Hannibal Regional Medical Group Pediatrics

If you’re a parent, or about to be one, you know when it comes to choosing the right healthcare provider for your child, nothing but the best will do. Our pediatric team provides the specialized care your child needs from birth through college. When it comes to healthcare for your family, the one you choose, the one you trust and the one you see makes all the difference.

Pediatric Express Care

Pediatric Express Care offers personalized, prompt care for children of all ages, from babies to college, for minor health concerns or unexpected illnesses. Jennifer Bowler, DNP provides walk-in pediatric care Monday - Friday from 8 am - 5 pm (with the exception of holidays) at Reception 2E.

Pediatric Express Care is not intended for chronic and wellness issues such as medication checks, well checks, immunizations, etc.

What is Pediatrics?

Pediatrics is the field of medicine that is concerned with the health of infants, children, and adolescents; their growth and development; and their opportunity to achieve full potential as adults.

From routine checkups to immunizations, Hannibal Regional Medical Group is equipped to handle all of your child's health needs. To help you and your family understand your treatment options, we've included descriptions of some of our leading services on this page.

  • Asthma
  • Immunization
  • Autism
  • Diabetes
  • Allergies
  • ADHD
  • Fever
  • Bronchitis
  • Conjunctivitis
  • Tonsillitis
  • Colds
  • Strep Throat
  • Flu
  • Whooping Cough
  • Learning/Developmental Disabilities
  • Chronic Conditions
  • Ear Infections
  • Urinary Tract
  • Infections
  • Burns
  • Sports Injuries
  • Sports Physicals

Acute Illness Concerns

What should I do when my child has a fever? (Specify between neonatal fever and fever in other age groups)
Don’t panic. Fever is helpful and necessary to fight infection. A fever is 100.4 or above. Anything under 100.4 is not a true fever. A fever of 100.4 or above in the first 4 weeks of life, go straight to the ER. If a fever of 100.4 or above is noted in month 2-3, call your doctor to discuss other symptoms. If over 3 months and not having any other concerning symptoms, give Tylenol. No Motrin until 6 months of age. Older than 6 months, give Tylenol or Motrin for fever. Go to the ER if in respiratory distress or if not urinating at least 3 times in 24 hours. Make certain to push fluids and monitor symptoms.

Call your doctor if:

  • Your child looks or acts very sick
  • Any serious symptoms occur such as trouble breathing
  • Any fever 100.4 or above and your child is less than 28 days old
  • Any fever 100.4 or above and your child is less than 12 weeks old
  • Fever without other symptoms that lasts more than 24 hours (if age less than 2 years)
  • Daily fevers > 5 days
  • You think your child needs to be seen

How do I take my child’s temperature?
Typically, we recommend a rectal temperature for infants under the age of 2 months. But any other mode with a reliable thermometer is fine.

How do I take care of my newborn's umbilical cord? (Touch on things to watch out for that are concerning)
Just leave it alone. We no longer recommend placing rubbing alcohol on the site. It can increase risk for infection. It should dry up and fall off by itself in the first 1-2 weeks of life.

How do I take care of my newborn’s circumcision?
Hannibal Regional is currently using a gomco for circumcision. After circumcision, we would recommend covering the glans of the penis with Vaseline to help protect it from sticking to the diaper. This will help with healing. Apply Vaseline until it is completely healed, likely 5-7 days.

What can I do if my baby has diaper rash?
Allow diaper to air dry. Apply a zinc oxide barrier cream with each diaper change. Use water wipes or a sensitive towel with lukewarm water and sensitive soap for cleansing. If it worsens or persists, see your doctor.

My baby’s poop is weirdly colored. What does it mean?
Baby’s poop can be a lot of different colors, especially dependent on the foods they eat. Let your pediatrician know if stool is white, black or bloody.

When can I start giving my child Acetaminophen/Tylenol? What is the correct dose of Tylenol for my child?
You can start giving your child Tylenol at 1 month of age. Usually, a fever under 2 months needs an evaluation prior to Tylenol. View dosage chart here.

When can I start giving my child Ibuprofen/Motrin? What is the correct dose of Ibuprofen for my child?
You can start giving your child Ibuprofen at 6 months of age. View dosage chart here.

What should I do if my child gets a fever after receiving a vaccine?
Give Tylenol or Motrin, based on age.

What should I do if my baby is feeding poorly?
Try to wake baby up by getting them naked with just a diaper on. See your doctor if this lasts beyond a day.

Should I be concerned if my baby is spitting up?
Spitting up is very common. Seek immediate medical attention for green emesis, projectile emesis or if baby doesn’t urinate at least 3 times in 24 hours.

What should I do if my child is vomiting and/or having diarrhea?
Offer small amounts of liquid frequently and monitor urine output. Looking for child to have at least 3 voids/wet diapers in a 24-hour period.

My child has belly pain, what should I do?
It depends how the child looks – ill-appearing and belly pain should be seen right away. Distractible from the pain and not ill-appearing can usually wait for PCP visit.

My child has groin pain, what should I do?
For females
, if there is concern for suprapubic pain and/or a fever, see your pediatrician in the office to get a urinalysis to check for a urinary tract infection.
For males
, if they have groin pain and having any associated symptoms including scrotal swelling, exquisite tenderness to palpation, inability to visualize a testicle that they normal do you should seek care immediately in the ER. If pain is excruciating, or your child wakes up in 10/10 pain they need to be seen immediately. If less severe pain and more insidious in onset, it is recommended to see PCP that day.

What should I do if my child has a head injury?
Typically, we use PECARN criteria to decide whether head injuries can be monitored or require emergent evaluation or imaging.

Risk factors considered in PECARN:

  • severe mechanism of injury (falling from a high surface)
  • vomiting
  • altered mentation (ask basic questions if child is old enough)
  • if an infant, check for lethargy or level of responsiveness
  • difficulty ambulating for a child that is mobile
  • loss of consciousness

What should I do if my child is having difficulty breathing and/or wheezing?
Difficulty breathing requires urgent in-person evaluation.

My child is having difficulty swallowing, what should I do?
Call 911 or go to the ER.

My child has ingested something abnormal, what should I do?
Depends on the ingestion and how the child looks. If child is not immediately ill-appearing, it does not mean that side effects cannot happen later. ALWAYS CALL POISON CONTROL for advice. Call Poison Control at 1-800-222-1222.

What should I do if my child has a foreign body lodged in a body orifice?
Can be seen in office same day if not in any acute distress to get the object removed. If there is concern for an object being put in the vagina or rectum, your child should be seen same day by PCP.
If the foreign body is obstructing the airway, causing acute onset stridor, causing difficulty breathing, or causing bleeding in the orifice, then go to the ER.
If there is pain in the area, you are unsure of foreign object, it is reasonable to come in to see PCP.
If your child has unilateral foul-smelling nasal discharge, it is concerning for a foreign body.

What should I do if my child has COVID or may have been exposed to COVID?
If no respiratory distress or dehydration – ok to monitor at home.

Developmental/Wellness Concerns

When is it safe to start taking my baby out?
Some doctors prefer for parents to wait until their baby is a few months old before going to crowded public places. But there are no set rules about how long to wait before taking a newborn out into the world or when to let people near the baby. When you're out and about, though, do avoid exposing your newborn to anyone who is clearly sick. A newborn's immune system is still developing and may not be able to fight off infections. And ask anyone who holds, touches, or feeds your newborn to wash their hands first. It's also important to make sure your baby's vaccines are up to date. Your doctor may advise you to take extra precautions if your child was premature or has a condition that affects the immune system.

Should I wake up my baby to feed him/her? How often should I feed my baby?
In the first 2 weeks of life, it is recommended that baby goes no more than 4 hours max between feeds so you should wake up baby to feed. On average, should aim for 2-3 hour intervals during the day. If the infant is above birth weight by 2 weeks of age, you can stop waking baby. But if they are continuing to have weight gain issues, then continue to wake to feed every 4 hours at night and 2-3 hours during the day, unless your PCP tells you otherwise. Remember if you are breastfeeding, emptying breasts every 2-3 hours during the day and 3-4 hours at night is the best way to establish good production and flow.

When can I start giving Vitamin D drops to my baby?
Can be started once feeding is well established, usually at 2 weeks of age. Dose of vitamin D3 = 400 IU daily for baby. If you have any questions about concentrations for drops, you can always call the office. 

Why should a baby sleep on their back?
Studies show there is a lesser incidence of sudden infant death if infants sleep on their back.

Where is the safest place for my baby to sleep?
In their own sleep space, on their back, with nothing but them in the space.

Should I sterilize bottles and pacifiers after every use?
Typically, for healthy, term, non-immunocompromised patients, washing baby bottles and nipples after each use in dishwasher or sink is sufficient. If your child is born prematurely or immunocompromised, discuss with a pediatrician. If you are concerned or your baby has been diagnosed with thrush, then sterilizing pump parts, nipples, and bottle supplies is important.

How should I dress my baby?
Whatever layers you as the parent are comfortable in is probably appropriate for baby. If your baby was premature, then discussing this further with your PCP is recommended for potential additional layers needed.

When should I start potty training my child?
When they seem interested and ready – different for all kids.

My child is wetting the bed at night. Is that normal?
Typically, bedwetting can be developmentally normal up through age 7-8 years old. It can run in families. Usually, there is no intervention with treatment unless your child is above the age range. If parents are wanting to do something, you can try withholding liquids after dinner time. If your child was not having issues with bedwetting and suddenly started wetting the bed, you should see your PCP.

When can my child transition from a car seat to a booster seat? When does my child no longer need a booster seat?

Per the AAP,

  • All infants and toddlers should ride in a rear-facing car safety seat (CSS) as long as possible, until they reach the highest weight or height allowed by their CSS’s manufacturer. Most convertible seats have limits that will permit children to ride rear-facing for 2 years or more.
  • All children who have outgrown the rear-facing weight or height limit for their CSS should use a forward-facing CSS with a harness for as long as possible, up to the highest weight or height allowed by their CSS’s manufacturer.
  • All children whose weight or height is above the forward-facing limit for their CSS should use a belt-positioning booster seat until the vehicle lap and shoulder seat belt fits properly, typically when they have reached 4 ft 9 inches in height and are between 8 and 12 years of age.
  • When children are old enough and large enough to use the vehicle seat belt alone, they should always use lap and shoulder seat belts for optimal protection.
  • All children younger than 13 years should be restrained in the rear seats of vehicles for optimal protection.

What is a typical vaccine schedule for my child?
View the CDC birth - 18 years immunization schedule here

Which is better, baby-led weaning or traditional introduction of solids?
Either one is fine. Regardless of which one you choose, it’s important to make sure your child is developmentally ready to start solids. Once discussed with PCP that your child is ready for solids, you can proceed with either method. It is recommended that you introduce single-ingredient foods every couple of days to pinpoint any adverse reactions to certain foods.
Baby-led weaning
– giving baby fully intact foods that the family eats like traditional table foods. The babies introduce themselves to foods and feed themselves, letting them guide the food that makes it into their mouths. It requires closer monitoring from parents due to potentially increased choking risk.
Traditional introduction
– starting with purees, cereals, fruits and veggies. You as the parent spoon-feed baby.


Our Pediatric Providers

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