No Worries, Mate

By Jeff Cersonsky, MD, FAAP

Many seemingly serious problems can be handled by parents at home without a rush trip to the Emergency Room. Hopefully, these hints can prevent such a visit.

My toddler just ate some of the dog’s food. Do I have to bring him in to get his stomach pumped?

You’d be surprised to know this is not a rare question! Regular dog food is not dangerous to children. It is not uncommon for a child to vomit after eating the dog food, but I believe that the vomiting might be a reaction to the parents’ disgust as much as to the taste of the food. Dry dog food can be a choking hazard to young children, so be safe and keep it out of reach of everyone except the dog.

My daughter fell on her face and is bleeding from the mouth where that piece of skin is in front of the top middle teeth. Does she need stitches?

This piece of tissue is called the frenulum and is easily torn during a fall. It can bleed a lot but quickly stops with pressure and a cold compress over the upper lip. No stitches are usually necessary. If bleeding does not cease within a few minutes, the cut extends elsewhere, teeth are broken, or the pain is unbearable, medical attention should be sought.

My 2-year-old has swelling next to the first toenail and it’s red and there’s some white stuff under the skin.

This sounds like an ingrown toenail. Some experts believe that cutting the nails too short might be a cause; others disagree. In any case, what is happening is that the nail is acting like a splinter in the skin next to it. The white stuff is an inflammatory fluid and can start draining. Usually, this condition responds to frequent (four times a day, if possible) soaks in warm water. Antibiotics are rarely necessary. Occasionally, a trip to the podiatrist to get part of the nail removed is necessary if a trial period (about a week) of soaking yields no improvement.

My 8-year-old is complaining of severe ear pain. She seemed fine when she went to the back-to-school party, but now says it hurts badly. Doesn’t she need antibiotics for the ear infection?

Ear infections are relatively rare during the warm months, especially in older children. My guess is that your daughter has been swimming lately and has swimmer’s ear (or, more technically, “otitis externa”). Swimmer’s ear is the result of a decrease in the acidity caused by water entering the ear. Normally the ear canal is very acid, but the pool or lake water raises the pH allowing bacteria to overgrow and then the skin of the canal becomes inflamed. The best treatment is a buffering drop (Star-Otic is my favorite over-the-counter medication), which brings the acidity to where it should be and keeps it there. Making the differentiation between swimmer’s ear and a middle ear infection can frequently be made at home. Push on the piece of cartilage in front of the ear canal (the tragus). If that is tender, it is almost always swimmer’s ear. However, if the child is running a fever or the ear seems to be protruding from the head more than usual (indicating a severe infection called mastoiditis), call your pediatrician.

My son was stung by a yellow jacket and his hand is very swollen. Should I rush him to the Emergency Room?

There are two types of reactions to stings (bees, yellow jackets, hornets, or wasps), the local reaction and the systemic reactions. With the systemic reactions, the child gets hives, wheezing, and possibly a drop in blood pressure. These reactions are dangerous and immediate medical care should be sought. If your child has any of these symptoms, even once, they should always have an Epi-Pen available should they get stung again.

A local reaction (swelling, redness, and itching at the site of the sting), as described for this child, can seem severe but is not harmful. Cool compresses, diphenhydramine (Benadryl), and acetaminophen (Tylenol) should be sufficient.

Never hesitate to contact your doctor if you are not sure what is happening. Just as many seemingly severe conditions are easy to deal with, many conditions that seem minor can fool you into a false sense of comfort. I will address some of these in a future article.