Your private paediatric practice in 1100 Vienna

A Wahlarzt is a doctor in private practice who does not have a contract with your statutory health insurer.

The term comes from Austrian social insurance law: insured patients are free to choose a doctor outside the public health insurance system.

In many other countries, the simpler term would be a private doctor.

How payment works

• Depending on the services required, an appointment generally costs between €130 and €160.
• The treatment is not billed through the e-card. You pay us directly and receive an itemised invoice.
• You can submit this invoice to your statutory health insurer and, if applicable, to your supplementary private health insurer for reimbursement.
• Your statutory health insurer reimburses part of the cost. Depending on your policy, supplementary private insurance will often cover the remaining amount. See “How does payment and reimbursement work?” for details.

What are the benefits?

At our private practice, we offer prompt appointments, waiting times usually under 15 minutes and enough time to examine your child carefully and answer your questions.

If your child is acutely unwell, we will give you an appointment the same day — including on Saturdays. For acute appointments, the entire visit usually takes about 20 to 30 minutes.

We carry out many important tests directly at our practice, including:

• hip ultrasound scans for newborn babies,
• ECGs,
• urine tests,
• full blood counts and CRP tests from a finger-prick sample.

Results are often available within just a few minutes.

How quickly you need to act depends mainly on your child’s age and overall condition, rather than the exact number on the thermometer.

Call an ambulance immediately on 144 (Austria) or 112 (throughout the EU), regardless of your child’s age, if your child:

• is visibly struggling to breathe, has blue lips or has pauses in breathing. Signs of breathing difficulty include the skin pulling in between the ribs or at the neck, flaring nostrils or grunting with each breath;
• is very drowsy, difficult to wake or unusually unresponsive;
• has a seizure. Always call 144 for a first seizure; for recurrent febrile seizures, see “Febrile seizures — what should I do, and how dangerous are they?”;
• has a stiff neck or a rash that does not fade when pressed with a glass;
• is a baby with a bulging, tense fontanelle while calm and upright, or cries in an unusually high-pitched way and cannot be settled. These may be early signs of meningitis;
• looks grey or ashen and remains pale even when warmed, or has skin that takes longer than three seconds to turn pink again after brief pressure, for example over the breastbone;
• refuses all fluids and becomes increasingly unresponsive, or shows signs of severe dehydration, such as no wet nappy for several hours, sunken eyes or fontanelle, or no tears.

For reassurance, cool skin may look slightly mottled. If it turns pink again when warmed, this is usually harmless. The warning sign above is a bulging, tense fontanelle. A sunken fontanelle is a sign of dehydration, not increased pressure inside the head.

Go directly to a paediatric emergency department the same day if your baby is under three months old and has a rectal temperature of 38.0 °C or above.

At this age, fever can be caused by a serious infection that may not be obvious at first and needs prompt assessment in hospital. Very young babies can be seriously ill without a high fever, so also watch how your baby feeds, behaves and breathes.

Three to six months: seek advice sooner

Continue to take the temperature rectally and err on the side of caution. Have your baby assessed sooner rather than later, particularly if the temperature reaches 39 °C, the fever persists, your baby seems listless, feeds poorly or you are worried.

From around six months, your child’s overall condition matters most

From this age, the overall picture matters more than the precise temperature. A child who is drinking, alert and still plays at times despite a fever will usually have a harmless viral infection. If early signs of dehydration appear — noticeably fewer wet nappies, a dry mouth or no tears — have your child assessed the same day.

Make an appointment at our practice

• if the fever lasts for more than about two days, especially if it is still present on day five;
• if it returns after one or two fever-free days;
• if your child remains listless or drinks poorly even after the fever has come down;
• if new symptoms develop, such as earache, a rash, repeated vomiting, abdominal pain or a persistent cough.

If in doubt, always contact us.

It may help to know that fever is not an illness in itself. It is part of the body’s natural defence response, and the raised temperature helps the immune system. You do not need to bring it down at all costs, only when your child is clearly uncomfortable. With an infection, there is no temperature that is inherently “too high” and harmful in itself. External overheating is different, for example in a hot car or when a child is wrapped too warmly. In that situation, the body’s temperature regulation is overwhelmed and the heat can be dangerous. The most important thing is for your child to drink enough. Do not use cooling measures in young babies. For an older child who is uncomfortable and whose legs are warm, you may wrap lukewarm, never cold, wet cloths around the calves.

Outside our opening hours: children under one year should be taken directly to the nearest paediatric emergency department, not to the GP out-of-hours service on 141. For advice, the health advice line 1450 is available around the clock. In a life-threatening emergency, call 144.

Most coughs in children are harmless and settle on their own. What matters is not how loud or alarming the cough sounds, but how your child is breathing and how well they seem overall.

Pay particular attention between coughing bouts: Is your child breathing comfortably? Are they drinking? Are they alert and more or less their usual self?

Call an ambulance immediately on 144 (Austria) or 112 (throughout the EU) if your child:

• has difficulty breathing: the skin pulls in between or below the ribs or at the neck, the nostrils are flaring, there is grunting, breathing is clearly laboured or there are pauses in breathing;
• is so breathless that they can barely speak, drink or cry;
• has blue lips or bluish skin;
• is unusually drowsy, very difficult to wake or no longer responding normally;
• has a harsh, high-pitched sound when breathing in (stridor) even at rest — not only when crying — that does not improve when your child is held upright, calmed and taken into cool, fresh air;
• suddenly develops a severe cough, starts choking or cannot breathe after possibly inhaling an object while eating or playing.

Go directly to a paediatric emergency department if:

• your baby is under three months old, has a cough and a temperature of 38.0 °C or above.

If your child’s condition is deteriorating quickly or you cannot transport them safely, call an ambulance on 144 or 112.

Bring your child to our practice if they:

• have a cough and fever and are generally unwell — drinking very little, listless or unusually tired. Please come in the same day;
• have a cough and fever lasting more than two days;
• have a barking cough with hoarseness (croup), provided none of the emergency signs above are present;
• have newly developed wheezing without acute breathing difficulty;
• have repeated episodes of bronchitis or pneumonia;
• have an acute cough that shows no sign of improving after seven days;
• have a cough lasting longer than four weeks.

You can usually monitor your child at home if they:

• are breathing calmly without visible effort,
• have a normal skin colour,
• are awake and responsive between coughing bouts,
• are drinking enough,
• are not getting worse overall.

A loud cough, or one that is particularly severe at night, is not in itself a warning sign as long as your child is well between coughing bouts. You can also read our blog article on the subject.

What may help at home

• Use saline nose drops and gently clear the nose with a nasal aspirator.
• Offer fluids regularly.
• Once your child is over 12 months old, you can give them one teaspoon of honey before bedtime.

Never give honey to a child under one year old.

If you are unsure

• During our opening hours, call the practice.
• For telephone advice at any time, call the health advice line on 1450.
• Outside our opening hours, call the GP out-of-hours service on 141. It operates from 7 p.m. to 7 a.m. on weekdays and around the clock at weekends and on public holidays.

For babies under one year:

If your baby needs medical care outside our opening hours, please go directly to a paediatric emergency department. The GP out-of-hours service is not set up to assess babies.

In a life-threatening emergency, call an ambulance immediately on 144.

Feed your baby responsively, not according to a chart. Healthy babies are generally good at regulating how much they need. The best guides are their signs of hunger and fullness and their weight gain, which we monitor at check-ups. Never force your baby to “finish the bottle”.

Roughly how much?

As a very broad rule of thumb, not a fixed target, the total daily amount is about one sixth of your baby’s body weight. A baby weighing around 4,800 g, for example, may drink approximately 800 ml over the course of the day. The guidance on the formula packaging can also be useful. Both figures are only a guide. The markings on the bottle do not tell you whether the amount is right; a contented baby who is growing well and has enough wet nappies does.

Responsive bottle-feeding, or paced feeding

Milk flows from a bottle by itself, unlike at the breast, where your baby controls the flow. This can lead to overfeeding. Hold your baby in a semi-upright position, keeping the bottle almost horizontal with just enough tilt to keep milk in the teat. Pause regularly and watch for signs of fullness, such as slower sucking, turning away or relaxed fists. Stop when your baby seems full; never try to “empty the bottle”.

Which formula: Pre, Stage 1 or Stage 2?

• Pre formula (the standard first infant formula sold in Austria): like breast milk, its only sugar is lactose. It is thin and can be fed responsively. It is suitable from birth and throughout the first year.
• Stage 1 formula: this may also contain starch, making it thicker, and is marketed as “more filling”. It is not necessary.
• Stage 2 follow-on formula: this should be used only after your baby has started solid foods. There is no need to switch, as follow-on formula has no proven advantage. Iron-rich solid foods meet the slightly increased iron requirement during the second half of the first year.

Our advice is simple: you can use Pre formula throughout the first year. There is no need to “move up” to another stage. Even if allergies run in the family, your baby does not need a special formula. Based on current evidence, hypoallergenic or HA formula does not prevent allergies. See “Does my baby need hypoallergenic formula to prevent allergies?” for more information.

Preparing formula safely

• Powdered formula is not sterile. Prepare each feed fresh, shortly before it is needed; discard any leftovers and do not keep formula warm.
• Follow the instructions exactly. Level off the measuring scoop, do not add extra powder and never dilute formula with extra water. Formula that is too weak can be dangerous, while formula that is too concentrated puts strain on the kidneys.
• Use fresh water that has been boiled and then allowed to cool. During the first few months, clean and sterilise bottles and teats carefully. The WHO recommends making up powdered formula with water that is at least 70 °C to kill rare bacteria, particularly for premature babies and unwell newborns. For healthy, full-term babies in Austria, local guidance also accepts boiled water cooled to feeding temperature, provided the formula is fed immediately.