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The information/links below serve as an aid for you after hours. Please call our nursing line or have your child seen by a physician if you have a concern you feel needs to be addressed before our office opens or if you are worried about the health of your child.  


We recommend taking your child to a children's hospital or pediatric urgent care if you need to be seen after hours.  If you are in the Katy area, the closest locations are listed below:



Texas Children’s West Campus – 832-227-1000

Memorial Hermann Memorial City – 713-242-3000



Urgent Care for Kids – Cinco Ranch - 281-392-3033

Pediatric Night Light – Katy - 832-321-5848

Texas Children's Urgent Care - Cinco - 281-789-6300


Fever is a normal response by your body to various causes (i.e., infections, vaccines). Fever can make a child feel uncomfortable, but it can also be beneficial. Fever helps the body fight infection, turns on the body's immune system, and may help shorten the course of illness. Fever is defined as a temperature ≥ 101ºF in a child older than 3 months. There are many ways to take temperature including under the arm (axillary), rectally, orally, in the ear, or with a temporal scanner.

Keep track of your child’s actual temperature and how you take the temperature. If your child has a fever, we recommend treating the fever only if the child is uncomfortable. In most cases the anti-fever medicine (i.e., ibuprofen (Motrin, Advil) and acetaminophen (Tylenol,)) will only bring the child’s temperature down 1º-2º degrees. For example, if your child has a 104ºF temperature, we expect the fever to drop to 102º-103ºF with medication. As an adjunct to fever reducers, you can give your child a tepid (water temperature of 85º-90ºF) bath. In certain circumstances, fever can be a sign of a more serious illness. Notify the on-call physician of your child’s fever if it meets one of the criteria listed below.

Immunizations Reactions

When your child receives vaccines, it is quite common for him/her to have fever, discomfort, swelling and redness around the injection site. For more information about shot reactions, consult the vaccine handout you received in the office.

In most cases shot reactions are not emergencies.

When to call the doctor:

  • If your child is unresponsive or has a fever >105ºF after the immunization
  • If the immunization site is very swollen, greater than 3 inches in size, or has a red streak running from the injection site


There are many illnesses that will cause vomiting and/or diarrhea. These illnesses are commonly referred to as viral gastroenteritis. In most cases, children do not need to be seen immediately for these symptoms. The most important thing you can do is keep your child hydrated. The best way to keep small children (< 3 years old) hydrated is with an oral rehydration liquid (i.e., Pedialyte). Older children can take water, flat ginger ale, or Gatorade. Avoid red or green colored drinks for it may artificially make the vomit appear to be blood-stained or bile-stained.

Also avoid drinks high in sugar such as apple juice. If your child has vomited, let his/her stomach rest for 1-2 hours after an episode of vomiting before introducing liquids. Then start with small sips of liquids – 5cc or 1tsp every 5 minutes. If your child tolerates this you can increase or double the amount you give them each time. Some children will continue to vomit but in most cases the frequent, small amount of liquid will keep them hydrated.

When to call the doctor:

  • If your child is unable to keep liquids down for several hours (6 hours for infants or 12 hours for older children)
  • If your child is having severe pain in his/her stomach with vomiting
  • If the vomit has blood in it or is green in color
  • If your child is unresponsive, or appears very dehydrated (sunken eyes, not urinating for > 8 hours)


As with vomiting, diarrhea is most often caused by a viral gastroenteritis. The key is to keep your child hydrated with water. Avoid juices (especially apple, pear, or prune juice) or any drinks high in sugar as these types of drinks can worsen the diarrhea. For breast fed or formula fed infants, continue normal feeds. In older children (> 1 year old), give more starchy foods (rice, bread, plain pasta).

In most cases, diarrhea is not an emergency and can be addressed during office hours. We do not recommend any medication to stop diarrhea. Such medications may prolong the illness.

When to call the doctor:

  • If your child is having bloody stools
  • If your child has become very dehydrated (sunken eyes, not urinating for > 8 hours)


Cough is a normal response to most upper respiratory infections. With a few exceptions, you can treat your child at home. Cough medicine is not recommended for children younger than 4 years old. For children >1 year you can give 1 tsp of honey every 4-6 hours. For children >4 years you may also give cough drops or throat lozenges to help soothe the throat.

When to call the on-call doctor:

  • If your child is having trouble breathing or is breathing rapidly
  • If your child has asthma or reactive airway disease and his/her breathing is not responding to breathing treatments given every four hours

Nasal Congestion

As with cough, children may suffer from nasal congestion or runny nose with colds. Nasal congestion is not an emergency.

For infants and young children unable to blow their nose, you can help them by suctioning their nose out. You can also use nasal saline (salt water) drops to thin the nasal discharge.

You may also use a cool-mist humidifier in your child’s bedroom during the illness. This helps to moisten the air and may help to clear their nasal passages.

Earache and Sore Throat

In general, both earaches and sore throats are not emergencies, but may need to be seen in the morning. Antibiotics, if warranted, will be prescribed after your child has been evaluated. If you feel that your child cannot wait until the morning to be seen, then take him/her to an urgent care center. In the meantime, pain relievers and warm compresses may provide comfort. For an older child with a sore throat, try having him/her gargle with a teaspoon of salt dissolved in warm water for temporary relief.

When to call the doctor:

  • If your child’s sore throat includes other symptoms: excessive drooling, severe difficulty swallowing, difficulty breathing, or being unable to open his/her mouth fully
  • If your child’s earache includes other symptoms: stiff neck, loss of balance when walking, or redness and swelling behind one ear in comparison to the other ear


In most cases, rash or unusual skin changes are not emergencies and cannot be diagnosed over the phone. If you are concerned about a rash, please call during regular office hours. If your child has recently started a medicine and develops a rash, stop the medication and call our office in the morning.

When to call the doctor:

  • If your child is inconsolable or unresponsive or with a high fever (>104ºF) and also has a new rash. This situation is considered an emergency. We recommend that your child be seen immediately in an emergency room or urgent care facility.
  • If the rash is purple/blood-colored spots, or bright red and tender to touch, or red streaks that is spreading, or appears like a burn
  • If the rash is associated with swollen lips, swollen tongue, difficulty breathing, or abdominal pain, go to the emergency room as this may be a severe allergic reaction.


Conjunctivitis is also commonly referred to as pink eye. Pink eye does not require immediate therapy in most cases. If your child has developed redness in the eye or discharge from the eye, please call our office during business hours. Until your child is seen, you can treat the eye with warm compresses or artificial tear drops (available at most drug stores).

The tear drops can be used as often as needed to irrigate away the discharge. Remember, conjunctivitis may be contagious, so wash your hands after caring for your child. Medication, if warranted, will be prescribed after your child has been examined.

When to call the doctor:

  • If your child sustained trauma to the eye
  • If your child is unable to see from the eye or complaining of severe pain
  • If your child cannot open his/her eye because of eyelid swelling. First wipe away any discharge with a warm washcloth to help the eye open.

Accidental Ingestions

Please call the poison control hotline (800-222-1222) for all accidental ingestions. They are best equipped to answer all of your questions.


In general, if your child sustained a severe injury, you will need to bring him/her to an emergency room or urgent care center. A diagnosis can only be made after an evaluation of your child. The doctor in most cases will only be able to give recommendations as to whether your child needs to be seen immediately or if it can be addressed during our regular hours.


Constipation is not an emergency and can be addressed during office hours. If your child is having difficulty stooling, make certain they are well hydrated. You may offer natural laxatives such as apple juice and prunes. If they are still having difficulty please call our office for additional medication advice.

Prescriptions and Antibiotics

In the best interest of a sick child, an examination should always be done first before any medication, if warranted, is prescribed. If you are concerned about your child’s illness and think your child cannot wait until the morning to be evaluated, take your child to an emergency room or to an urgent care center. Should issues arise with a refill request, please call during regular business hours when we are best able to handle these requests.

Tylenol and Motrin Dosing

Click here to download the dosing file.

After Hours