Physician: International Travel, pg 2

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Diaper Care

Diaper rash commonly appears as below but it can be erosive with bleeding or with small bumps or pimple, which usually means superinfection with either a fungus or a bacteria. Normally most diaper rashes can be taken care of as outlined in the table below.

(Source Shwayder July 2003 contemporary pediatrics)


Preventing and treating diaper rash

  • Keep the child's bottom clean and dry; change the diaper frequently
  • Clean the perineum gently when changing the diaper
  • If the skin is red, use 1% hydrocortisone cream twice a day mixed with lotrimin cream, which is an antifungal foot cream available over the counter. Cover the cream and the diaper area with zinc oxide paste or desitin ointment.


Scabies are caused by a round mite that is 0.4mm long has four legs and is spread by direct contact. It is incredibly itchy with pustules and burrows on the skin. Treatment is with elimite commonly and needs to be prescribed by your pediatrician.

(Source Shwayder July 2003 contemporary pediatrics)

Allergic reactions

Use of benadryl liquid 12.5mg/5ml(one teaspoon) usually is a safe medicine to use for acute allergic reactions associated with hives.

The dose is approximately 1mg/kg. It is not used in infants, follow the package directions.

Some kids respond to benadryl by becoming extremely active. It should not be used to provide sedation.

(Schmitt cont peds 2003)


Sometimes with lice there can be no signs or symptoms and they are discovered when cleaning the child’s hair.

As with scabies this is commonly found in institutionalized children and is treated with an over the counter preparation called nix most commonly/effectively.

Follow the package directions.

(Source Shwayder July 2003 contemporary pediatrics - picture)


Tylenol or Motrin is invaluable when the child has fever or sick and appears off. The dose for Tylenol and Motrin is 10mg/kg; both can be given every 6 hours. It is easier to travel with the children’s formulation and if dosed appropriately can be given at any age.

It is a good idea to bring a dosing syringe available at any pharmacy so you can dispense these medicines.

Nasal congestion

Plain nasal decongestants are usually all that are needed if a child has a stuffy nose and cannot sleep. Plain pedicure nasal decongestant for kids 3 months to one year and plain Sudafed for children are commonly used.

Dosages depend on the formulation and can be obtained from your pediatrician.


Diarrhea and vomiting can occur at any time in children and it is advisable to be prepared. Pedialyte or powdered electrolyte solutions, which can be reconstituted with boiled water as needed, are usually brought. These are usuallly given if the child is having excessive vomiting or diarrhea. Normally most pediatricians try to feed through bouts of diarrhea in infants with small amounts of formula given more frequently. However if there is decreased tears/urine output or saliva and oral rehydration solution and consultation with a professional is advisable.


The opposite end of the spectrum is constipation and certainly with a change of diet this can be seen. Most constipation is treated effectively by increasing fruit intake especially prunes/prune sauce. Instant relief can nearly be provided through the use of glycerin suppositories although regular use is not advisable it is very helpful in a pinch.


What to feed and bring with you depends on the health background and age of the child you are adopting and it is advisable to consult your pediatrician.

You may also ask the adoption agency to provide information as to what the child is currently eating and use this as a guideline for what types of foods your child will accept. For example if the child is not eating from a spoon then the time to start will be back in the states.

The Academy of Pediatrics puts out a book called "Caring for Your Young Infant and Child." It has almost everything that you ever wanted to know and perhaps things you do not want to know about children. If you want a definitive source for childcare, this is it. It goes into great depth about how to feed children and to take care of them.

by James Reilly, M.D.

Submit Your Question


The information and advice provided is intended to be general information, NOT as advice on how to deal with a particular child's situation and or problem. If your child has a specific problem you need to ask your pediatrician about it - only after a careful history and physical exam can a medical diagnosis and/or treatment plan be made. This Web site does not constitute a physician-patient relationship.

This material has been provided by, an innovative adoption medicine private practice and educational service, dedicated to helping parents and adoption agencies with the complex pre-adoption medical issues of internationally adopted children. All medical interactions are performed via, e-mail, express mail, telephone, and fax. There is no need to make a live appointment or travel outside of your hometown. For more information, visit or call 631-499-4114.

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