Pediatrics
The Pediatric Medical Home Port is located on the 3rd Floor of Naval Hospital Bremerton. The Pediatric Medical Home Port delivers healthcare using a team approach. Our team consists of Providers, Nurses, Hospital Corpsmen, Clerical Staff and Red Cross volunteers. Each team member is valued for their skills and training, and is available to assist you in any way possible. The Pediatric Medical Home Port provides primary and subspecialty health care services for pediatric patients. We provide a full spectrum of care, with our primary care medicine complemented by our Developmental Pediatrician and Endocrinologist.
We provide a variety of services to include:
- Developmental Pediatrics
- Endocrinology (monthly outreach clinic with provider from Madigan Army Medical Center)
Exceptional Family Member Program
The EFMP includes identification of the family member's special needs and enrollment in the program, assignment coordination and family support. The Program assists Sailors during the assignment process by addressing the special needs of their exceptional family members (EFM) and ensuring they are assigned to areas where they can access necessary resources.
Fleet and Family Support Programs
Fleet and Family Support Programs (FFSP) support individual and family readiness through a full array of programs and resources which help Navy families to be resilient, well-informed and adaptable to the Navy environment. Programs include:
- Deployment support for sailors and their families
- Personal and family wellness education and counseling
- Emergency Preparedness and Response
- Crisis Intervention and Response
- Military and Personal career development
- Financial Education and Counseling
- Spouse Employment
Women Infant & Children Program
WIC provides Federal grants to States for supplemental foods, health care referrals, and nutrition education for low-income pregnant, breastfeeding, and non-breastfeeding postpartum women, and to infants and children up to age five who are found to be at nutritional risk. Find out if you are eligible for WIC by visiting the
WIC program page on USDA today.
Common Illnesses
ADHD
What is ADHD?
ADHD stands for Attention-Deficit Hyperactivity Disorder and is one of the most common neurobehavioral disorders of childhood. It is usually first diagnosed in childhood and often lasts into adulthood. Children with ADHD may have trouble paying attention, controlling impulsive behaviors (may act without thinking about what the result will be), or be overly active.
What are the signs and symptoms of ADHD?
A child with ADHD might:
- have a hard time paying attention
- daydream a lot
- not seem to listen
- be easily distracted from schoolwork or play
- forget things
- be in constant motion or unable to stay seated
- squirm or fidget
- talk too much
- not be able to play quietly
- act and speak without thinking
- have trouble taking turns
- interrupt others
How is ADHD diagnosed?
Deciding if a child has ADHD is a several step process. There is no single test to diagnose ADHD, and many other problems, like anxiety, depression, and certain types of learning disabilities, can have similar symptoms. One step of the process involves having a medical exam, including hearing and vision tests, to rule out other problems with symptoms like ADHD. Another part of the process will include a checklist for rating ADHD symptoms and taking a history of the child from parents, teachers, and sometimes, the child.
How is ADHD treated?
In most cases, ADHD is best treated with a combination of medication and behavior therapy. No single treatment is the answer for every child and good treatment plans will include close monitoring, follow-ups and any changes needed along the way.
What should I do if I suspect my child may have ADHD?
If you have concerns that your child may have ADHD, please contact the Pediatric Clinic at (360) 475-4216 and select option 2. An ADHD evaluation packet will be given to you and once complete, an appointment with your child’s primary care provider will be scheduled.
Fevers
What is considered a fever?
Fever is a higher-than-normal body temperature. A normal temperature is usually 98.6° Fahrenheit (F) or 37° Celsius (C). Most temperatures are considered normal until a temperature is greater than 100.4° F or 38° C (rectal temp preferred in young infants). Your child's body temperature changes during the day, but when you have a fever these temperature changes are usually the greatest in the morning and early evening. Fever is a symptom (problem). Fever is not a disease. A fever may mean that there is something else going on in the body. Fever helps the body fight infections. It makes the body's defense systems work better. Fever can be caused by many conditions. The most common cause for fever is viral or bacterial infections, with viral infection being the most common.
What are the signs and symptoms of fever?
The signs and symptoms of a fever depend on the cause. At first, a fever can cause a chill. When the brain raises the body's "thermostat," the body responds by shivering. This raises the body's temperature. Shivering produces heat. When the temperature goes up, the child often feels warm. When the fever goes away, the child may start to sweat.
How should I check my child’s temperature?
Your child's temperature can be taken many ways, but the best way is to take the temperature in the rectum or by mouth (only if the patient can cooperate with holding the thermometer under the tongue with a closed mouth).
How can I prevent my child’s fever?
- Generally, nothing can be done to prevent fever.
- Avoid putting your child in the heat for too long.
- Give more fluids than usual when your child has a fever.
- Fever causes the body to lose more water.
- Ibuprofen (if older than 6 months) or Acetominophen (Tylenol) may be given to reduce a fever. For dosage calculation based on your child’s weight, please refer to below.
| Acetaminophen Dosing |
| Weight (LBS) |
Children's Oral Suspension (160 mg/5 mL) |
Children's Meltaway Chew Tablets (80 mg) |
Jr. Meltaway Chew Tablets (160 mg) |
| 6-11 lbs |
1.25 mL |
-- |
-- |
| 12-17 lbs |
2.5 mL |
-- |
-- |
| 18-23 lbs |
3.75 mL |
-- |
-- |
| 24-35 lbs |
5 mL (1 tsp) |
2 tabs |
-- |
| 36-47 lbs |
7.5 mL (1.5 tsp) |
3 tabs |
-- |
| 48-59 lbs |
10 mL (2 tsp) |
4 tabs |
2 tabs |
| 60-71 lbs |
12.5 mL (2.5 tsp) |
5 tabs |
2.5 tabs |
| 72-95 lbs |
15 mL (3 tsp) |
6 tabs |
3 tabs |
| |
| Ibuprofen Dosing |
| ***Ibuprofen should not be given to infants under 6 months of age*** |
| Weight (LBS) |
Children's suspension
(100 mg/5 ml) |
Chewable tablets
(50 mg) |
Chewable tablets
(100 mg) |
| 12-17 lbs |
2.5 mL (1/2 tsp) |
-- |
-- |
| 18-23 lbs |
5 mL (1 tsp) |
2 tabs |
1 tab |
| 24-35 lbs |
7.5 mL (1.5 tsp) |
3 tabs |
1.5 tabs |
| 36-47 lbs |
10 mL (2 tsp) |
4 tabs |
2 tabs |
| 48-59 lbs |
12.5 mL (2.5 tsp) |
5 tabs |
2.5 tabs |
| 60-71 lbs |
15 mL (3 tsp) |
6 tabs |
3 tabs |
| 72-95 lbs |
20 mL (4 tsp) |
8 tabs |
4 tabs |
Always use measuring spoon to measure amounts!
My child has a mild fever, what can I do to help?
- Mild or moderate fevers lasting <3 days generally have no long-term effects and often do not require treatment.
- Only give over-the-counter medicines for fever as directed by your child’s caregiver.
- Do not use aspirin. There is an association with Reye's syndrome.
- If an infection is present and medications have been prescribed, give them as directed. Finish the full course of medications until they are gone.
- Do not over-bundle children in blankets or heavy clothes.
When should I seek medical attention for my child’s fever?
- Your child has an a fever lasting greater than 3-5 days
- Your baby is 3 months old or younger with a rectal temperature of 100.4° F (38° C) or higher.
- Your child becomes fussy (irritable) or floppy.
- Your child develops a rash, a stiff neck, or severe headache.
- Your child develops severe abdominal pain, persistent or severe vomiting or diarrhea, or signs of dehydration.
- Your child develops a severe persistent cough, shortness of breath, or sustained rapid breathing
It is important for you to participate in your child's return to good health. Children with fever almost always get better within a few days. However your child's condition may change. Monitor your child's condition and do not delay seeking medical care if your child develops any of the conditions listed above.
Rash
Many things can cause a rash. Some causes include infection, allergic reactions, medications, and chemicals. Sometimes something in your home that comes in contact with your skin may cause the rash. These include pets, new soaps or laundry detergents, cosmetics, and foods.
My child has a rash, what can I do to make my child more comfortable?
- Avoid extreme heat or cold, unless otherwise instructed. This can make the itching worse.
- A cool bath or shower or a cool washcloth can sometimes ease the itching.
- Avoid scratching. This can cause infection.
- Take those medications prescribed by your caregiver.
When should I seek medical attention for my child’s rash?
- Child develops increasing pain, swelling, or redness.
- Child develops a fever.
- Child develops new or severe symptoms such as body aches and pains, diarrhea, vomiting.
- The rash is not better in 3 days.
My newborn has an unexplained rash. What could it be?
Newborns commonly have rashes and other skin problems. Most of them are not harmful (benign). They usually go away on their own in a short time. Some of the following are common newborn skin conditions.
- Acrocyanosis is a bluish discoloration of a newborn's hands and feet. This is normal when your newborn is cold or crying, as long as the rest of the skin is pink. If the body or face is blue, you should seek immediate medical care.
- Milia are tiny, 1 to 2 mm, pearly white spots that often appear on a newborn's face, especially the cheeks, nose, chin, and forehead. They can also occur on the gums during the first week of life. These clear up in 3 to 4 weeks of life without treatment and are not harmful. Sometimes, they may persist up to the third month of life.
- Heat rash (miliaria, or prickly heat) happens when your newborn is dressed too warmly or when the weather is hot. It is a red or pink rash usually found on covered parts of the body. It may itch and make your newborn uncomfortable. Heat rash is most common on the head and neck, upper chest, and in skin folds. It is caused by blocked sweat ducts in the skin. It gets better on its own. It can be prevented by reducing heat and humidity and not dressing your newborn in tight, warm clothing. Lightweight cotton clothing, cooler baths, and air conditioning may be helpful.
- Neonatal acne (acne neonatorum) is a rash that looks like acne in older children. It may be caused by hormones from the mother before birth. It usually begins at 2 to 4 weeks of age. It typically gets better on its own over the next few months without any treatment. Neonatal acne has nothing to do with whether your child will have acne problems as a teenager.
- Toxic erythema of the newborn ( erythema toxicum neonatorum) is a rash of the first 1 or 2 days of life. It consists of harmless, red blotches with tiny bumps. It may appear on only part of the body or on most of the body. It is usually not bothersome to the newborn. The blotchy areas may come and go for 1 or 2 days, but then they go away without treatment.
- Pustular melanosis is a common rash in African American infants. It causes pus-filled pimples. These can break open and form dark spots surrounded by loose skin. It is most common on the chin, forehead, neck, lower back, and shins. It is present from birth and goes away without treatment after 24 to 48 hours.
- Diaper rash is a redness and soreness on the skin of a newborn's bottom or genitals. It is caused by wearing a wet diaper for a long time. Urine and stool can irritate the skin. Diaper rash can happen when your newborn sleeps for hours without waking. If your newborn has diaper rash, take extra care to keep him or her as dry as possible with frequent diaper changes. Barrier creams, such as zinc oxide paste, also help to keep the affected skin healthy. Sometimes, an infection from bacteria or yeast can cause a diaper rash. Seek medical care if the rash does not clear within 2 or 3 days of keeping your newborn dry.
- Facial rashes often appear around your newborn's mouth or on the chin as skin-colored or pink bumps. They are caused by drooling and spitting up. Clean your newborn's face often. This is especially important after your newborn eats or spits up.
- Cradle cap is a common, scaly condition of a newborn's scalp. This scaly or crusty skin on the top of the head is a normal buildup of sticky skin oil and dead skin cells. Cradle cap can be treated at home with olive oil and/or a gentle infant shampoo. Do not vigorously scrub the affected areas in an attempt to remove this rash. Gentle skin care is recommended. It usually goes away on its own by the first birthday.
- Forceps deliveries often leave bruises on the sides of the newborn's face. These usually disappear within 1 to 2 weeks.
Conjunctivitis (Pink eye)
Conjunctivitis is commonly called "pink eye." Conjunctivitis can be caused by bacteria, viral infection, allergies, or injuries. There is usually redness of the lining of the eye, itching, discomfort, and sometimes discharge. There may be deposits of matter along the eyelids. A viral infection usually causes a watery discharge, while a bacterial infection causes a yellowish, thick discharge. Pink eye is very contagious and spreads by direct contact.
How do I know if my child’s pink eye is bacterial or viral?
The signs and symptoms of bacterial and viral conjunctivitis can appear similar. Bacterial conjunctivitis is less common in children older than 5 years of age. These germs are spread from person to person (contagious). The white part of the eye may look red or pink. The eye may be irritated, watery, or have a thick discharge.
Viral conjunctivitis is caused by a virus and is also associated with a clear, watery discharge. If a discharge is present, there may also be some blurred vision in the affected eye.
What can I do to help my child’s pink eye and how can I lessen the likelihood of it spreading?
- Only have your child take medicine as told by your doctor.
- Apply a cool, clean washcloth over closed eyelids.
- Gently wipe away any fluid coming from the eye with a warm, wet washcloth or cotton ball.
- Do not share towels or washcloths. This may spread the infection to others.
- Make sure your child washes their hands often with soap and water or alcohol-based cleaner. Use paper towels to dry your child’s hands.
- Change or wash your child’s pillowcase every day.
When should I seek immediate medical care for my child’s pink eye?
- Your child’s eye is not better after 3 days of medicine (if prescribed).
- A yellowish white fluid (pus) is coming out of the eye.
- The redness is spreading.
- Your child’s vision worsens or becomes blurry.
- Your child has eye/face pain or puffiness (swelling) around the eye.
- Your child is older than 3 months with a fever lasting > 3 days.
- Your child is 3 months old or younger with a rectal temperature of 100.4° F (38° C) or higher.
Could my child have allergic conjunctivitis?
Allergic conjunctivitis is common in people who have other signs of allergic disease, such as hay fever, asthma, and eczema. It is caused by the body’s reaction to certain substances to which it is allergic, such as:
- Pollen from trees, plants, grasses, and weeds
- Dust mites
- Animal dander
- Molds
- Contact lenses and lens solution
- Cosmetics
Diarrhea
Diarrhea is watery stool. The most common cause of diarrhea is a virus. Other causes include:
- Food poisoning
- Bacterial Infection
- An allergy
- Too much juice/sugary beverages
What can I do to help with my child’s diarrhea?
- Have your child drink pediatric formulated electrolyte containing fluids (such as pedialyte). This can stop your child from losing too much body fluid (dehydration).
- Have your child drink enough fluids to keep the urine clear or pale yellow.
- Avoid giving dairy products for a few days.
When should I seek medical attention for my child’s diarrhea?
- The watery stool lasts longer than 3 days.
- Your child has a fever >3 days duration.
- There is blood in your child’s stool.
- Your child also has persistent vomiting.
- Your child seems to be losing too much fluid and is dehydrated.
- Significant drop in number or amount of wet diapers
Medications
For refills of current medications, please call the Pediatric Clinic at (360) 475-4216, option 2.
For medications your child is not currently taking, please call 1-800-404-4506 to schedule an appointment with your child’s primary care provider.
*Medication refills may take up to 3 business days before pick up is available.* If you have not received a phone call informing you that the requested medication has been filled, please contact the Pediatric Clinic at (360) 475-4216, option 2.
ADHD medication refills
If your child has not been reevaluated for symptoms pertaining to ADHD in the past 6 months, please schedule an ADHD follow up appointment with your child’s primary care provider by calling 1-800-404-4506, otherwise call (360) 475-4216, option 2 for a refill request.
Links
Important Numbers
Washington Poison Control: 1-800-222-1222
Pediatric Clinic: 360-475-4216
Developmental Clinic: 360-475-4216, option 3