Paediatrics (Paediatric and Adolescent Medicine)
As a paediatrician, I pay particular attention to the physical, mental and emotional development of your child and ensure holistic medical care from birth to adulthood.
As a paediatrician, I pay particular attention to the physical, mental and emotional development of your child and ensure holistic medical care from birth to adulthood.
Attentive listening, comprehensive consultation and competent treatment are particularly important to me when dealing with my patients and their parents.
In addition to paediatric and juvenile care for acute or chronic diseases, I offer the following services:
More information about Dr. Barbara Roithner-Kolarik.
More information about:
Mother-child pass examinations
The mother-child pass examinations represent an important preventive measure. They serve the observation of the child’s development and the early detection of diseases. Thus, they have great significance for the health in adult life. During every mother-child pass examination your baby is weighed and measured. It is thoroughly examined and I observe the posture and movements of your child. In addition to advice on recommended vaccinations and age-appropriate nutrition, I am also happy to answer every question you might have about living with your child.
The orthopaedic examination, the ENT examination and the eye examination are carried out in the practice.
Breastfeeding
Breast milk and breastfeeding are very important for children. As a certified breastfeeding and lactation consultant IBCLC, I can give you comprehensive advice on this subject (preparation for breastfeeding, increasing the amount of breast milk, help with sore nipples, inflammation of the breast, cessation of breast milk, clogged milk ducts, milk duct thrush, vasospasm,…).
Breastfeeding is more fun when exchanging experiences with like-minded people. Therefore, I recommend visiting of our nursing group “All about your baby” .
How to get off to a good start?
When your baby is born, it will be placed – as soon as it is possible – naked and unwashed on your bare belly or the chest. If there is no medical emergency, the new family can enjoy an undisturbed and intimate contact, the bonding. The baby can find the nipple itself via the smell and will suck. The colostrum, foremilk, which was formed during the first days of life, protects your baby from infections, mobilises the intestines and can reduce the severity of neonatal jaundice. Even if your baby cannot suck at the breast, it is important that it gets some foremilk which has been pre-massaged out of the breast. A midwife or lactation consultant will help you in this case.
Is it good if my baby wants to be breastfed every 2 hours?
Yes, it is ideal if the baby drinks every 2-3 hours, about 8-12 times a day.
You’ve already come to know your baby and know that it’s showing with signals that it wants to be fed (such as sucking movements and sounds, hand-to-mouth-movements, fast eye movements, gentle cooing or sighing, restlessness). The sucking of your baby at the breast causes more milk to be produced. It is both nice and important that you and your baby spend a lot of time together and have direct skin contact again and again.
It is hot. Does my baby need any extra fluid?
If your baby is fully breastfed it will not need any extra food or fluids during the first 4-6 months.
What am I allowed to eat?
Try to eat healthy according to general recommendations (see also information on nutrition), you have an increased energy requirement of about 500 kcal. There is no clear evidence that certain foods cause colic in babies. Broccoli, cabbage, cauliflower, chocolate, cow’s milk and onions can cause restless behaviour. Usually after 8-12 hours your baby might react with increased screaming which settles again after 24 hours. A diary can help to find out which foods your baby reacts to.
Should I drink a lot?
It is best if you drink according to your thirst and have a glass of water ready when breastfeeding. Increasing the amount you drink does not lead to an increase of your breast milk.
May I have a glass of wine?
It is recommended that you do not drink alcohol while breastfeeding, in any case not more than a glass of wine or sparkling wine once or twice a week. Alcohol changes the smell and the taste of the breast milk. If you consume an alcoholic drink to toast occasionally, it is advisable to take a breastfeeding break of about 2 hours afterwards.
How much coffee may I drink?
About 3 cups of coffee are harmless and are usually well tolerated by the baby.
May I take painkillers or antibiotics?
Doctors often advise to wean when mothers should take medicine. This is usually not necessary. If you have pain or fever, ibuprofen (e.g. Nurofen®) is the drug of choice, as it does not pass into the breast milk.
Among the common antibiotics such as penicillin, cephalosporins and macrolides you may continue to breastfeed.
I am supposed to be operated. What should I consider?
First of all: In case you need anaesthesia, you can still continue to breastfeed without worrying!
It is advisable to make a plan before the operation as to who can support you after the surgery. You may be able to pump out a supply of breast milk.
Breastfeed your baby right before the surgery and as soon as you wake up from anaesthesia. It is not necessary to take a break from breastfeeding. You can take painkillers after the operation.
Where can I get further support?
Midwives and lactation consultants are happy to help you, also nursing groups are highly recommended for the exchange of experiences with other mothers.
Recommended reading: Stillen-ein guter Start für Mutter und Kind, Guoth-Gumberger, Hormann, GU-Verlag
Links:
Nutrition
Food should taste good and be fun. . In childhood you can lay the foundation for your child to enjoy healthy food. For children, as for adults, it is especially nice to eat together. Try to eat a meal together at least once a day. Children like to help prepare food and are particularly keen to pick freshly cut, bite-sized pieces of raw vegetables and fruit.
The Austrian Food Pyramid provides the framework for healthy nutrition:
Plenty: Sugar-free drinks, vegetables, fruit, cereals
Moderate: animal products (milk and dairy products, fish, egg, meat, ham)
Economical: fat, salt and sugar-rich foods
It is especially important that your child only drinks water, unsweetened fruit or herbal tea or diluted fruit and vegetable juices (1 part juice, 3 parts water) and that it eats a maximum of 1 handful of sweets or snacks per day.
Links and literature:
Die-osterreichische-Ernahrungspyramide-fur-Kinder-Plakat
Die-osterreichische-Ernahrungspyramide-Plakat
Complementary foods
Like many things in the development of your baby, the introduction of complementary foods usually happens naturally. Your baby starts to take interest in the food you’re eating at the age of 6 months. It can sit upright with minimal help, it can hold its head without help for longer periods of time. It can bring its hands to the mouth and with its lips it can take porridge from a spoon on its own.
How should we start?
It is best to start in a relaxed atmosphere without pressure or constraint, regardless of the time of day. Start with 2-3 teaspoons of pureed complementary baby food (mostly vegetables). After the feeding of the complementary food you can breastfeed your baby or give it a bottle. Little by little your baby will eat more. Continue breastfeeding your baby as long as you and your child want. Longer breastfeeding prevents allergies and infections! The first baby food should not be given before the 17th week of life and if possible not after the 26th week of life.
What’s the next step?
A slow and careful introduction of the complementary food is no longer recommended. Rather, it is good if it is oriented on the offer from the family table but without the addition of salt, hot spices or sugar.
Which foods are recommended?
Daily vegetables, fruit, cereals, 1x daily a portion of high quality protein: meat (30g) or fish (char, salmon, trout) or egg or legumes.
Which foods are not suitable?
Honey, salt and salty foods, hot spices, ham, bacon, sausage, reduced-fat foods, raw eggs, raw fish, raw meat, curd, cheese, pudding, cocoa, sugar and sugary foods, lemonades, small foods like nuts, seeds, grains, berries, sweets, chewing gum, fish with bones.
Can give cow milk to my baby?
Yes, even during the first year of life cow milk may already be given, 100-200ml of whole milk, natural yogurt or buttermilk for the preparation of the complementary food.
May my baby eat cereals before the age of 6 months?
Yes, contact with gluten-containing cereals in an amount of about 7g/day (½ slice of sugar-free rusk, a piece of bread, 1 tbsp cooked pasta, 1 tbsp flakes, 1 tsp semolina or flour) is recommended between the 5th or 7th month of life. To continue with breastfeeding while introducing cereals prevents the development of celiac disease, wheat allergy and type 1 diabetes mellitus.
We parents have many allergies? What should my baby not eat?
Even with inclination to allergy, there are no prohibitions or restrictions. Fish, egg and finely ground nuts may already be given in the first year of life.
My baby does not want to drink. What should I do?
Babies usually start to drink as soon as they eat firmer foods, which means at around 10 months. Before that, they receive enough liquid through the milk and complementary food. This you can notice when your baby is active and its diapers are full (urine) several times a day. It is ideal to offer water from suitable drinking or beak cups. Alternatively, you can give unsweetened tea; your baby does not need juices or other sugary drinks.
My baby does not like complementary food. Is there an alternative?
Yes, you can try finger food. Cook vegetables (for example broccoli), potatoes, meat in larger pieces and let your child try and eat with its hands. This method is called baby-led weaning.
Can I also use complementary food jars?
You can also use complementary food in jars for your baby. It is important to ensure that no sugar (declared as fructose, glucose, glucose syrup, honey, maltodextrin, maltose, sucrose), salt and no flavouring is added and that only few ingredients are used.
Literature/Recommended reading:
Essen und Trinken im Säuglingsalter, Mag.Ingeborg Hanreich, Hanreich-Verlag
Baby-led weaning, Das Grundlagenbuch, Gill Rapley, Tracey Murkett
Mein Kind will nicht essen, Dr.Carlos Gonzales, LaLecheLiga
Das vegetarische Baby, Irmelda Eckbrecht
Vaccinations
It is important to me to inform you professionally about the vaccinations and to ensure an adequate protection of your child through vaccination. Every year the Ministry of Health and the National Vaccination Board recommend a vaccination plan, and various vaccinations against frequently occurring or rare but very serious diseases are included in the free vaccine programme. After a vaccination, it is necessary for your child to stay in the area of the practice for about 15-20 minutes in order to be able to be treated quickly in the very rare case of an allergic reaction. I can understand that the early start of vaccinations causes uncertainty and worry. The reason for this early start is that passive maternal immunity diminishes with about 4 months and it is the aim that the baby has already produced its own antibodies through the vaccination.
Rotavirus oral vaccine (at the age of about 6 weeks, 10 weeks and 14 weeks) – free vaccination
Rotaviruses cause vomiting, diarrhoea and fever. Before the vaccination, 2900-4400 children were hospitalised in Austria every year. The oral vaccination protects >70% against rotavirus infections and >90% against severe rotavirus diarrhoea.
The most common side effects of the vaccine are fever, diarrhoea and vomiting.
“6-fold vaccination” (at the age of about 2 month, 4 months and 12 months) – free vaccination
It contains vaccines against:
The most common side effects of the vaccine are loss of appetite, fatigue, unusual crying, irritability, agitation, fever, swelling and redness at the injection site, diarrhoea and vomiting.
Pneumococcal vaccine (at the age of about 2 months, 4 months and about 12 months) – free vaccination
Pneumococci colonize the mucosa membrane in the pharynx and can cause severe blood poisoning and meningitis in infants and young children, most commonly at the age of 6-12 months.
The most common side effects of the vaccine are sleepiness, loss of appetite, irritability, pain, redness and swelling at the injection site, fever.
Meningococcal B vaccination (from the age of 2 months)
Meningococci occur worldwide. In Austria about 60-100 cases (about 50-70% of group B meningococci and 20-30% of group C meningococci) are registered each year.
The transmission happens through droplet infection; about 10% of all healthy people are populated with meningococci in the nose and throat region. A meninigitis or blood poisoning can occur, the disease can lead to death from full health within a few hours. The most common serious infections occur in children under the age of 1 year; this is why it is recommended that the vaccination should be carried out at the earliest possible date, from the age of 2 months.
The most common side effects of the vaccine are reactions at the injection site such as pain, swelling, redness, hardening; general symptoms include fever, sleepiness, restlessness, irritability, headaches, gastrointestinal complaints such as loss of appetite, nausea, diarrhoea and vomiting, skin rash.
Influenza – from 6 months, in the 1st year 2x, then 1x a year
Infections with the influenza virus (A and B) often lead to severe illnesses with high fever, muscle pain, headaches, sore throats and coughs after an incubation period of a few hours to a few days. Nausea, vomiting or diarrhoea often occurs. The vaccine is recommended to anyone who wants to protect themselves.
The most common side effects of the vaccine are reactions at the injection site such as pain, swelling, redness, hardening; general symptoms include fever, malaise, chills, sweating, fatigue, headaches, muscle and joint pain.
Measles-Mumps-Rubella vaccination (at the age of 10 months and 11 months) – free vaccination
It contains vaccines against:
The most common side effects of the vaccine are redness, pain and swelling at the injection site, fever, infection of the upper airways, skin rash.
Meningococci C – from 12 months, 1x
Meningococci occur worldwide. In Austria around 60 to 100 cases (about 50-70% of group B meningococci and 20-30% of group C meningococci) are registered each year. Transmission happens through droplet infection; about 10% of all healthy people are populated with meningococci in the nose and throat region. Meningitis or blood poisoning can occur and the disease can lead to death from total health within a few hours.
The most common side effects of the vaccine are reactions at the injection site such as pain, swelling, redness, bruising and itching; general symptoms include fever, irritability, dizziness, sleepiness, headaches, gastrointestinal complaints such as loss of appetite, nausea, diarrhoea and vomiting, rash, common colds and coughs.
TBE – from 12 months, 3x (0/1/9-12 months)
TBE (tick-borne encephalitis) is a meningitis or encephalitis (inflammation of the cerebral membrane or the brain) transmitted predominantly by tick bites, sporadically also by the consumption of non-pasteurised milk and dairy products (from sheep and goats, very rarely also cows).
The most common side effects of the vaccine are reactions at the injection spot such as pain, swelling, redness; general symptoms include fever, sleeplessness, irritability, fatigue, headaches, gastrointestinal disorders such as loss of appetite, nausea and vomiting, flu-like symptoms, muscle aches and joint pain.
Varicella / Chickenpox – from 12 months, 2x (0/6 weeks)
The classic clinical picture of varicella (chickenpox) is an itchy rash with water-clear blisters and fever. Complications include meningitis, lung and liver inflammation and bacterial superinfections, which are more likely to develop in adults. It is recommended to vaccinate twice in the second year of life, the second vaccination should in any case take place before entering community facilities. Since chickenpox is a serious disease in adults and can cause serious complications during pregnancy, it is particularly important to vaccinate children from 9 years of age if they have not been vaccinated or have not had the disease yet.
The most common side effects of the vaccine are reactions at the injection site such as pain, swelling, redness, and itching; general symptoms include fever, irritability, varicella-like rash (approx. 5 lesions, non-contagious), common colds and coughs.
Hepatitis A – from 12 months, 2x (0/6-12 months)
After general complaints such as nausea, vomiting, fever, tiredness, jaundice occurs. Hepatitis A does not have a chronic course, the disease usually heals completely. The course of the disease is usually mild in children, whereas in adults it becomes more severe; cases of deaths from the age of 40 or in persons with a pre-damaged liver are possible. Next to the protection of the child, the vaccination of children also effects the elimination of the most important source of infection for adults. It is recommended to vaccinate children before entering community facilities, as the virus is introduced and spread after stays abroad.
The most common side effects of the vaccine are reactions at the injection site such as pain, swelling, redness, hardening; general symptoms include fever, malaise, irritability, drowsiness, headaches, and gastrointestinal complaints such as loss of appetite, nausea, vomiting and abdominal pain.
6 – 8 years – 4-times vaccination, 1x – free vaccination
It contains vaccines against diphtheria, tetanus, pertussis, poliomyelitis.
The most common side effects of the vaccine are reactions at the injection site such as pain, swelling, redness, bruising and itching; general symptoms include fever, fatigue, headaches, loss of appetite, nausea, diarrhoea, vomiting, rash, joint and muscle pains and joint swelling.
6 – 12 years – Hepatitis B – Refreshment or Primary Immunization (0/1 / 6months) – free vaccination
The highly infectious hepatitis B virus is one of the most common viral infectious agents worldwide. It is transmitted via blood or blood contact. It can cause acute or chronic inflammation of the liver (hepatitis), which can lead to cirrhosis and liver cancer. The WHO recommends a global general vaccine and inclusion in the vaccine programme for children in order to eradicate the disease worldwide.
The most common side effects of the vaccines are reactions at the injection site such as pain, redness and hardening.
9 – 11 years – HPV vaccination, 2x (0 / 6 months) – free vaccination
Human papillomaviruses (HPV) are spread globally. About 70% of all women and men are infected with genital HPV in the course of their lives. The HPV types 16 and 18 (from which the vaccine protects) cause >70% of cervical cancers. In addition, some cases of cancer of the vagina, the penis and the area of the mouth are caused by HPV. The HPV types 6 and 11 from which the vaccine protects) cause 90% of all genital warts (condylomas). The vaccine is recommended before entering the sexually active age.
The most common side effects of the vaccine are reactions at the injection site such as pain, swelling, redness, bruising and itching; general symptoms are fever, headaches and nausea.
11 years – 4-fold meningococcal vaccine (A, C, Y, W135), 1x – free vaccination
Meningococci occur worldwide, the groups A, B, C, W-135 and Y have the greatest significance for the occurrence of serious illnesses. In Austria, about 60-100 cases are registered annually (about 50-70% of meningococci of group B and 20-30% of meningococci of group C). Typical high risk areas for meningococci A or W135 are Africa and the Middle East. The transmission happens through droplet infection. A meningitis or blood poisoning can occur and the disease can lead to death from total health within a few hours. Teenagers often get infected when travelling together in groups.
The most common side effects of the vaccine are reactions at the injection site such as pain, swelling, redness, bruising; general symptoms are fever, irritability, fatigue, headaches as well as gastrointestinal complaints such as loss of appetite, nausea, diarrhoea and vomiting.
Fever
Fever is very common in childhood and often causes insecurity and worry. Fever itself is not a disease and does not lead to lasting neurological damages. Fever is a sensible and natural reaction of the body to pathogens and the increased body temperature has beneficial effects on the healing process because it activates the immune system.
When do we speak of fever?
From a temperature of about 38 degrees Celsius we speak of fever, from 39 degrees Celsius of high fever and from 40 degrees Celsius of very high fever.
How do I measure fever?
In infancy, it is best to measure the temperature with a digital thermometer rectally, meaning in the bottom. Later you can also measure the temperature in the ear, under the armpit or in the mouth.
The temperature that is measured rectally matches the actual body core temperature, with all the other measure methods you can add about 0.5 degrees Celsius.
What should I do?
Infants who have a temperature should be examined by the paediatrician to clarify the cause of the fever.
For older children that are generally in good condition– meaning that your child still wants to play, is active and does not seem very ill – you can wait and see. Make sure that your child limits its physical activities and that it drinks enough. Here it is advisable to offer sips of cool drinks. If the feet or lower legs are hot, you can make calf wraps. From about 40 degrees Celsius body temperature you should definitely give fever-lowering medicine. Up to about 40 degrees Celsius it is up to you whether you give fever-lowering medication to increase your child’s well-being. In poor general condition, shivering fits or long-lasting fever it is necessary to clarify the fever.
What is dangerous?
For the following symptoms it is important to call the Ambulance (144):
Change in consciousness, spasms, neck stiffness, bleeding into the skin, pale or blue complexion, shortness of breath, blood vomiting, massive bloody stools, blood in the urine, no urine, bilious vomiting, rigid belly.
Emergency
For the following symptoms it is important to call the Ambulance (144):
Change in consciousness, spasms, neck stiffness, bleeding into the skin, pale or blue complexion, shortness of breath, blood vomiting, massive bloody stools, blood in the urine, no urine, bilious vomiting, rigid belly.
122 Fire Brigade
133 Police
144 Ambulance
141 Overnight Medical Service
147 Rat auf Draht, Emergency contact for children, teenagers and any person to whom they are attached
Poison Control Centre
phone: 01 406 43 43
Crisis Intervention Centre
phone: 01 406 95 95
http://www.kriseninterventionszentrum.at/
Pharmacy Search – where is the next open pharmacy?
phone: 1455
http://www.apotheker.or.at/internet/oeak/Apotheken.nsf/webApothekensuche?Readform
Emergency Departments
St. Anna Kinderspital
Telefon: 01 40170-2100
Kinderspitalgasse 6, 1090 Wien
Klinik Donaustadt – hier auch Kinderchirurgie
Telefon: 01 28802-4350
Langobardenstraße 122, 1220 Wien
Univ.Klinik für Kinder-und Jugendheilkunde – hier auch Kinderchirurgie
Telefon: 01 40400-32290
Währinger Gürtel 18-20, 1090 Wien
Klinik Ottakring
Telefon: 01 49150-2810
Montleartstraße 37, 1160 Wien
Klinik Favoriten
Telefon: 01 60191-2850
Kundratstraße 3, 1100 Wien
Klinik Floridsdorf
Telefon: 01 27700 2660
Brünnerstraße 68, 1210 Wien
Emergency Hospitals
Unfallkrankenhaus Lorenz Böhler
phone: 05 93 93-41000
Donaueschingenstraße 13, 1200 Wien
Caution! Outpatient treatment:
open daily only from 6am until10 pm
Unfallkrankenhaus Meidling
phone: 05 93 93-45000
Kundratstraße 37, 1120 Wien
Univ.Klinik für Unfallchirurgie, Ebene 6C
phone: 01 40400-59400
Währinger Gürtel 18-20, 1090 Wien
SMZ-Ost (Donauspital)
phone: 01 28802-3402
Langobardenstraße 122, 1220 Wien
Home and Travel First Aid Kit
With children often happen unforeseen events and then it is good to have the right item at hand quickly.
I recommend always having the following items in the home or travel first aid kit:
When travelling by air children often have problems with pressure equalisation at take-off and landing. What can help? You could give something to drink to small children and you could give a chewing gum to older ones. Decongestant nose drops and painkillers in the form of juice or suppositories should be taken on board to give to your child in case it does not stop crying.
