and the antibiotics will make no difference to the course of fever or symptoms.

FOR CHILDREN OVER THE AGE OF 1 year:
Honey has been shown to be MORE EFFECTIVE that cough syrup in children, especially at night. This is great news for you. Recommend to take it straight off the spoon and not mixed with any liquid. Some adults like some lemon juice on top to cut the sweetness but this is not a problem for most kids.

If your kid is old enough and doesn't like the taste of the honey or the feel of it in their mouth, I recommend swishing with water and spitting it out. Also, prevent drinking fluids right after administration to allow the honey to coat the throat and treat the cough.

To note no cough medicine will prevent all coughing, the goal is reduced coughing and more sleep. My patients have noted good success with this treatment.

You should see your physician, this could be a sign of allergies.

If she does not have a viral infection (runny nose, fatigue, +/- fever) she may have allergies or perhaps asthma. Coughing at night for long periods of time (more than 3 weeks which is an acceptable length during/after a viral upper respiratory infection) needs assessment by your family doctor or pediatrician. Children over the age of 1 year can have honey straight (1/2 to 1tsp) before bed to help with cough, it has been shown superior to cough “medicine” prescribed or over the counter. You could do that for temporary relief while awaiting evaluation.

If your child is up to date on vaccination he/she should not need any additional vaccine after a catch scratch. However, some infections are easily acquired from a cat scratch, I would keep the are clean, apply Vaseline or some other non medicated ointment daily or more, and monitor for signs of infection like redness, swelling and any discharge. If you see that, be sure to contact your family physician/pediatrician for advice.