Practical information for common situations — from fever to injuries and illnesses to medical certificates. If you are unsure, get in touch with us.
We have collected answers to the questions we hear most often at the practice. This advice is for information only and does not replace an examination — if in doubt, always call us.
Fever in children
We consider a temperature above 38 °C in the armpit (above 38.5 °C rectally) to be a fever. Fever itself is not dangerous — it is the body's defense response, and with viral infections it usually lasts no longer than 3 days. More important than how high the temperature is, is the child's overall condition: how they are drinking, how alert they are, how they are breathing.
Bed rest, plenty of lukewarm fluids, easily digestible food and supervision by an adult.
Give fever-reducing medicines (ibuprofen from 6 months, paracetamol from 3 months) according to the child's weight, not “by the clock.” You will find dosing tables in the fever treatment leaflet (in Czech).
If the fever lasts more than 1 day in an infant or more than 3 days in an older child, do not continue treatment without consulting a doctor.
See a doctor immediately if there is
an infant in the first six months of life,
a temperature above 39.5 °C in the armpit,
a change in behavior — the child cries for no reason, is confused, does not respond, cannot be woken,
bluish skin, a rash or blood spots that do not fade when pressed,
shortness of breath, severe coughing fits, difficulty swallowing, drooling,
a severe headache, stiff neck or seizures,
severe abdominal pain, repeated vomiting and diarrhea, frequent and painful urination.
When to see a doctor and when to go to the emergency service
During office hours we see sick children without an appointment every weekday from 7:00. Outside office hours, the pediatric emergency service of University Hospital Hradec Králové (495 833 427) is available: Mon–Fri 16:00–20:00, Sat, Sun and public holidays 8:00–20:00, and daily 20:00–7:00 at the Children's Clinic. If a life is in danger, call 155 (emergency medical service).
Not for urgent conditions: the “Message the doctor” form is for routine requests (prescriptions, certificates, questions), not for dealing with a sudden worsening.
Preparing for a preventive checkup
Bring your child's vaccination record and health record.
Write down any questions you want to ask — there is time for them.
For older children, comfortable clothing is a good idea because of measurements and the examination.
Medical certificates and assessments
We issue certificates for nursery and kindergarten, secondary school applications, summer camps, school trips, sports, temporary jobs and driving licenses. For a certificate, we will book you an appointment at a specific time — please call in advance. Most certificates are not covered by health insurance (see the price list).
Blunt head injury
After a blow to the head (a bruise or mild concussion) when the child did not have to stay in the hospital, supervision at home is still necessary — a normal finding on examination does not rule out late complications.
Do not leave the child alone and do not go away for long.
At night, wake the child at regular intervals (every 1–2 hours; for infants, at feeding intervals), always until fully awake.
Watch whether the child responds normally and moves all limbs equally — and above all, watch for a change in behavior: “Is this still my child?”
Give light food and fluids in small amounts; you can cool bruises.
Go to the hospital immediately (within 24 hours of the injury) if the child
cannot be woken even with a strong stimulus,
does not respond appropriately, is listless, does not follow with their eyes,
suddenly speaks unintelligibly or does not communicate,
vomits repeatedly and uncontrollably,
has a severe headache that does not respond to medication,
has seizures, or on the contrary is floppy “like a rag doll,”
suddenly changes behavior — is unusually quiet, withdrawn.
If even one of these symptoms appears, go to the outpatient clinic of the Department of Neurosurgery, University Hospital Hradec Králové; if transport by car is not possible, call 155 (emergency medical service). Details are in the University Hospital Hradec Králové instructions (PDF, in Czech).
Croup (acute laryngitis)
A viral inflammation of the larynx with swelling below the vocal cords, mainly in children under 6. Typical signs are a sudden dry, barking cough, often at night, a hoarse voice and sometimes a fever.
Breathing cool air helps — an open window or a short walk outside (about 5 minutes), a cool drink and, above all, calming the child.
For fever, you can give paracetamol or ibuprofen according to weight. The most effective treatment is dexamethasone — consult a doctor about giving it and the dose.
See a doctor immediately / call 155
difficulty breathing — noisy breathing in (stridor), the skin pulling in between and below the ribs: see a doctor without delay,
severe difficulty breathing with a change in behavior (restlessness, or on the contrary drowsiness) or turning blue: call the emergency medical service, do not drive the child in your own car.
Do not wash the body for the first 5 days; dab the blisters with a liquid powder (shake lotion) (or Tanno-hermal, Sudocrem, Virasoothe gel, Fenistil).
If the temperature is above 38.5 °C, give a fever medicine according to weight.
For the mucous membranes (mouth, genitals), rinses or sitz baths with chamomile or agrimony help.
After 5 days, wash the body and hair; keep using liquid powder on the remaining blisters and a cream (e.g. Bepanthen) on healed areas.
The illness and healing take at least 14 days. If the fever lasts more than 7 days, come in for a checkup immediately. Leaflet: Chickenpox (PDF, in Czech).
Diarrhea and vomiting — diet
Day 1: cold sweetened tea (black tea, with Glukopur), Kulíšek (baby water), still mineral water (Mattoni, Magnesia), always 1 teaspoon every 5 minutes, more often if tolerated, until the child is sipping. Then try a sponge biscuit, 1–2 teaspoons of fruit puree, a day-old bread roll, salted sticks, grated banana.
Day 2: continue fluids; grated or cooked apples, bananas, sponge biscuits, beef or chicken broth, carrot or rice water, plain potatoes, rice, pasta.
Day 3: stewed beef or chicken, potatoes or rice without fat, plenty of fluids, banana.
Day 4: normal diet.
While the diarrhea lasts, the diet should be free of fat, eggs and milk (including dairy products). Breastfeeding is not restricted in any way. If the child is not drinking, is drowsy, is not urinating or vomits everything, get in touch with us.
Infant colic
Colic is when an otherwise healthy, thriving baby cries for more than 3 hours a day, more than 3 days a week, for at least 3 weeks. It usually starts after the 2nd week of life, mainly in the afternoon and evening, and resolves on its own around 3–4 months.
Feed calmly and slowly, let the baby burp during feeds as well; do not overfeed, the baby should not swallow air.
For breastfed babies, it helps to avoid gas-producing foods and carbonated drinks and to adjust the breastfeeding technique.
For formula-fed babies, a formula for sensitive tummies and anti-colic bottles may help.
Exercises and positioning: drawing the knees up to the tummy and making circles, tummy massage with circular movements, a warm cloth diaper, carrying the baby in the “tiger in the tree” hold, tummy time.
A rectal tube or thermometer can bring the baby relief, but not too often.
Constipation
In children, constipation means a bowel movement less than once every 3 days, or hard stools that are difficult to pass; it can also show up as soiled underwear or blood on the toilet paper from a small tear. It is usually functional constipation, which we treat at the practice — first empty the bowel, then soften the stool over a long period (even months) with a macrogol preparation at a dose based on weight. It is not habit-forming.
Always follow the package leaflet. If the temperature stays above 38.5 °C for more than 3 days or the condition is getting worse — call us.
Infectious mononucleosis (glandular fever)
A viral illness spread through saliva that mainly affects the liver, spleen and lymph nodes. It causes severe tiredness (even for several weeks), fever, sore throat and swollen lymph nodes. Treatment is supportive: rest, a gentle diet and no sports — because the spleen and liver are enlarged, there is a risk of injuring them. Blood count and liver tests return to normal in roughly 2–3 months.
Diet: avoid fatty, fried, gas-producing and very spicy foods, ice-cold and strongly carbonated drinks; eat smaller portions regularly; boil, stew or bake without fat. Recipes are in the leaflet Mononucleosis — diet (PDF, in Czech).
Reactions after vaccination
After vaccination, wait 30 minutes in the waiting room because of the very rare possibility of an allergic reaction.
For a few hours the child may be more tearful or sleepy — go along with it; put a breastfed baby to the breast more often.
Cool swelling and redness at the injection site with a gel pack wrapped in cloth for no more than 10 minutes, repeatedly if needed.
A fever appears a few hours after inactivated vaccines or 7–10 days after MMR. Up to 38 °C, do not give medicines, just monitor; above 38 (38.5) °C, give a fever medicine according to weight.
Children under 15 must not be given acetylsalicylic acid (e.g. Acylpyrin) unless recommended by a doctor.
Get in touch with us if there is a fever above 40 °C, a fever that does not respond to medicines or lasts longer than one day, a noticeably different condition of the child, or long, unexplained crying. Leaflet: Reactions after vaccination (PDF, in Czech).
Flat feet
Flat feet develop from an imbalance between the load on the foot and the strength of the muscles and ligaments — unsuitable footwear, excess weight and too little movement in the toddler and preschool years contribute to it. We examine children's feet on a podoscope.
Walking barefoot on uneven ground, alternating hot and cold foot baths, and foot massages.
Regular exercise, for younger children in the form of play — rolling a ball with the soles, picking up a pencil with the toes, walking on tiptoe and on the outer edges of the feet.
Proper footwear: a roomy toe box, a firm heel, a flexible sole, a low heel, socks of the right size.