Frequently asked questions

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.

What are the benefits of supplementary private health insurance for my child?

The main benefit is financial, so it is worth being clear about the costs. During the first year of life, most children see a doctor seven to ten times for routine check-ups, vaccinations and minor infections. At a private practice, this can quickly add up to more than €1,000. By comparison, a child’s supplementary health insurance policy that reimburses around €2,000 a year in private doctors’ fees is available for less than €25 per month, or around €300 per year.

Insurers can offer relatively low premiums because they expect many families to keep the policy long term. Children also tend to become ill less often from around the age of four. At that stage, you can cancel the policy or keep it for peace of mind, knowing that you can see a doctor easily whenever you are concerned.

Freedom to choose a doctor — including abroad

With supplementary insurance, you can see any private doctor in Vienna — in Vienna’s first district, in Döbling or at our practice — and then claim reimbursement. Depending on the policy, the cover may even apply abroad. If your child becomes ill on holiday, the cost of private medical care may also be covered.

What to look for in a policy

Any additional cover depends on the policy. Some policies reimburse medicines or privately funded vaccinations, although the cheapest options usually do not.

Private hospital cover, including a private room and a choice of doctor, is a separate matter. It increases the premium considerably, and whether you need it is a personal decision. Most hospitals in Vienna provide excellent care even without private cover. If your main aim is reimbursement for appointments with private doctors, an inexpensive policy will therefore usually be enough.

One tip: you do not need a broker. Take your time and compare policies yourself so that you do not pay more than necessary. Check the excess and annual reimbursement limit, and whether the policy covers medicines, privately funded vaccinations and medical fees abroad.

How does payment and reimbursement work — and how much will I get back?

You pay for the appointment directly and receive an itemised invoice. You then submit this to your statutory health insurer. Depending on the insurer, you can do this online, through an app, by post or in person. For example, you can submit your invoice to ÖGK through “Meine ÖGK” using ID Austria. You have up to 42 months to submit the claim, so there is no immediate rush.

How much will be reimbursed?

Your statutory health insurer reimburses around 80% of the fee it would have paid a contracted doctor for the same service — not 80% of our invoice. Because that fee is lower than the amount charged by a private doctor, you will still pay part of the cost yourself. For example, an appointment at our practice costs around €140 on average. In our experience, the statutory insurer reimburses about €30. This leaves approximately €110 unreimbursed. Supplementary private insurance covers this balance for many families, often in full. See “What are the benefits of supplementary private health insurance?” for more information.

How quickly can I get an appointment?

We can usually see acutely unwell children the same day. Routine child health check-ups and vaccination appointments are normally available within a few days.

You can book easily online through our website, or call us on +43 1 6061088 and leave a message.

Will we have to wait?

Usually not. You will usually wait less than 15 minutes – and often there is no wait at all, or just a few minutes. Our appointment system is designed so that your child can be seen promptly and we deliberately avoid overcrowding the waiting room. Only on exceptionally busy days with many acutely unwell children might it take a little longer.

If you are bringing a newborn or young baby, we will give you an appointment at the beginning of the day whenever possible. The practice is well ventilated and not yet busy at that time, so the risk of infection is at its lowest. See “Separate waiting areas” for more information.

What should I bring to the appointment?

Please bring three things to every appointment:

your child’s e-card,
your child’s parent-child health record (the Austrian Parent-Child Pass, formerly the Mother-Child Pass),
your child’s vaccination record.

For an urgent appointment, the e-card alone will do if necessary. It is better to come promptly than to delay because you do not have everything with you.

Before an appointment to discuss test results

Please send us all relevant medical reports and test results, preferably at least one day before the appointment. Email them to praxis@meinkinderarzt.wien or upload them through your patient account on Latido, and bring the originals to your appointment.

This means we can use the appointment to discuss the findings rather than spending time scanning and reading documents.

If your child is unwell, please add a short note in the comments field when booking:

why you are coming and when the symptoms began,
the highest temperature you have measured,
any medicine your child has recently received, including the name, dose and time given,
accompanying symptoms, such as a cough, breathing problems, vomiting, diarrhoea, pain, a rash or anything else you have noticed.

Example: Fever since yesterday; maximum rectal temperature 39.2 °C at 7 a.m. and 6 p.m. Gave 5 ml Nureflex at 7:30 a.m. Coughing, drinking less and very clingy.

How can I cancel an appointment?

It is straightforward: leave us a message on +43 1 6061088, email praxis@meinkinderarzt.wien, or cancel online through Latido up to the day before your appointment. Please let us know at least 24 hours in advance whenever possible. This allows us to offer the appointment to another child who urgently needs to be seen.

If you cancel on the day or do not attend, we must charge a missed-appointment fee of €80. This is not intended as a penalty; the fee reflects the appointment time reserved exclusively for your child. If a genuine emergency prevents you from attending, call us. We will of course take the circumstances into account.

How is my healthy child protected from infection in the waiting room?

We keep the risk of infection as low as possible. Unwell and healthy children wait in separate waiting rooms, so your healthy child is not sitting next to a child with a cough during a routine check-up.

For the youngest babies, we go one step further. Whenever possible, appointments for newborns and young babies are scheduled at the beginning of the day, when the practice is not yet busy and has just been ventilated. During the first few months, before the initial vaccinations have taken effect, we want to minimise their exposure to infection.

Can I get medical advice by phone or email?

Yes, and for many questions this is the quickest option. Email is the fastest way to reach us. Questions about a test result or treatment, uncertainty about a dose, updates on how an illness is progressing — “better since yesterday, but…” — and the common question “does my child need to be seen?” can often be dealt with by email or phone. That is what we are here for, so if in doubt, it is better to ask.

How to contact us

Email praxis@meinkinderarzt.wien, preferably including your child’s name and social insurance number, or call +43 1 6061088 and leave a message. We usually reply within half an hour. If the matter is not urgent, we will respond by the end of the day.

An important limitation

We cannot safely diagnose or treat a new, acute illness in a child we have not examined. In that situation, we need to see your child. This is particularly true of rashes, which cannot be assessed reliably by email or phone. We also issue prescriptions for new symptoms only after an appointment. Repeat prescriptions for known, ongoing treatments can usually be arranged easily after speaking to us.

Where can I find the nearest pharmacy or an out-of-hours pharmacy?

The Rotenhof Pharmacy is just around the corner, so you can collect prescribed medicines immediately after your appointment.

At night and on Sundays and public holidays, pharmacies provide out-of-hours cover according to a fixed rota. You can find the nearest pharmacy currently on duty at nachtapotheke.wien, through the Austrian Chamber of Pharmacists’ out-of-hours calendar, or by calling the pharmacy information line on 1455. The automated service will tell you which nearby pharmacy is on duty.

Please note that pharmacies charge a small statutory out-of-hours fee for overnight services.

When should my newborn first see a pediatrician?

In the first week of life you should arrange your baby's first pediatric check-up. At this visit we do a hip ultrasound, measure the bilirubin level painlessly through the skin (photometry) and discuss how your baby's weight is coming along.

The second appointment with us is at around seven weeks: the first Mutter-Kind-Pass check-up, the second hip ultrasound, the orthopedic check, the third vitamin K dose and the first vaccinations, all in one appointment (vaccinations aren't possible any earlier).

Two practical notes: getting the full childcare allowance (Kinderbetreuungsgeld) is tied to the check-ups being done on time, so keep a good eye on the dates. A missed check-up can't be entered retrospectively, so plan it in good time. And outside the schedule you may come any time your baby seems unwell or you're worried.

Newborn jaundice — why does it happen, and is it dangerous?

These warning signs need prompt review — don't wait and see:
Your baby is barely rousable to feed or skips feeds; or cries unusually shrilly and is hard to settle.
The yellowing deepens from day to day or reaches down onto the tummy, legs, or hands and feet.
Time-critical: pale, unpigmented stools (whitish, clay-colored) together with dark urine.
Book an appointment in that case — we measure the bilirubin level here, painlessly through the skin, with no needle at all. Jaundice can't be judged reliably over the phone. If the signs are marked, or outside our opening hours, drive straight to a children's emergency department.
How to judge it yourself: in daylight, press briefly on the skin with a finger (the bridge of the nose or the forehead) — the briefly blanched spot shows the yellow tinge. The further the yellowing reaches down (tummy, legs, feet), the sooner you should bring your baby in to us. Marked yellowing already on the first day of life is usually picked up in the maternity unit; only with early discharge or a home birth do you need to watch for it yourselves.

Most newborns go a little yellow in the first days of life — as a rule this is harmless and passes on its own. About one in two babies born at term shows visible yellowing.

Why does it happen? After birth the body breaks down the "old" blood from the pregnancy. In doing so it produces the yellow pigment bilirubin. The still-immature liver can't quite keep up with clearing it at first, the bilirubin builds up, and the skin and the whites of the eyes turn yellow. This normal newborn jaundice usually starts on the 2nd–3rd day of life, peaks around the 4th–5th day and fades by about the 10th–14th day.

Breastfed babies are sometimes yellow for longer and more intensely — this so-called "breast-milk jaundice" can harmlessly last several weeks. What matters most then is that your baby feeds often and well, gains weight well, and has normally colored (yellow, mustard-colored) stools — not whitish or pale. The more they feed and pass, the faster the bilirubin clears. Stopping breastfeeding is almost never necessary — on the contrary, frequent feeding helps. If your baby is still clearly yellow after about two weeks, have them checked by us — no emergency, just to make sure the stool color is normal and there's no rarer underlying cause.

What you should NOT do: put your baby in sunlight as a treatment. It's often suggested, but it's neither effective nor safe — it risks sunburn, overheating and fluid loss, and light coming through window glass has no effect anyway. The actual treatment (a special light therapy above certain blood levels) is carried out under supervision in the hospital when needed.

Why the warning signs matter: very high bilirubin levels can, in rare cases, harm the brain — which is why the level is measured when needed (in the maternity unit often painlessly through the skin) and treated in good time. Severe cases are very rare today precisely because of this early attention. The pale stool with dark urine is a separate, time-critical warning sign: an underlying disorder of the bile ducts can be the cause, and it must be picked up early.

In Austria jaundice is monitored around the time of birth and at the first Mutter-Kind-Pass check-ups. If you're unsure whether your baby is "too yellow" or is feeding too little, it's always better to make an appointment and have us check — we measure the level here painlessly through the skin. Jaundice can't be judged reliably over the phone.

Vitamin D — when, how much and why?

The essentials

From the second week of life, give your baby vitamin D every day:

one drop of Oleovit D3 = 400 IU, once daily.

This applies to breastfed and formula-fed babies alike.

How to give the drop

Give it directly into your baby’s mouth or on a small spoon with a little milk or water. Do not mix it into a full bottle, as you will not know how much your baby received if they do not finish it. Give it every day throughout the year, including in summer.

Use only one vitamin D product and check the dose on the packaging, as different drops contain different amounts.

For how long?

Continue until the start of the second summer after your baby was born — usually for around 12 to 18 months, depending on the month of birth:

born in spring or summer: usually around 12 months,
born in autumn or winter: usually around 18 months.

We will discuss when to stop at your child’s routine check-ups.

When is a different dose needed?

From the first birthday, we recommend two drops, or 800 IU, a day during the winter months, approximately October to March. Sunlight is sufficient in summer.

Some children need a higher dose at other times too, including certain premature babies and children at increased risk of deficiency. We will prescribe the appropriate dose for your child. Do not change it yourself.

Why is vitamin D needed?

Vitamin D helps the body absorb calcium, which is needed for strong bones. A severe deficiency leaves the bones soft, a condition called rickets. Breast milk and infant formula alone do not reliably provide enough, and babies should not be exposed to direct sunlight. The daily dose helps prevent vitamin D deficiency and rickets.

Prescription

Oleovit D3 is available only on prescription in Austria. We can issue this for you.

Baby acne and newborn rashes — what to do?

The short answer: most rashes in the first weeks of life are completely harmless and clear on their own — no cream, no treatment. This includes baby acne, the "newborn rash" and tiny white milk spots. Usually all you need to do is watch and wait.

The most common harmless rashes:

Baby acne (neonatal acne): small red spots or pustules on the cheeks, forehead and nose, often from the 2nd–4th week of life. The cause is hormones — not the wrong diet or your care. It clears on its own, usually within a few weeks. Please don't squeeze and don't use adult acne products.
Newborn rash (erythema toxicum): very common (around half of all term newborns), in the first days of life; reddened blotches with a yellowish dot in the middle, "like flea bites". Harmless, gone after a few days.
Heat spots (miliaria): small red or clear blisters when the baby is too warm. What helps here: don't overheat, one layer less, and don't let the room get too hot (see the room-temperature question).
Milia (milk spots): tiny white dots on the nose and cheeks — they go on their own.

What you can do: as a rule, nothing beyond gentle care: wash mildly, don't scrub, don't squeeze, don't overheat. Almost all of it sorts itself out in time.

When NOT to wait and see: if your baby develops blisters and also seems unwell — floppy, feeding poorly, feverish — or if clustered blisters on a reddened base appear, then please have your baby reviewed by a doctor straight away. In very young babies an infection can be the underlying cause (for example, with herpes viruses) that needs prompt treatment — and a fever isn't always present. Have these checked too: small pinpoint bleeds that don't fade when pressed (petechiae), or a widespread rash with a distinctly unwell child.

If you're unsure whether a rash is harmless: when in doubt, book an appointment and come in — we can only judge a rash reliably if we see it. With young babies especially, we would always rather take one extra look than miss something.

Cradle cap — what helps, and what's the difference?

Put simply: what most parents call "cradle cap" is usually the harmless, greasy kind — yellowish, greasy scales that stick firmly to the scalp. It's nothing to worry about, doesn't itch and clears on its own. There's little you need to do beyond gently loosening the scales when necessary.

Two things that often get confused:

Cradle cap (seborrheic eczema): yellowish, greasy scales and crusts that stick firmly to the head, sometimes with slight redness. The baby is comfortable, and it doesn't itch. It often starts in the first weeks of life and grows out over weeks to months. It has nothing to do with milk, diet or poor hygiene (the German name "milk crust" is just a historical one).
True infantile eczema, by contrast, can be the first sign of atopic dermatitis: red, weeping, itchy patches, often on the cheeks, with a fussy, unsettled baby. It looks similar but is something different.

What helps with cradle cap:

Soften gently: dab a little oil (e.g. a mild baby or plant oil) onto the scales in the evening, let it soak in, and the next day loosen it carefully with a soft little brush or washcloth and a mild wash.
Don't scratch it off: please don't force the crusts off — that injures the skin and can encourage infection.
Patience: it's purely cosmetic. Even if you do nothing at all, it disappears in time.

When to come into the practice? If the patches are weeping, markedly red, itchy or your baby scratches at them or is unsettled — then we'll look at whether atopic dermatitis is the underlying cause. That's well managed with the right moisturizing skincare. Also, if the cradle cap spreads a lot, looks inflamed, or you're unsure, just drop in.

The umbilical stump — how do I care for it, and when does it fall off?

The umbilical stump needs one thing above all — to stay dry and clean. It dries out over the first days and usually falls off on its own within about 1–2 weeks (the range runs from a few days to around three weeks). You don't need to disinfect anything. A faint smell as it dries out is normal; only a strong, foul smell is a warning sign (see below).

How to care for the navel:

Keep it dry: fold the top of the diaper down at the front so the stump is left uncovered and isn't tucked into the damp diaper.
Keep it clean: wash your hands before touching it. If the stump gets dirty, clean it with a little lukewarm water and pat it carefully dry — don't rub.
No powder, no oil, no ointment on the stump — keeping the area damp tends to encourage infection.
Bathing: in the first few days, washing with a washcloth is enough. A short bath is fine as long as you dry the navel well afterward; it shouldn't be constantly soaked. (More on bathing in the separate question.)
Let it fall off on its own: please don't pull at it or help it along, even when it seems to hang by a thread.

Bathing normally again after it comes off: once the stump has fallen off and the spot is dry, you can bathe your child normally again. A small damp or crusty patch in the first days afterward is normal — keep the navel clean and dry. If you notice redness, weeping or a foul smell, please let us know.

Warning signs — please have these reviewed promptly: if the skin around the navel is red, swollen, hardened or warm, if pus comes out or it smells foul, or if your baby develops a fever, feeds poorly or seems unusually floppy. This can be an infection of the navel (omphalitis) — rare, but it can spread quickly and needs to be seen by a doctor the same day. And if a baby under 3 months also develops a fever of 38.0 °C or more (rectal), then in any case: have your baby seen straight away, even at night — don't wait until the next day (see the fever question).

Two harmless things to put your mind at rest: if a small reddish, weeping lump remains after it falls off (an umbilical granuloma), that's easily treated at the practice. A soft bulge that pushes out when your baby cries (an umbilical hernia) is not an infection — it usually settles on its own over the first years of life.

Still not off after three weeks? Usually that's harmless too — we'll look at it at the next check-up, or you can drop by.

Head shape and a preferred side — what's normal?

In brief: many babies develop a slightly flattened or asymmetrical back of the head in the first months, because they lie a lot on their back and often have a preferred side. This is usually harmless, responds well to simple measures, and improves on its own as they become more mobile. What works best is tummy time while awake and regular repositioning.

Why does it happen? Since babies have been put to sleep on their back, sudden infant death has fallen sharply — a major step forward. One side effect is that a baby's soft head can become a little flatter under the pressure. Important: this is no reason to move away from sleeping on the back — back sleeping is still right. There are other ways to influence head shape.

What you can do (preventing and evening out):

Tummy time while awake: several times a day, put your baby on their tummy while awake and supervised. This strengthens the neck and back and takes the pressure off the back of the head. (For sleep, they stay on their back.)
Reposition and mix up what catches their attention: switch which way the head faces in the crib, offer interesting things (light, the window, your face) from either side in turn, and vary the side when carrying and feeding.
Less time in baby seats, bouncers and car seats when it isn't needed — there the head always presses on the same spot.

Does my baby need a helmet? In the vast majority of cases no. Studies show that helmet therapy for moderate deformity is no more effective than letting it correct naturally with repositioning — and it's costly and stressful. Only in marked cases is it even considered, at a specialist center.

When to have it looked at by a doctor:
The preferred side is very fixed and your baby can't turn the head well to the other side — this can be due to a shortened neck muscle (muscular torticollis). It's usually well treated with early physiotherapy.
The deformity doesn't improve despite repositioning, or gets worse, you feel a bony ridge on the head, or the head shape seems unusual — this should be reviewed by a specialist (very rarely a skull suture closes too early — a craniosynostosis).
The face looks noticeably asymmetrical.

Head circumference is measured at every Mutter-Kind-Pass check-up anyway — if you're unsure, we're happy to look at head shape and movement together.

Green, yellow, mucousy or nothing for days — which baby stool is normal?

Check straight away, without waiting: a white or pale (light, clay-colored) stool in your baby. This can point to a problem with the bile ducts (biliary atresia) and is time-critical — the sooner it's spotted, the better it can be treated. If in doubt, photograph the stool in daylight (so we can judge the color) and come to us or to a children's emergency department the same day. Important: a single normal stool doesn't reliably rule the problem out — keep an eye on the color over about a week.

You should also have these checked quickly: blood in the stool; a black, tarry stool after the first days of life (which can point to bleeding in the upper digestive tract — not to be confused with the normal black meconium of the first day or two); and a hard, pellet-like stool with pain (constipation).

And now for the reassuring part — because in infancy a surprising amount is normal:

The first stool (meconium) is sticky and almost black, and should come in the first day or two after birth; if, in a baby born at term, it fails to appear at all for longer than 48 hours, this should be checked (partly to rule out a congenital bowel-nerve disorder — Hirschsprung's disease; see also the question on constipation).
After that, for a week or two, comes a greenish transitional stool, later yellow to mustard-colored in breastfed babies (often grainy and soft) and firmer and light brown in bottle-fed babies.
Green, mucousy stools, or stools that change color, are usually harmless and reflect the food and the pace of digestion.
The frequency, too, varies widely: a fully breastfed baby can range from several times a day to — in some cases — only once in one to two weeks. As long as they drink well, thrive and the stool is soft, there's no cause for concern (a rule of thumb, not a rigid rule).

So the essentials are a soft stool and a content, thriving child — plus the warning signs above, where you shouldn't wait. When in doubt, get in touch with us.

What temperature should the home be set to for a newborn?

Briefly: by day a normal room temperature of around 20 °C is comfortable, and the bedroom can be a touch cooler (about 18–20 °C). More important than the exact thermometer reading is that you don't dress or cover your baby too warmly — better a little cooler than too warm.

Why cooler rather than warmer? Overheating is one of the risk factors for sudden infant death. A baby bundled too warmly or kept too hot is more at risk than one kept a little cooler. So keep the bedroom on the cool side, with a sleeping bag instead of a thick duvet (more on that in our question on safe sleep).

How to tell whether your baby is too warm:

Feel the back of the neck or the back between the shoulder blades — the skin should feel warm, but not sweaty.
Hands and feet are naturally cooler in babies — they're not a reliable guide. Cold little hands don't mean your baby is cold.
It's too warm if your baby is sweating, has damp hair at the neck, has hot or reddened skin on the body, or develops heat spots.

Clothing — the simple rule of thumb: your baby needs at most one layer more than you in the same room — often not even that. For sleep, a sleeping bag instead of a duvet, and no hat indoors (a baby gives off heat through the head — a hat indoors traps it and overheats). Hats are for outdoors.

One more practical point: air out the room regularly, don't let the air get too dry (during the heating season, a little humidifying is fine), and keep the bed away from direct heat from radiators or sun. Premature and very small babies cool down and overheat more quickly — with them we'll go through the details individually.

A common misconception is that a baby must be kept "nice and cozy warm". The opposite is true: too warm is a risk, pleasantly cool is safe.

Can I fly with my baby — and how can I help with the pressure in their ears?

Healthy babies born at term can generally fly — there's no fixed medical minimum age. To help ease the pressure in their ears there's a simple, effective rule: let your baby suck or feed at take-off and landing (breast, bottle or pacifier). Swallowing opens the Eustachian tube and relieves the pressure.

From what age? For a healthy term baby, there's no medical reason not to. That said, airlines set their own age limits (often only from a few days to two weeks), and from a pediatric point of view it makes sense not to fly with a very young newborn without good reason — mainly because of the still-immature immune system and the many people on board. For very young babies, it's best to talk the flight through briefly with us.

How to ease ear pressure:

On the climb and descent (take-off and especially landing) give your baby something to suck — breast, bottle or pacifier. Swallowing is the natural way to relieve the pressure.
Keep your baby awake at take-off and landing — a baby who's awake swallows more, which clears the pressure better than in deep sleep.
Special earplugs aren't needed and do nothing for ear pressure — swallowing is what counts.

If your baby has a cold: with a blocked nose, and especially a middle-ear infection, the Eustachian tube is swollen, so the pressure can't clear as easily — and that can hurt. So if your baby has an acute infection or an acute middle-ear infection, please discuss the flight with us beforehand; sometimes it's better to postpone. Decongestant nose drops only after checking with us and in the appropriate infant dose; no essential oils in babies.

On board: the cabin air is dry — offer the breast or fluids often so your baby doesn't get dehydrated, and avoid close contact with visibly unwell fellow passengers.

Premature babies or babies with heart/lung conditions should always have medical advice before a flight, as the oxygen level in the cabin is lower.

Is my baby getting enough milk?

The most reliable sign is steady weight gain along your baby’s growth curve. We check this at routine check-ups and record it in your baby’s parent-child health record. Other signs, such as wet nappies and a contented baby, are useful rules of thumb, but your baby’s weight and growth curve remain the true measure.

Signs at home that your baby is getting enough

From the fourth or fifth day of life, your baby should have around five to six wet nappies a day and the urine should be pale. After a feed, your baby seems content and relaxed, you can hear them swallowing, and your breast feels softer. Some initial weight loss is also normal: almost every baby loses weight at first, and up to around 7% of birth weight during the first few days is expected. Most babies should regain their birth weight within about two to three weeks.

How often is normal?

Breastfeed on demand — whenever your baby shows feeding cues — day and night. During the first few weeks, this often means eight to twelve feeds in 24 hours. It is entirely normal for your baby to want several feeds close together, particularly in the evening. This is known as cluster feeding. It does not mean that you have too little milk. Cluster feeding helps stimulate milk production.

Recognise hunger early: your baby shows feeding cues before they cry. They may turn their head and root, bring their hands to their mouth, make sucking sounds or become restless. Crying is a late sign of hunger. Feeding before your baby starts crying usually makes feeding easier and calmer.

Have your baby assessed promptly

Have your baby assessed promptly if, from day five onwards, they have noticeably fewer than four to five wet nappies a day or the urine is very dark or concentrated. The same applies if your baby has not regained their birth weight after around two to three weeks or continues to lose weight. A baby who is unusually sleepy, difficult to wake or too weak to feed should also be seen promptly. Other warning signs include dehydration, such as a dry mouth, sunken fontanelle or no tears, and increasing yellowing of the skin. If you are ever unsure whether your baby is getting enough milk, we will be happy to advise you at the practice, provide breastfeeding support and weigh your baby.

How much milk does my baby need, and which formula should I use: Pre, Stage 1 or follow-on formula?

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.

Why does my baby bring up milk — and when should I be concerned?

For most babies, bringing up milk is completely harmless. This is especially reassuring if your baby is feeding normally, seems content and continues to gain weight. To help you distinguish normal reflux from a problem, here are the signs that need medical attention.

Call an ambulance immediately on 144 (Austria) or 112 (throughout the EU) if your baby has green or bloody vomit, which may indicate a bowel obstruction, or becomes increasingly unresponsive or difficult to wake.

When to seek prompt medical care

Seek prompt medical care if your baby:

has forceful projectile vomiting, particularly between about two and eight weeks of age, as this may indicate a narrowing where the stomach empties into the intestine;
is gaining weight poorly or losing weight, refuses feeds or is clearly in pain during feeds;
is under three months old and vomits repeatedly;
has a fever, unusual drowsiness or signs of dehydration;
develops vomiting for the first time after six months of age, or is still bringing up milk after 12 to 18 months, particularly if the reflux is getting worse.

How to recognise harmless reflux

Bringing up milk is not the same as vomiting. With normal reflux, a small amount of milk simply dribbles out without effort, and the baby remains unbothered. True vomiting is more forceful, involves a larger amount and makes your baby appear uncomfortable or unwell.

What helps with harmless reflux

Offer smaller, more frequent feeds and avoid overfeeding.
Burp your baby carefully and hold them upright for a while after feeding, but only while they are awake.
For formula-fed babies, thickened anti-reflux formula can reduce how often or how much your baby brings up, but please use it only after speaking to us.

Important advice for sleep

Even if your baby brings up milk, always place them on their back to sleep. Sleeping on the front or side, or raising the head of the cot, does not improve reflux and increases the risk of sudden infant death syndrome. Hold your baby upright only while awake after feeding. See “Safe sleep” for more information.

Why does it happen?

The muscle at the entrance to a baby’s stomach is still immature, milk is liquid and babies spend a great deal of time lying down, so milk can easily flow back up. Around half of all healthy babies regularly bring up milk, with symptoms peaking at about four months. It then becomes less frequent: around nine out of ten children outgrow it by their first birthday as they sit more upright and begin eating more solid food. There is no need to worry about a cheerful baby who brings up milk and is growing well. Green or bloody vomit, projectile vomiting and failure to gain weight are different and need medical attention.

Does my baby need hypoallergenic formula to prevent allergies?

Based on current evidence, no — not even if your baby has a higher risk because of a family history of allergy.

What genuinely helps to prevent allergies

Breastfeeding remains the best-known protective factor. If breastfeeding is not possible or does not provide all of your baby’s feeds, use ordinary Pre formula — the standard first infant formula sold in Austria — just as you would for any other baby, even if the allergy risk is higher.

What matters for prevention is not the type of formula but the regular introduction of common allergens from the time your baby starts solid foods:

thoroughly cooked egg,
fish,
peanut in a smooth form, such as peanut butter or purée — never whole nuts, because of the choking risk.

For practical guidance, see “Which foods should I offer first?”

If your baby already has a cow’s milk allergy

If a cow’s milk protein allergy has already been diagnosed, we prescribe an extensively hydrolysed formula or an amino-acid formula specifically for your baby. This is treatment, not prevention, and should be managed by a doctor.

Is my baby ready to start solid foods?

You can start offering solid foods between four and six months of age. We recommend offering a few first tastes from a spoon at around five months and introducing one regular solid meal by six months at the latest. Your baby’s signs of readiness are more important than the calendar.

How to tell that your baby is ready

Your baby can sit with support and hold their head steady. The tongue-thrust reflex has faded, so they no longer automatically push everything back out of their mouth. They deliberately reach for food, bring it to their mouth and show interest when the family eats. When all these signs are present, your baby is ready. One sign on its own, such as interest in food, is not enough; curiosity alone does not mean your baby is ready for solids.

Why not earlier?

Before around four months of age, babies are not yet ready. Their kidneys, digestive system and oral motor skills need this time to mature.

Important to know

At first, solid foods complement milk rather than replace it. Breast milk or Pre formula — the standard first infant formula sold in Austria — remains your baby’s main source of nutrition, with solids offered alongside it. The first spoonful does not mean you need to stop breastfeeding. You can continue for as long as you and your child wish.

We can advise you at check-ups

We routinely assess your baby’s development at check-ups and record the findings in their parent-child health record. We will also be happy to discuss the right time to start solids for your child. This is particularly important if your baby was born prematurely, as their corrected age is usually the more relevant guide.

Which foods should I offer first?

Start with a mild vegetable at lunchtime. Carrot, parsnip or pumpkin are good choices because they are soft, slightly sweet and easy to digest. Offer your baby’s usual milk afterwards. Over time, add an afternoon or evening meal and then a morning meal. There is no need to follow a strict rule of introducing exactly one new vegetable each week.

You can later turn the plain vegetable purée into a purée containing vegetables, potato and meat. Meat, or another source of iron, is important because iron requirements increase from six months of age.

Three basic rules for the first year

Do not add sugar to cereal or fruit purées.
Do not add salt, as your baby’s kidneys are not yet mature enough.
Do not give honey, as it can cause infant botulism. See “When can my baby have honey, salt, spices and gluten?” for details.

Do not avoid allergens

Do not deliberately avoid the common allergens. Well-cooked egg and fish with all bones removed should be offered regularly as soon as your baby starts solids. This is more likely to help prevent an allergy than cause one. Peanut can also be introduced when your baby starts solids, but only in a smooth form, such as smooth peanut butter spread thinly or mixed into a purée.

Preventing choking

Do not give whole nuts or popcorn before your child’s fifth birthday. Even chopped nuts can still be a choking hazard.
Until at least age four, prepare hard, smooth or round foods such as raw carrot, whole grapes, cherry tomatoes or hard sweets as follows: quarter grapes and cherry tomatoes lengthways, not across; cook carrot until soft or grate it finely; and offer nuts only finely ground or as a smooth nut butter. Depending on your child’s development, these precautions may be needed for longer.
Avoid raw egg throughout the first year because of the risk of infection.
Your child should always eat while seated and supervised.

Baby-led weaning, where your baby feeds themselves finger foods from the start of weaning, is fine too. The pieces must be soft and shaped appropriately for your baby’s age, and the high-risk foods listed above must still be avoided.

If your baby has severe eczema, speak to us before introducing peanuts. We will decide whether allergy testing beforehand would be useful. See “How can I recognise a food allergy, and when is it an emergency?” for more information.

When can my baby have honey, salt, spices and gluten?

No honey during the first year — not in tea, purée or on a spoon. The same applies to maple syrup and corn syrup. Honey can contain spores that cause infant botulism, a rare but serious illness. A baby’s immature gut cannot yet protect against these spores.

If your baby has already had some honey, there is no need to panic. Over the following days and weeks, watch for early signs such as persistent constipation, a weak suck or difficulty feeding, unusually floppy muscles or a weak cry. If any of these signs appears, have your baby assessed by a doctor the same day. If your baby is very floppy or refuses feeds, go to a paediatric emergency department immediately.

From the first birthday

After the first birthday, honey no longer poses a botulism risk. It is still a form of sugar, so use it sparingly.

Salt and spices

Do not add salt to your baby’s food during the first year. The kidneys are not yet mature enough to excrete large amounts of sodium. When cooking for the family, simply remove your baby’s portion before adding salt. Mild spices and herbs, such as cinnamon, caraway, basil or a little vanilla, can be added in small amounts from the start of weaning. They are safe and introduce your baby to a wider range of flavours. It is best to avoid very spicy foods and seasonings.

Gluten

There is no need to avoid or deliberately delay gluten, which is found in wheat, spelt, rye, oats and barley. It can be included in your baby’s normal diet once solids begin, ideally introduced gradually and in small amounts rather than as a large portion all at once. Current evidence does not support any particular “protective window” for introducing it.

When can my baby start drinking water?

Your baby can drink water once they start solid foods, at around six months of age. Before then, a healthy baby needs no additional water. Breast milk or Pre formula, the standard first infant formula sold in Austria, fully meets their fluid needs, even in hot summer weather. There is no need to give extra water.

Two important safety points

Do not offer large amounts of plain water while your baby is still very young. And never dilute formula with extra water.

Once solids are established

You can offer a few sips of water with meals, ideally from an open cup or a training cup so your baby becomes accustomed to drinking. By the time your baby is eating three solid meals a day, offer a drink with each meal. Water or unsweetened tea are the best choices. Do not offer sweetened drinks, and avoid fruit juice throughout the first year.

When can my child drink cow’s milk, and how much?

Cow’s milk should not be given as a drink until after the first birthday. Until then, breast milk or Pre formula, the standard first infant formula sold in Austria, should remain the basis of your baby’s diet. During the first year, the high protein content of cow’s milk places an unnecessary burden on immature kidneys, and cow’s milk contains too little iron.

Two amounts that are easily confused

From six months of age, a small amount of cow’s milk may be used as an ingredient in solid food — up to around 200 ml per day, for example in a milk-and-cereal porridge. This milk is part of a meal and is not intended as a drink. After the first birthday, your child may drink cow’s milk. At that stage, around 300 ml of milk and dairy products in total per day is a useful guide, counting milk, yoghurt and cheese together. Much larger quantities can interfere with iron absorption and reduce your child’s appetite for other foods.

Which type of milk?

Choose whole milk with 3.5% fat. During the second year of life, toddlers need the energy and fatty acids. Lower-fat milk, such as 1.5% milk, is more suitable for older children. Reduced-fat milk is therefore not appropriate at this age. Raw, unpasteurised milk, including milk bought directly from a farm, should not be given because of the risk of infection.

A common misconception

Plant-based drinks made from oats, almonds, rice or soya are not a substitute for breast milk, cow’s milk or infant formula. They do not provide the right balance of protein and nutrients. Rice drinks are unsuitable for young children because of their arsenic content.

My child eats very little — is this normal?

Usually, yes. In most cases, this is part of normal development. Growth slows after the first birthday, so appetite decreases and varies from day to day. Between roughly one and three years of age, many children also go through a phase of rejecting unfamiliar foods. This is normal too. As long as your child is healthy and continues to grow steadily along their growth curve, there is usually no cause for concern. Their food intake usually balances out over the course of a week.

The most important rule of thumb

You decide what food is offered and when; your child decides how much to eat. In everyday life, it helps to eat together without distractions such as screens, as children learn by example. Offer small portions rather than an overflowing plate; you can always provide more. Keep offering unfamiliar foods without pressure. You may need to offer a new food eight to ten times before your child accepts it — sometimes more. Do not force your child to finish a meal or use dessert as a reward. Regular meals with one or two snacks are better than constant grazing. Too much milk or juice between meals can also spoil your child’s appetite.

When to seek advice

Contact us if your child loses weight or drops noticeably on their growth chart, moving down from their usual percentile. The same applies if your child strictly refuses entire food groups, repeatedly gags or vomits during meals, or has difficulty swallowing. At the next check-up, we will review your child’s growth chart and assess whether there may be an underlying issue. If in doubt, simply contact the practice.

My child has a fever — when should I see a doctor?

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.

Where should I take my child’s temperature?

For babies, taking the temperature rectally is the most reliable method. As a general rule, use a thermometer rather than judging your child’s temperature by touch.

Under six months: take the temperature rectally

At this age, rectal measurement is the most reliable method. Ear thermometers are still inaccurate in very young babies: the ear canal is too narrow, and measuring in the ear often misses a fever at this age. This is a genuine risk, particularly under three months, when every fever matters.

To take a rectal temperature, apply a little lubricant to the tip of the thermometer, insert it only a short distance and keep your baby still. Wash your hands before and afterwards.

From around six months: an ear thermometer is reliable

From this age, an infrared ear thermometer is reliable, quick and practical for everyday use. Forehead thermometers are convenient but less accurate. If your child seems unwell, check the temperature rectally.

A baby under three months with a rectal temperature of 38.0 °C or above must be taken directly to a paediatric emergency department the same day. See “My child has a fever — when should I see a doctor?” for details.

Temperatures measured in the ear may be slightly lower than rectal readings and can vary depending on the position of the probe. A temperature of 38.0 °C or above is generally considered a fever. Ear thermometers are more likely to underestimate than overestimate a fever, so if your child seems unwell or the ear reading is borderline, take a rectal temperature to be sure.

Body temperature also varies by around half a degree over the course of the day. It is lowest in the morning and highest in the late afternoon and evening. A slightly raised evening temperature of around 37.5 °C in a lively child is therefore usually normal and is not yet a fever. The overall picture matters more than a single peak reading: Is your child drinking? Are they responsive? Do they still play at times? If in doubt, check again the following morning when your child is calm.

My child is constantly ill — can I strengthen their immune system?

First, some reassurance: eight to ten infections a year, and sometimes as many as twelve, are entirely normal in toddlers and preschool children. Each infection helps train their developing immune system; frequent infections are not a sign of weakness. Infections are particularly common during the first few months at nursery or preschool, but this settles over time.

Commercial “immune boosters” do not live up to their claims, and none has proven benefits. Vitamin C supplements do not reduce the number of colds either. What does help is less exciting: a varied diet, enough sleep, physical activity and fresh air, regular handwashing, a smoke-free home and keeping vaccinations up to date.

When a pattern warrants closer attention

An underlying immune problem is rare. The vast majority of children who are often ill are completely healthy. The number of ordinary infections matters less than an unusual pattern. The three most informative signs are:

poor growth or failure to thrive;
a known immune deficiency in the family;
severe infections that could only be controlled with intravenous antibiotics.

We also pay attention to infections that are unusually deep-seated or keep returning, such as recurrent pneumonia, deep or recurrent abscesses, or persistent fungal infection or thrush beyond infancy. Frequent colds, middle-ear infections or sinus infections alone do not suggest an immune deficiency; they are particularly common in healthy children.

If your child has any of these unusual signs, there is no need to panic. It is simply a reason to discuss them with us and investigate further.

Paracetamol and ibuprofen for fever or pain — when should I give them?

Paracetamol and ibuprofen relieve both pain and fever. Give them when your child is in pain — from teething, earache, a sore throat, a headache or a sore injection site — or when a fever is clearly making your child uncomfortable, for example if they cannot sleep or do not want to drink. Do not give them simply because the thermometer shows a particular number.

Call an ambulance immediately on 144 (Austria) or 112 (throughout the EU) if your child looks seriously ill, has difficulty breathing, has pauses in breathing or blue lips, turns blue, grey or unusually pale, is not responding normally, has a seizure, or has a stiff neck or a rash that does not fade when pressed with a glass. Signs of difficulty breathing include the skin pulling in around the ribs, flaring nostrils or grunting.

At what temperature should I treat a fever?

There is no fixed threshold. A lively child who is drinking and playing may not need any medicine even at 39 °C. Fever is not an illness but a useful part of the body’s defence response. With an infection, there is no temperature that is inherently “dangerously high”. The common fear that a temperature of around 40 °C will cause brain damage is not supported by evidence: fever caused by an infection does not damage the brain. These medicines usually do not make a child completely fever-free; they lower the temperature by around one to one and a half degrees. They do not prevent febrile seizures, so there is no need to lower a fever “just in case”.

One important exception: take a baby under three months with a rectal temperature of 38.0 °C or above directly to a paediatric emergency department. At this age, do not try to lower the fever yourself; have your baby assessed promptly.

We will prescribe the right medicine

We will tell you which medicine and dose are right for your child. Paracetamol, such as Mexaratio or ben-u-ron, is our first choice. We usually give you a paracetamol suppository at your baby’s seven-week check-up and vaccination appointment, so you have something at home in case a fever develops after the vaccine. This is normal during the first 48 hours. As your child grows, we adjust the formulation, moving from suppositories to liquid medicine. If needed, we prescribe liquid ibuprofen from around four months of age. It may provide slightly stronger pain relief and works just as well for fever.

Using these medicines safely

When and how often: give a dose only if your child is genuinely uncomfortable, and wait six to eight hours before giving another dose, even if the temperature rises again in the meantime.
Never give aspirin or acetylsalicylic acid. It can cause Reye’s syndrome, which is rare but life-threatening.

What if one medicine is not enough?

One medicine, either paracetamol or ibuprofen, is usually enough. If the temperature rises above 39 °C and does not come down enough to make your child more comfortable, or returns after only a few hours and your child is listless, contact us. As a temporary measure until the appointment, you may then alternate the two medicines at intervals of around four hours. This keeps each medicine at the correct dosing interval. This advice mainly applies to persistent or rapidly recurring fever, for example with influenza or bacterial tonsillitis. For a straightforward infection, it is better to use just one medicine.

What else helps without medicine

Offer fluids regularly — this is the most important measure. Do not dress your child too warmly, but keep them from becoming cold if they are shivering. Let them sleep; there is no need to wake a child who is sleeping peacefully just to take their temperature. For an older child with warm hands and feet, you may wrap lukewarm, never cold, wet cloths around the calves. Do not use this cooling measure for a young baby or a child with cold hands or feet.

Make an appointment at our practice

Make an appointment if the fever lasts for more than about two days, if your child remains listless or drinks poorly even after the temperature comes down, or if you are unsure.

Earache and fever — what can I do at home?

Good pain relief is the most important treatment for a middle-ear infection. Most children do not need an antibiotic.

Call an ambulance immediately on 144 (Austria) or 112 (throughout the EU) if your child has a stiff neck, reduced consciousness, a seizure or one side of the face starts to droop.

Go directly to a paediatric emergency department if:
there is redness, swelling or tenderness behind the ear, or the ear starts to stick out. These may be warning signs of mastoiditis, a complication of a middle-ear infection;
your baby is under three months old and has a fever.

Have your child seen at our practice the same day

if your child has severe or persistent earache, fluid draining from the ear or seems clearly unwell;
even without these signs, if the pain has not improved after about three days despite pain relief or your child is getting worse.

The good news is that most middle-ear infections clear up on their own, often within about three days. The most effective treatment at home is an age-appropriate dose of paracetamol or ibuprofen, given regularly for pain and fever. Encourage rest, fluids and sleep; keeping the head slightly raised while your child is awake may be more comfortable. Do not put anything into the ear: no cotton buds and no oil. Decongestant nose drops and antihistamines have also been shown not to help.

Why is an antibiotic often unnecessary? Studies show that in most children, antibiotics make little difference to how long the pain lasts but are more likely to cause side effects such as diarrhoea. Careful observation with good pain relief is therefore usually the better approach. We recommend antibiotics earlier in certain cases, including children under two with infections in both ears, children with fluid draining from the ear and children who are clearly very unwell. We will decide whether antibiotics are needed after examining your child.

Outside our opening hours: take children under one year directly to the nearest paediatric emergency department rather than calling 141. For advice, call 1450. In a life-threatening emergency, call 144.

Safe sleep — how do I protect my baby from sudden infant death (SIDS)?

First things first: the essentials are sleeping on their back for every sleep, a crib of their own in the parents' bedroom, and a firm, clear sleep space with no pillows, duvets or bumpers. That alone cuts the risk of sudden infant death (SIDS) very sharply — the reason cases are so rare today is largely down to these few simple rules.

The measures proven to protect, point by point:

Always put your baby down on their back — for daytime naps as well as at night, until your child reliably rolls both ways on their own. Lying on their side is not safe, because a baby can tip from there onto their tummy.
Firm and flat: a firm mattress in their own crib. Bouncers, car seats and inclined surfaces are not suitable for regular sleep. If your child falls asleep in the car seat or the bouncer, lay them down flat as soon as you can.
Their own bed, but in the same room: your baby should sleep in the parents' bedroom, in a bed of their own — for at least the first 6 months, and longer is fine. That's safer than either a room of their own or the parents' bed.
Keep the bed clear: no pillows, no duvets, no crib bumpers, no sheepskins, no large soft toys — and no weighted blankets, weighted sleeping bags or swaddle wraps (they can restrict breathing and are specifically advised against). Instead of a duvet, use an age-appropriate sleeping bag.
Smoke-free — in pregnancy and everywhere around your child. Smoke is one of the strongest risk factors.
Don't let them get too warm: keep the bedroom around 18–20 °C, err on the side of one layer too few rather than too many, and no hat indoors — a baby gives off heat through an uncovered head. To check whether your child is too warm, feel the back of the neck between the shoulder blades, not the (often cool) hands.
Breastfeeding adds protection, as does a pacifier at settling time (no need to force it — if it falls out you don't have to put it back in; only offer it once breastfeeding is well established).
Swaddling (wrapping snugly) calms some babies — if you do it, always put them down on their back and stop by the time they first try to roll; never place a swaddled baby on their tummy.
Vaccinations on the Austrian schedule lower the SIDS risk rather than raising it — the old worry has been disproved.

On bed-sharing: we advise against taking your baby into your own bed, especially in the first months. Bed-sharing is particularly dangerous if anyone smokes, if alcohol, sedatives or sleeping pills are involved, and with premature or very small babies. Never fall asleep with your baby on a sofa or armchair — that's the riskiest situation of all. If you take your child into bed to feed, put them back into their own bed to sleep afterward.

What you don't need: heart-and-breathing monitors, "smart socks" and baby monitors with breathing monitoring do not prevent SIDS — there's no evidence they do, and they're no substitute for the sleep rules. Spare yourself the worry (and the money) and stick with what's proven.

And during the day: while your child is awake and supervised, feel free to lay them on their tummy now and then ("tummy time") — short spells from the very first weeks, building up by around seven weeks to a total of roughly 15–30 minutes a day. This strengthens the muscles and helps prevent a flat spot on the head. Lying on the tummy is only a risk during sleep.

Call 144 (Austria's emergency number) / 112 (Europe-wide) at once if your child is not breathing, unresponsive or blue or gray — call for help and, if you've been trained, start resuscitation immediately. In any case, we recommend an infant first-aid course for new parents.

Is it normal for my newborn to sleep so much?

Yes — newborns sleep a great deal, around 16 to 18 hours a day, spread across many short naps around the clock. This is entirely normal. All that matters is that your baby wakes regularly to feed (or is easy to rouse) and is thriving.

What's normal: newborns often sleep only one to four hours at a stretch and then wake to feed — day and night, because the day–night rhythm has yet to develop. In the first weeks your baby shouldn't sleep much longer than four to five hours at a stretch without feeding. As a rule of thumb, a newborn is breastfed or fed at least 8 times in 24 hours in the first weeks.

To put weight in context: almost all babies lose a little weight in the first days of life — that's normal, and the low point is usually around the 3rd–4th day of life. Your baby should be weighed and examined promptly if the loss approaches or exceeds 10% of the birth weight or if they keep losing after the 3rd–4th day. Most newborns are back at their birth weight within about 10–14 days, some a little later — nearly all within three weeks.

Warning signs — please look more closely here and contact us:
Your baby is too sleepy to feed, skips feeds, or even after rousing feeds only weakly.
They are barely rousable, seem floppy ("like a little rag doll"), or are unusually unresponsive even when awake.
Signs of dehydration: fewer than about 4 wet diapers in 24 hours, dark urine, dry mouth, a sunken fontanelle, no tears.
They aren't gaining or are losing weight, turn yellow and are feeding poorly too, or have a fever or an unusually low temperature.
If a baby deteriorates acutely — not rousable, floppy, blue, breathing problems — call 144 (Austria's emergency number) / 112 (Europe-wide) at once.

The bottom line: "sleeping a lot" is no cause for concern in a baby who feeds well, gains weight and is easy to rouse. It only becomes a worry when the sleepiness gets in the way of feeding and thriving. Weight is checked at the Mutter-Kind-Pass check-ups — if you're unsure in between, we're happy to weigh again, or give us a call.

My baby doesn't sleep through the night — what helps?

The short answer: in the first months, waking at night is entirely normal and no sign that you're doing anything wrong. "Sleeping through" is something children grow into, not a parenting goal. You can gently support sleep with rituals, a clear day–night rhythm and a safe sleep space — but there's no miracle method, and patience is the most important "technique" here.

Why babies wake at night: babies have shorter sleep cycles than adults and naturally wake in between — partly to feed. In sleep research, "sleeping through" often means only a block of about five to six hours, not the whole night. The ability to do it usually matures over the first months, with big differences from child to child. Even at one year, about half of all babies still need help getting back to sleep at night. That's normal.

What gently helps:

A calm evening ritual (always a similar sequence: wash, dress, quiet time, down to bed) gives a sense of security.
Make day and night distinct: by day bright, active, normal noise; at night quiet, dim light, little interaction, only the essentials. The day–night rhythm develops step by step over the first months of life.
Put your baby down tired but still awake, so that over time they learn to find their own way back to sleep.
Stay realistic: we don't think much of rigid "sleep training" programs that promise sleeping through. In the first few months, such programs have been shown to do little; what counts more is a safe sleep space, routine, and taking the pressure off yourself.

Safe sleep space (always, please): on their back, a firm crib of their own in the parents' bedroom, no pillow, no duvet, no soft toys — a sleeping bag instead of a duvet. (Details in our question on safe sleep.)

When to talk to us: if your baby seems in pain or inconsolable on waking, is bringing up a lot of milk, sleeps persistently very restlessly, gains weight poorly, or snores or has pauses in breathing — then please talk to us, and we'll take a look.

Important for you, too: lack of sleep grinds you down. Take your exhaustion seriously and get support. And most important of all: never shake your baby. If it all gets too much, put your baby safely on their back in their bed, leave the room for a moment, breathe, and get help. Letting them cry for a few minutes is safe — shaking can cause severe, lasting harm.

A colicky baby (excessive crying) — how can I help my baby (and myself)?

Some babies cry a great deal in the first months even though they're healthy and thriving — we call this colic. It's exhausting but temporary: it usually begins at around two weeks, peaks at around six weeks and eases on its own by the 3rd–4th month, at the latest the 5th. You're doing nothing wrong.

Why a healthy baby cries so much: all this crying usually has no identifiable illness at its root. The baby's nervous system first has to get used to the world — specialists call it a temporary "difficulty with self-regulation". The old idea that "wind" is always at the root of it doesn't hold up. As a rough guide there's the "rule of three": more than 3 hours of crying a day, on more than 3 days a week. But: you may seek help even if your baby cries less — what matters is how much of a strain it is on you.

What can help your baby:

Closeness and movement: carrying (in a sling or carrier), gentle rocking, rhythmic swaying, skin contact. This calms many babies.
Warmth and a gentle tummy massage (clockwise), a warm bath.
Dial down the stimulation: a calm, low-stimulus environment, dim light, monotonous sounds.
Predictability: similar routines give a sense of security.
Swaddling calms some babies — but always put swaddled babies on their backs and stop swaddling as soon as your baby starts to roll (leave the legs loose).
What makes little difference: "anti-gas" drops (simeticone) have been shown to work no better than nothing. Probiotic drops may help a little in exclusively breastfed babies but aren't essential. Change the diet only if there's a real reason to suspect a cow's-milk-protein intolerance — we'll discuss that beforehand.

Please never shake. This is the most important sentence on the subject. Persistent crying pushes parents to their limits — that's human. If you notice anger or despair coming over you: put your baby safely on their back in their bed, leave the room for a moment, breathe, and get help. A baby crying briefly on its own is safe — shaking can cause severe, lasting brain damage.
Come into the practice if your baby doesn't fit the "healthy but crying" pattern: with fever, vomiting (especially green, bilious or bloody), blood in the stools, poor weight gain, a sudden change to the crying or a shrill cry, refusing to feed, or if your baby seems unwell overall. Then there may be an underlying physical cause, and we'll take a close look.

You are not alone. Seeking help is a sign of care, not of failure. These Viennese services will support you:

Baby-Care-Ambulanz, Klinik Favoriten — specializing in crying, feeding and sleep problems (up to the 3rd year of life). Appointments: +43 1 60191 72680, Mon–Fri 8am–3pm.
Frühe Hilfen — free, confidential support, at your home if you wish, in several languages. Find your nearest service via the website.
Familienzentrum Katharinengasse (10th district) — free parenting and psychological advice, a baby drop-in. +43 1 4000-10894.
Nanaya – "Die Schreierei" — an open drop-in group for parents of babies who cry a lot, no appointment needed. 01 523 17 11.
Emotionelle Erste Hilfe (frau.kinder.mann) — private one-to-one support (fee-based). +43 680 558 5518.

And you can call us any time — we're glad to point you to the right service.

My baby often has gas and cries — what can I do?

In the first months of life, gas and crying spells are very common — the digestive system simply hasn't found its rhythm yet, and this has nothing to do with any mistake in care or feeding. The crying typically peaks at around six weeks of age and then improves on its own — usually around the third or fourth month.

What you can do right away (this helps most reliably):

Carry your baby a lot and give plenty of skin contact.
Gentle tummy massage clockwise and bicycling their legs.
Warmth on the tummy (at body temperature — e.g. a warm cherry-pit pillow, not hot).
After every feeding, let them burp in their own time.
Give them a calm, low-stimulation environment.

And from the pharmacy? There's no miracle cure, but a few well-tolerated things are worth a try — they can't do any harm:

Simeticone (e.g. Anti-Flat) binds the small gas bubbles in the tummy. In studies it works no better than a placebo, but some parents notice clear relief — and for many it's reassuring to have something on hand.
Caraway suppositories — a mild, tried-and-tested remedy.
Probiotic drops with Lactobacillus reuteri (e.g. Bellybiom): of these options, this one has the best evidence, especially in breastfed babies.

Just talk to us — together we'll work out what suits your child. What we advise against: fennel tea — the European Medicines Agency explicitly advises against it for children under 4 (because of its natural estragole content).

If it all becomes too much, that's only human — and then one rule applies without exception: never shake your baby. Shaking can cause the most severe brain injuries, even a brief shake, even out of desperation. Instead, lay your baby safely on their back in the crib, step out of the room for a moment, take a breath and get help — from your partner, from us, or from a crying-baby clinic. Reaching out for support is a sign of care, not of failure. (More on this under "Crying baby — how can I help my baby (and myself)?".)

As long as your child drinks well, gains weight and also has calm, contented spells between the crying, there's no cause for concern. You should, however, have fever, repeated vomiting, blood in the stool or poor weight gain checked quickly — and blood in the stool in a baby who is crying hard should be examined the same day.

How do I protect my child from the sun?

In the first year of life, one simple, clear rule applies: no direct sun. A baby's best protection is shade, along with light clothing that covers the body and a sun hat with a neck flap — and this is true even on cloudy days (clouds still let through up to 80% of UV radiation) and outside the height of summer. Steer clear of the midday sun (roughly 11am to 3pm) altogether. Sunscreen is secondary at this age; apply it only to the small areas you can't protect any other way — the face and the backs of the hands.

Two labels help when you're choosing UV-protective clothing: look for the UPF 30 mark or the UV Standard 801 test seal. For baby skin, mineral sunscreens (with zinc oxide or titanium dioxide) are the preferred choice, as they are generally better tolerated and barely absorbed into the skin. Many parents worry that chemical filters pass through the skin and harm their child. Here are the facts: certain filters can be detected in the blood in small amounts, but this has not actually been shown to be harmful, and the filters approved in the EU are considered safe when used as directed. For a baby, mineral sunscreens are nonetheless the obvious, well-tolerated choice.

As your child gets older, the order stays the same: avoid the midday sun, and reach for shade and UV clothing first. On exposed areas, use a water-resistant sunscreen with SPF 50. Apply it generously, and reapply after swimming and sweating — reapplying maintains the protection but doesn't extend it indefinitely. At a UV index of 3 or above, a hat, sunglasses and sunscreen are all a must.

Why does all this matter? Sunburn in childhood is an important risk factor for skin cancer later in life. Good sun protection from an early age is one of the most effective forms of prevention there is. On hot days, watch for overheating too: a baby should never be left in the blazing sun or under an airtight stroller cover (heat builds up fast). If you notice a high fever, vomiting, very red, hot skin or listlessness after sun or heat, don't hesitate — call 144. And if a baby in the first year of life does get a genuine sunburn despite your best efforts — especially with blisters, marked redness, fever or clear distress — please have them checked at the practice; at this age the skin is especially sensitive.

From what age should we brush teeth — and what about fluoride?

Start brushing as soon as the first tooth appears — usually between six and eight months of age, though earlier or later is just as normal. From then on, brush twice a day with a soft children's toothbrush, and brushing in the evening is especially important. Baby teeth aren't "disposable": they can get cavities too, and they hold the space for the permanent teeth to come in.

With fluoride — the substance that makes tooth enamel more resistant to decay — we take the approach that is standard in Austria: the fluoride comes from the toothpaste, from the moment the first tooth comes in. A daily fluoride tablet isn't needed for this.

Until the first tooth: no fluoride is needed yet.
From the first tooth: brush twice a day with a rice-grain-sized amount of fluoride children's toothpaste (1,000 ppm). From the second birthday, the amount can go up to pea-sized.

If your family has a particular risk of tooth decay, we'll discuss extra fluoride with you personally.

How do I prevent diaper rash?

Diaper rash comes mainly from moisture, friction and irritation from urine and stool. The best way to prevent it is to change often, clean the bottom gently, let it air-dry now and then, and apply a zinc paste as a barrier. With this kind of care, most redness clears up within a few days.

Why does the bottom get sore? Inside the diaper it's warm and damp, so delicate baby skin softens and turns sensitive. Add friction and the substances in urine and stool, and the skin responds with redness. This is very common — it affects most babies at some point, particularly around teething and when the stools turn looser.

What you can do:

Change often, as soon as the diaper is full — and with a sore bottom, more often still. The less time urine and stool sit on the skin, the better.
Clean gently: ideally with lukewarm water and a soft cloth or washcloth. Use wipes sparingly, and preferably ones free of fragrance and alcohol — on already irritated skin, harsh wipes only cause more friction.
Diaper-free time: several times a day, let your baby kick and wriggle for a few minutes without a diaper (on a washable mat). Dry, airy skin heals faster.
Protect with zinc paste: a thin layer of a zinc-oxide barrier cream forms a protective film over the skin. You don't have to scrub off every last trace when cleaning — that only irritates the skin.
No talcum or baby powder: talc can be inhaled and clumps together with moisture — please leave it out.

When is it not simple diaper rash but thrush (diaper candida)? If the redness is intense and sharply defined, extends into the skin folds too (simple diaper rash tends to spare the folds), and small red dots or pustules appear at the edges ("satellites"), the cause is often a yeast (Candida). That calls for a special antifungal cream, so please book an appointment.

Come and see us if: the bottom is no better after 2–3 days despite consistent care; the skin is weeping, blistered or open; thrush seems likely; or a fever develops. We'll get to the bottom of it together — usually a targeted ointment is all it takes.

How often should I bathe my baby, and what should I use?

In the first weeks and months, once or twice a week is plenty — bathing more often tends to dry out sensitive baby skin. On the other days, a quick wash with plain water does the job: the face, hands, skin folds and diaper area. The bath water should be about 37 °C (check with a thermometer or your elbow), the room pleasantly warm (above 22 °C), and the bath itself kept short — 5 to 10 minutes, so the baby doesn't get cold.

You'll rarely need soap or shampoo — and when you do, a small amount of a mild product that is free of fragrance and preservatives. Bath products and oils are usually unnecessary and can irritate the skin. After the bath, dry your baby well, including in the skin folds; if the skin is dry, apply an emollient moisturizer. With babies, less is more. As your child grows older and more active, feel free to bathe them more often.

One safety point matters more than anything else: never leave your baby alone in the water — not even for a moment. Young children can drown in very little water.

When should I start cutting my baby's nails, and how?

Usually not before four to six weeks of age. In the early weeks the nails are so soft that they wear down on their own, and the edge of the nail is still hard to tell apart from the fingertip — so it's easy to cut too deep. Until then, it's better to file them with a soft emery board, or simply let them wear away on their own. If your child is scratching themselves, cotton scratch mittens help for a short while — but not as a long-term fix, since little hands want to explore by touch.

When the time comes, use baby nail scissors or a clipper with a rounded tip. Cut the fingernails slightly rounded and the toenails straight across — that helps prevent ingrown nails. It's easiest when your baby is asleep or has just been fed. Hold the little hand firmly, gently press the fingertip pad back, and cut in several small steps rather than one big snip. This is just everyday advice — what matters most is finding whatever feels easy and relaxed for the two of you.

If a nail bed turns red, swells or oozes pus, come in and we'll take a look.

Ear care — are cotton swabs off-limits, and what else helps?

Cotton swabs don't belong in the ear canal — plain and simple. They tend to push the earwax deeper in (where it then forms a plug) and can injure the delicate skin or even the eardrum.

And there's really no need for them: earwax isn't dirt, it's protection. It keeps the skin of the ear canal supple, traps dust and germs, and is naturally carried outward as the ear cleans itself. The ear canal cleans itself — you don't need to, and shouldn't, "help it along" in there.

The only part to clean is the outer ear — the visible part and the area behind the ears (where milk or saliva residue tends to collect) — with a slightly damp cloth, washcloth or cotton pad, drying well afterward. Don't push water into the ear canal, and skip the ear candles. If a visible wax plug appears or your child starts hearing less well, please don't go digging it out yourself — we'll take a look and remove it gently if needed.

One important distinction: earwax care and earache are two different things. If your child complains of earache, keeps tugging or rubbing at the ear, has a fever alongside, is drinking poorly, or has discharge or pus coming from the ear, there's often a middle-ear infection involved — in which case, come and see us (what you can do at home is set out in "Earache and fever"). Bloody or purulent discharge, or a sudden drop in hearing, should likewise be checked by a doctor.

You've found a tick — how do I remove it properly, and should I be thinking about TBE?

Remove the tick promptly and calmly: grip it with fine tweezers or a tick card as close to the skin as possible, and pull it straight out with steady, even pressure, without squeezing the body. Don't use oil, glue, or nail polish — "suffocating" it doesn't help and can even push more pathogens into the wound. The direction you turn it makes no difference; all that counts is a straight pull. Afterward, clean the spot with a skin disinfectant. If a tiny remnant of the mouthparts stays behind in the skin, that's usually harmless — the skin normally pushes it out on its own; if the spot becomes inflamed, we'll take a look.

Make a note of the date and the spot (a photo will do) and keep an eye on the bite for 3 to 30 days. Come to us if a ring-shaped, expanding redness develops, or if your child comes down with fever and fatigue — either can be a sign of Lyme disease (borreliosis), which responds well to antibiotics. The sooner a tick is removed, the lower the risk of Lyme disease, since transmission usually takes many hours of feeding. A precautionary blood test right after the bite isn't worthwhile — testing is only done if symptoms appear.

As for tick-borne encephalitis (TBE, FSME), which is a real concern in Austria: removing the tick, however quickly, doesn't protect against it — only vaccination does, because the TBE virus can be passed on the moment the tick bites. All of Austria is a risk area — every province is affected. The TBE vaccination is recommended from 12 months of age (a primary course of three doses); only where the risk is particularly high can it be started earlier, after discussion with us. Conversely, the TBE vaccination does not protect against Lyme disease — there's no vaccine for it, so all you can do is remove ticks promptly and correctly and keep an eye on the site.

And to reassure you: the vast majority of tick bites cause no problems at all. Remove the tick quickly and correctly, keep an eye on the spot — that's almost always enough. If you're ever unsure, get in touch with the practice.

Is my child developing as expected, and when should I see a paediatrician?

When to make an appointment

Have your child’s development assessed by a paediatrician if:

an expected developmental milestone is clearly delayed or your child makes very little progress over several months;
more than one area seems affected, such as movement and speech;
during the first year, your child uses one hand or one side of the body almost exclusively;
their movements seem unusually stiff or your child seems unusually floppy;
they show little response to voices and sounds, or do not follow objects and faces with their eyes;
they make very little eye contact, do not point to things or rarely try to share enjoyment or interest with others;
carers or nursery staff also have concerns;
you repeatedly feel that something is not right.

Examples of developmental age thresholds include:

no purposeful grasping by 12 months,
not walking independently by 18 months,
fewer than around 50 words or no two-word phrases such as “Mummy come” by two years.

For children born prematurely, use their corrected age during the first two years: their actual age minus the number of weeks they were born early. Your concern alone is a sufficient reason for an assessment. You do not need to wait until several signs appear together.

When to seek advice promptly

Make an appointment within the next few days if your child has clearly and persistently lost skills they had previously used consistently, such as words, movements or ways of interacting with others. Showing a skill less often for a short time is not automatically a regression. What matters is whether an established skill has genuinely disappeared and remains absent.

Development varies from child to child

Children do not all develop to a fixed timetable. One child may walk early and speak later, while another does the opposite. The fact that another child of the same age can already do more does not automatically mean that something is wrong. Three questions are more useful than direct comparison:

Is your child continuing to learn new things?
Are they making progress across several areas, including movement, language, play and social interaction?
Is this a skill they have not yet acquired, or one they previously used consistently and have now lost?

If your child is otherwise curious and alert and continues to learn, a single delayed milestone is almost always part of the normal range of development.

Why developmental age thresholds matter

For important developmental skills, there are evidence-based developmental age thresholds: the ages by which around 90% of children have acquired the skill. If your child has not acquired the relevant skill by that age, it does not automatically mean that they have a developmental disorder, but it is a good time to look more closely. We consider not only whether your child can do something, but also how they do it and how their development is progressing overall.

The normal range is wide

Most children walk independently between about 11 and 18 months, with an average of about 13 months. Some do not crawl in the usual way and instead bottom-shuffle; some children skip certain stages or reach them in a different order. A child may also speak only a few words while understanding a great deal. A single late skill is therefore not in itself evidence of a developmental delay.

What happens at the appointment

We routinely review your child’s development with you during check-ups. Depending on your child’s age, we assess areas including:

movement and muscle tone,
hand and finger skills,
speech and language comprehension,
hearing and vision,
play, eye contact and social communication.

If only one skill is developing slightly later and everything else is reassuring, we will often review your child again after a few weeks. If there are clearer concerns, the next steps may include a standardised developmental assessment, a hearing test or referral for further evaluation. An assessment does not automatically mean that your child has a disorder. Its purpose is simply to determine whether your child needs more time or would benefit from support.

Preparing for the appointment

Make a few brief notes beforehand:

Which skill concerns you, and has your child never acquired it or have they lost it?
When did you first notice this, and what progress have you seen recently?
What have carers or nursery staff noticed?
Which languages does your child hear, understand and speak?

Short videos from everyday life are often more useful than a description, particularly for things that do not happen during an appointment. Until then, there is no need to keep testing or comparing your child. The best support is ordinary everyday interaction: play together, read aloud, talk to one another and allow plenty of free movement.

How would I recognize possible signs of autism in my child?

First, some perspective: almost every child does something a bit unusual at some point. What matters is the combination of several signs over time — not any single trait. Autism usually shows up in several areas at once. Typical signs are difficulties with social interaction (little eye contact, little interest in other children) and with communication (delayed or unusual speech, such as repeating words), along with repetitive patterns of behavior and a rigid insistence on routines, and a particular sensitivity to sounds, light or touch.

Age-related pointers where it's worth looking more closely:

around 9–12 months: barely responds to their own name, little eye contact, little social smiling, little imitation;
around 12 months: no babbling, no gestures such as waving;
around 14–18 months: doesn't point at things to share something interesting with you (shared attention is an important early sign);
around 18 months: no "pretend" play;
around 24 months: no meaningful two-word phrases;
at any age: if your child loses a skill they already had (speech or social interaction) — this always needs prompt attention.

If you notice several of these signs, or you're worried, talk to us — we'll go through it with you calmly. For children between about 16 and 30 months there is also a simple parent questionnaire (M-CHAT-R/F) that helps weigh up an initial concern. A concerning result is not a diagnosis, but a reason to look more closely together — the diagnosis is made later by a specialist team. An early assessment is not a catastrophe but an opportunity: early support makes a real difference.

One reassurance, since this question weighs on so many parents: autism is there from the very beginning — laid down in early brain development, and largely genetic. It is not triggered by vaccinations. The fact that the first signs often become noticeable in the second year of life, around the time of the MMR vaccine, is a coincidence of timing, not a connection (more on this under "Can vaccinations cause autism?").

When should my child be talking — and how can I best encourage speech?

The short answer first: with speech the range is wide, and a little earlier or later is normal. As a rough guide: babbling ("bababa") from the second half of the first year, first words around the first birthday, and by two years about 50 words and first two-word phrases ("Mama there"), after which vocabulary grows quickly. By three to four years, your child becomes easier and easier for strangers to understand too.

Talk to us if any of the following apply: your child says not a single word at about 18 months; at 24 months has fewer than 50 words or puts together no two-word phrases; at 3–4 years is barely understandable to strangers; doesn't respond when spoken to or doesn't seek eye contact; or is losing a skill they already had — this last one always needs prompt attention. Some children are simply "late bloomers" (late talkers) and catch up on their own, but a fair number do not fully catch up. So speaking late is no reason to panic, but a good reason to keep an eye on it and bring your child in to see us.

One point here is especially important: with any speech delay, we check the hearing. Even if the newborn hearing screening was normal, a hearing problem can develop later (for example from recurrent fluid in the middle ear) — and a child who hears poorly finds it harder to learn to speak.

You can encourage speech in everyday life, no program needed: talk a lot and attentively, name what you're doing, answer in full sentences. The best-evidenced "recipe" is shared, back-and-forth picture-book reading — that is, not just reading aloud, but asking, pointing, letting your child tell the story. When something comes out wrong, simply repeat it back correctly rather than making them correct it. And: less screen time, especially with the very little ones, because it crowds out real time spent talking. If a clear delay does appear all the same, we'll work out together whether speech and language therapy would help — the earlier, the better.

Crawling, walking and the first shoes — what's normal, and what do children's feet really need?

Two reassurances first. First: crawling is not a must. Some children never crawl but instead army-crawl, scoot along on their bottom or pull straight up to standing — and then walk perfectly normally. Second: walking unaided has a wide range of about 11 to 18 months; only if a child is still not walking unaided at around 18 months do we take a closer look together — that's the developmental milestone, not a starting gun.

On children's feet: almost all toddlers have flat feet with a slight inward roll (Knick-Senkfuß) — the arch looks flat and the ankle rolls in a little. At this age that's the normal state and not a problem: the arch forms by itself over the first few years, up to about school age. A foot like this that is painless and flexible needs no insoles and no treatment. Come to us if the foot looks stiff (doesn't lift up when standing on tiptoe), hurts, is unusual on one side only, or if the child is also floppy or shows signs of developmental delay.

And the shoes? Children's feet develop best barefoot — so indoors, ideally barefoot or in non-slip socks, which trains the muscles and balance. "First-walker shoes" are neither needed nor helpful, and standing a child up early "for practice" achieves nothing. The first proper shoe only makes sense once your child walks confidently outdoors — and then as protection against cold and rough ground, not as support. Look out for: light and flexible (you should be able to bend and twist the shoe in your hand), a thin, pliable sole, a wide toe box, and about a thumb's width of room in front of the toes. A healthy child's foot doesn't need firm, "supportive" shoes.

One more common topic: walking on tiptoe. During the learning-to-walk phase, many children go up on tiptoe at times; this is usually harmless and resolves on its own. Talk to us if your child walks almost only on tiptoe, if it persists beyond toddlerhood, if it affects one side only, or if the calf also looks shortened or stiff.

How much screen time is okay for my child?

The short answer: as a guide, the WHO and the American Academy of Pediatrics (AAP) set out clear, age-based guidance. Under 18 months, ideally no screen media at all — the one exception is a video call with grandparents and the like, which is real social interaction and perfectly fine. At about 18–24 months: if at all, then only high-quality content, and together with you, not alone. From 2 to 4 years: at most about 1 hour a day, good quality — and less is better.

And no lectures here: screens are part of family life today. A child who watches something now and then comes to no harm. This isn't about blame — it's that in the early years, movement, real play, attention and sleep matter most, and screen time shouldn't crowd them out.

What you can do in practice: choose calm, age-appropriate content. Watch along where you can and name what's happening — watching together and talking about it is actually good for them. Two practical rules work well: no screens at meals and no screens around sleep. Devices don't belong in the bedroom, because their very presence disturbs sleep. And because children learn from example, the way you handle your own phone — mindfully — often counts for more than any rule about minutes.

Why the caution at all? Children who spend a lot of time in front of a screen early on — and especially alone — tend, on average, to find speech a little harder. The links are real but small. What matters is less the amount of time than what, how, and with whom a child watches. If screen time becomes an ongoing issue or a flashpoint in your home, feel free to talk to us.

Growing up with more than one language — does it harm my child's speech development?

Short and clear: no. Growing up multilingual does not harm speech development and does not cause a speech disorder. Children are built for more than one language — all over the world, countless children grow up bilingual or trilingual as a matter of course. Your child reaches the speech milestones within the normal timeframe. Sometimes the first words seem a little later — and that, too, is still within the normal range.

One thing that tends to worry parents but is completely normal: the vocabulary is spread across several languages. In any single language it may therefore look smaller. Count both languages together, though, and it is on a par with that of monolingual children. That's why, with multilingual children, we always assess speech across all their languages together.

Mixing languages — switching from one to the other mid-sentence — is not a sign of confusion but of competence. Children know perfectly well which language belongs to whom, and they sort this out as they grow.

And there is no single right method. "One person — one language" is one option, but not a must. More important than the rule is that your child hears and uses each language enough, and in a lively, engaged way. Do keep up your heritage language — it's a gift, not a drawback.

And what if a genuine speech delay really is on the table? Then this applies: a true speech development disorder shows up in both languages. Multilingualism is then not the cause — and it would be wrong to give up a language because of it. Talk to us — regardless of multilingualism — for the same warning signs as with any child, counted across all languages: not a single word by about 18 months, fewer than 50 words or no two-word phrases by 24 months, or if your child is losing a skill they already had. As always, with a speech delay we check the hearing first. If in doubt, we'll take a look together — better safe than sorry.

Toilet training — when is my child ready, and when can they stop wearing diapers?

On age, the range is wide: most children become dry during the day between about 2 and 3½ years, boys often a little later than girls — both are normal. The order is always the same: daytime first, night-time much later. A child who is already dry during the day but still needs a diaper at night is completely normal. Night-time dryness isn't expected until about 5 years — and bed-wetting before then is not a disorder.

Readiness matters more than age. Toilet training is a step in maturing, not a parenting achievement — you can't drill it before your child's body and mind are ready. It can begin when your child stays dry for about two hours at a stretch and shows an interest in the toilet. Other good signs: they can pull their pants down themselves, follow simple instructions, and let you know (in words or gestures) that they "need to go".

The most important advice: don't push. Pressure, scolding or too early a start bring no benefit — on the contrary, they can lead a child to hold in their stool and develop constipation. Setbacks are normal, especially at unsettling times (a new sibling, a move, an illness) — that's not a relapse and not a failure. Praise small successes, stay relaxed, and if your child resists, feel free to take a break for a few weeks. Your child shouldn't be made to feel bad about it — and neither should you.

Talk to us if your child is still not dry in the daytime at about 5 years, or if they start wetting again after a longer dry spell. Get in touch, too, if the wetting comes with pain or burning, a constant urge to go, or signs of a urinary tract infection — or if your child is drinking noticeably more than usual and wetting. Then we'll look at whether there's an underlying cause that can be treated effectively.

My child has too large or too small a head — what does that mean?

The key thing first: a value on the 3rd or the 97th percentile is, on its own, not in itself a reason to worry. What matters more than any single value is the trend. A child growing steadily along their own curve — whether low or high on the chart — is usually completely unremarkable. And a large or small head very often simply runs in the family, which is why we always look at your own head circumference too.

By way of background: head circumference is measured at every check-up and plotted on a percentile curve in the Mutter-Kind-Pass — because it tells us how the brain is growing. Percentile simply means where your child sits compared with 100 children of the same age. We take note if the curve jumps across the percentile lines — that is, suddenly climbs steeply or flattens off.

With a large head (macrocephaly), by far the most common explanation is exactly that: familial and benign, with the child developing normally. A temporary, harmless widening of the fluid spaces in a baby also occurs, and usually resolves on its own. We look into it more closely if the head grows too fast across the curves, if the fontanelle is bulging or tense, if it's accompanied by signs such as vomiting, unusual sleepiness or irritability, or if development stalls. For that, a harmless ultrasound through the still-open fontanelle is often all it takes.

With a small head (microcephaly) we are a little more thorough: it too is often familial and harmless, but it is more often linked to an underlying cause — so as a rule we look into it, especially if development isn't keeping pace. Here too, a look at the head circumference of parents and siblings helps.

In short: a single borderline value is rarely a problem. What counts is the trend of the curve, your child's development, and the head circumference in the family — and that is exactly what we look at together at the check-ups.

Which vaccinations does my child need — and how does it all work here?

Vaccinations are one of the greatest achievements of modern medicine — they have all but banished diseases that once cost countless children their lives or their health. For your child, they are the best protection you can give: they prevent serious illness — whooping cough in a baby, meningitis, measles and its complications. Many of these diseases were once common and greatly feared; today, thanks to vaccination, we hardly ever see them. That is why we strongly recommend the important childhood vaccinations.

In infancy and early childhood, the recommended childhood vaccination program typically includes:

Rotavirus — an oral vaccine (given as a drink) against severe vomiting and diarrhea, from seven weeks of age.
The 6-in-1 vaccine (diphtheria, tetanus, whooping cough, polio, Hib, hepatitis B) — here, in three doses: at the Mutter-Kind-Pass check-up at seven weeks, then two months later, and once more at one year.
Pneumococcal — against bacterial meningitis and bloodstream infections.
MMR (measles, mumps, rubella) — two doses, the first from ten months of age, the second a while later, at the latest before your child enters a childcare setting.
At around five years, the 4-in-1 booster against diphtheria, tetanus, whooping cough and polio (e.g. Repevax) — the early protection fades over time, so it needs a booster.
Later, the HPV vaccination (free from your child's 9th birthday).

Are these the same vaccinations everywhere? In essence, yes: the important childhood vaccinations are broadly the same across Europe and worldwide (WHO standard). The timing and a few extras do differ from country to country, though — the BCG vaccination against tuberculosis, for example, is given in many countries but not in Austria, and the chickenpox (varicella) vaccination is part of the standard program in Germany but (not yet) in Austria. If you are coming from abroad, simply bring your existing vaccination record — we will check it against the Austrian immunization schedule.

How does it work here? Conveniently, most vaccinations line up with the Mutter-Kind-Pass check-ups, so we vaccinate at the appointment you are coming to anyway.

Private vaccinations — recommended, but you pay for these yourself and they are not part of the free program for the little ones: meningococcal B and meningococcal ACWY (ACWY is only free within a certain age window), the chickenpox (varicella) vaccination, and the tick-borne encephalitis (TBE) vaccination (protection against ticks, from 12 months of age onwards — more on this in the tick question). Paying for these yourself doesn't make them any less important.

Do they really all have to be done? We recommend them — and we mean it. The combination vaccines keep the number of shots small and don't overwhelm the immune system; a baby copes with far more germs every day. And the more children are protected, the safer it is for those still too small to be vaccinated. You don't have to decide everything at once — take your time and raise any questions with us; the Mutter-Kind-Pass check-ups are a calm, unhurried moment for exactly that.

Can vaccinations cause autism (MMR)?

Let me be clear: No. Vaccinations — including the MMR vaccine against measles, mumps and rubella — do not cause autism. Few questions in medicine have been studied as thoroughly; it has been examined in very large groups of children, always with the same result.

Where does the worry come from? From a single paper published in 1998 that raised a suspicion — based on just 12 children. That paper was later retracted in full, once it emerged that data had been falsified. The doctor behind it lost his medical license. So the claim was not merely a mistake — it was fraud — later disproven.

What the large, credible research shows:

A Danish study of more than 650,000 children found no link between MMR and autism — not even in children at higher risk of autism because of an affected sibling, and with no clustering of cases after vaccination.
A pooled analysis of studies covering more than 1.2 million children reached the same conclusion.
The independent Cochrane review (a database of over a million children) confirms it too: no autism from MMR — and that the vaccine reliably works.

Why does the timing feel so persuasive? The first signs of autism usually become apparent in the second year of life — right when the MMR vaccine is given. But two things coinciding in time does not mean one causes the other. Autism is largely there from the start (genetic, shaped in early brain development), long before any vaccination.

One more thing that often comes up: the MMR vaccine is a live vaccine and never contained the mercury-based preservative behind a second myth. There is no autism link there either.

If you are unsure, that is entirely understandable — this story has worried a great many parents. Talk to us, and we will go through your questions calmly.

Side effects and post-vaccination fever — what should I expect, and for how long?

Reassuringly, the vast majority of vaccine reactions are harmless and short-lived. With the "standard" shots (6-in-1, pneumococcal and the like), a reaction shows up quickly, within 1–2 days; with the MMR vaccine it comes later, around day 5 to 12. Either way, it usually settles by itself within a few days.

What you can expect:

At the injection site: redness, slight swelling, tenderness — usually 1–3 days.
General: mild to moderate fever, fussiness, tiredness, less appetite. This fever does no harm — it's the immune response; the body is busy building protection.
After the MMR vaccine, fever can come on with a delay (day 5–12), sometimes with a mild measles-like rash: a pale, non-infectious rash that clears on its own (in roughly 2–4 in 100 cases, often with slight swelling of the cheeks or salivary glands).

What helps? The same as for any other fever: let them drink plenty, keep your child comfortable, and give a fever medicine only if they are really unwell (for dosing, see our question on fever reducers). As a precaution — that is, "just in case" before or right after the vaccination — you should give no fever medicine; it isn't needed, and it can even slightly weaken the vaccine's effect.

And a febrile convulsion? After the MMR vaccine, a febrile convulsion is briefly a little more likely (roughly 1 in 1,150 to 1,700 vaccinations, in the day 5–12 window). These convulsions look frightening but are almost always harmless and pass on their own (more on this in our question on febrile convulsions). The benefit of the vaccine clearly outweighs this: real measles can lead to inflammation of the brain — exactly what the vaccine prevents.

Call the ambulance immediately — 144 (Austria's emergency number); the Europe-wide number is 112 — at any sign of a serious allergic reaction: difficulty breathing, swelling of the face or throat, sudden hives, faintness or collapse. This is very rare (around 1 in a million), and it is exactly why you stay in the practice for about 15–20 minutes after the vaccination for observation.

Come in to the practice — not as an emergency, but soon — if the fever lasts more than about 2 days or is very high, if the injection site becomes larger and warmer rather than healing, if your child is unusually drowsy or cries in a shrill, unusual way, or if you simply have the feeling that "something isn't right". Do let us know about any unusual reactions — we can also record them officially.

Feeling unwell before a vaccination appointment, or if a vaccination was missed — what should I do?

A mild infection is usually no reason to cancel, and a missed vaccination is nothing to worry about — we simply catch up on it later, without starting over.

Your child has a cold — vaccinate or postpone?

Minor infections are no obstacle: a runny nose, a slight cough or a mildly raised temperature up to 38.5 °C are no reason not to vaccinate. The appointment can usually go ahead.
Postpone if there is a genuine feverish illness (from 38.5 °C) or your child is acutely, seriously unwell. Then we wait for recovery and catch up on the vaccination soon afterward.
You don't have to make this call yourself: we will look at your child at the appointment and tell you whether it's fine. If you are unsure, it is always better to come and ask than to cancel from home.

Missed or overdue a vaccination? The reassuring rule is: every dose counts. A primary course that has been started is not restarted, however long the gap — some doses are simply still missing, and we catch those up. There is no interval that is "too long". The only downside of a delay is the longer stretch without full protection, so we catch up what has been missed promptly — but there's no need to panic.

In practice: bring the vaccination record and the Mother-and-Child Health Booklet (Mutter-Kind-Pass). That way we can see at a glance what's missing and plan the catch-up vaccinations — often several can be bundled into one appointment. Lost the vaccination record? Even then, no one has to start from scratch; together we work out what has already been done and sensibly fill in the rest.

Travel vaccinations — what matters before trips abroad?

Above all else: the best travel protection comes from up-to-date standard vaccinations — MMR first among them. Additional travel vaccinations depend on the destination and need planning well ahead: ideally 6–8 weeks before departure, because some vaccinations take several appointments.

Step 1 — get the standard vaccinations up to date. Check with us whether your child is up to date with the childhood vaccination program. Measles in particular still turns up in many travel destinations (Europe included), so full MMR protection is often the single most important piece of travel preparation.

Step 2 — destination-specific travel vaccinations. Depending on the country, style of travel and age, the options include, for example:

Hepatitis A — sensible for most trips outside Europe and North America; for children from their first birthday.
Typhoid — especially for India, neighboring countries and parts of South-East Asia.
Yellow fever — for certain countries in Africa and South America, in some cases compulsory with an international certificate of vaccination; available only at authorized vaccination centers and only from nine months of age.
Depending on the trip, also rabies, Japanese encephalitis, meningococcal disease or — for stays in Austria and other tick areas — TBE.

Important: there is no travel vaccine against malaria — here what counts is mosquito protection and, where appropriate, medication that we discuss separately. Travel vaccinations in Austria are usually paid for privately (not part of the free program).

In practice: arrange a travel-medicine consultation early, and bring your vaccination record and your exact route. In Vienna, the options include the city's travel-medicine vaccination service (Klinik Favoriten) and specialist practices; for the child's side of things and the vaccination record, we are of course here too. Very small babies can't yet have some vaccinations because of their age — we factor that into the planning.

My baby has a blocked or runny nose — what can I use?

For a baby with a cold, saline nose drops followed by gentle suction are the best option: simple, safe and effective. Decongestant nose drops and essential oils, on the other hand, should not be used in babies unless specifically advised by a doctor.

Call an ambulance immediately on 144 (Austria) or 112 (throughout the EU) if your baby is struggling to breathe — for example, if the skin pulls in between or below the ribs, the nostrils are flaring, breathing is laboured, there are pauses in breathing or the lips turn blue. This may be a lower respiratory tract infection, such as RSV bronchiolitis, particularly in a young baby.

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

Contact us the same day if your baby:

can no longer feed properly because of the blocked nose, or
has noticeably fewer wet nappies than usual.

What you can do at home

Use saline nose drops (0.9% saline solution): place a few drops in each nostril, ideally shortly before a feed. This helps loosen the mucus and is safe when used as directed.
Then gently clear the nose with a nasal aspirator. Use only light suction, keep it brief and keep the tip at the opening of the nostril.
Keep your baby’s upper body slightly raised while awake, and offer breastfeeds or other fluids regularly.
Air the room regularly and avoid overheating it.

Only after speaking to us

Decongestant nose drops, such as those containing xylometazoline, may occasionally be considered for babies, but only in a formulation specifically made for infants, for a short time and after speaking to us. Standard adult products can cause a dangerous overdose in babies.

Do not use essential oils. Camphor, menthol or peppermint, and eucalyptus should be avoided in children under two, whether used as a chest rub, in the bath, in a diffuser or for inhalation. Even a few drops reaching the nose or throat can trigger a spasm in the throat and cause breathing problems.

A clear nose is especially important during the first few months, when babies breathe almost entirely through their nose. When it is blocked, feeding and sleeping become particularly difficult. A straightforward cold with clear nasal discharge can be managed at home if your baby is otherwise feeding well and alert. Contact us if you are unsure.

My child has a cough — when should we go to hospital, and when should we come to the practice?

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.

Does my child need cough medicine, or is it better to wait?

In most cases, waiting is the better option. No cough medicine has been shown to shorten the illness in children, contrary to what many adults assume. Because there is no proven benefit but there is still a risk of side effects, cough medicines are no longer routinely recommended in paediatric respiratory guidelines.

What actually helps is simple: plenty of fluids to keep the mucus thin, avoiding dry, overheated rooms, and a little patience. From 12 months of age, some honey may soothe the cough. Never give honey before the first birthday because of the risk of infant botulism.

For a troublesome dry, tickly cough, a short trial of noscapine may be considered. It is regarded as relatively safe, but the evidence for its effectiveness is limited. Although it is licensed for younger children, we take a more cautious approach and generally recommend it only from 12 months of age and after speaking to us.

Call an ambulance immediately on 144 (Austria) or 112 (throughout the EU) if your child has acute breathing difficulty — visible chest recession, laboured breathing or blue lips. See “My child has a cough” for details.

Bring your child to our practice today if they:

have a high fever, around 39 °C or above, and are listless, or
have a cough that is not settling.

For a fuller explanation of why coughing is often a useful reflex and what genuinely helps, read our blog article about coughs.

Can I use essential oils for my baby’s cold?

No. Camphor, menthol and eucalyptus should not be used in children under two — not on the face, not for inhalation and not in ready-made cold rubs or balms containing these substances. What feels soothing to an adult can cause a spasm in a young child’s throat and may even stop them breathing. A small amount around the nose or face may be enough. This is not about sensitive skin; these products can affect your child’s breathing and should not be used.

Call an ambulance immediately on 144 (Austria) or 112 (throughout the EU) if your child develops breathing problems, a coughing fit or reduced consciousness after contact with these oils.

If your child has swallowed an essential oil or you suspect poisoning but there is no acute breathing difficulty, call the Austrian Poison Information Centre, available around the clock, on 01 406 43 43.

For a blocked nose in babies and toddlers, saline drops and a cool, well-ventilated room are usually all that is needed.

Barking cough, hoarseness and fever (croup) — what should I do?

First, watch how your child breathes when calm and at rest.

Call an ambulance immediately on 144 (Austria) or 112 (throughout the EU) if:
you can hear a harsh, high-pitched sound when your child breathes in (stridor) even at rest — not only when crying or exerting themselves;
your child is struggling to breathe — the skin pulls in around the ribs, breathing is laboured or the nostrils are flaring;
the lips or skin become pale or bluish;
your child becomes unusually drowsy or unresponsive, can no longer drink or swallow, or is drooling heavily.

If none of these signs is present, mild croup can usually be managed at home. Above all, stay calm, as distress can make the breathing difficulty worse. Hold your child upright and reassure them. Then take them into cool, fresh air — by an open window, outside into the cool night air or into a cool entrance hall. Let your child continue to drink if they want to.

If this does not bring rapid improvement, or if you are concerned about your child’s breathing, have them assessed by a doctor the same day. If needed, we will give a corticosteroid; a single dose is usually very effective at relieving croup symptoms.

If any of these signs develop or return, call an ambulance immediately on 144.

The barking cough, often described as seal-like, and hoarseness typically begin suddenly in the evening or at night, often with a mild fever. Croup is almost always caused by a virus and is usually harmless. It may recur for one or two nights.

My child has tummy pain — when does it need medical help?

Call an ambulance immediately — 144 (Austria's emergency number); the Europe-wide number is 112 — for sudden, very severe tummy pain with a rigid, board-like abdomen, listlessness or green (bile-stained) vomiting — this can be a bowel obstruction or another acute abdominal emergency.

You should also have these checked quickly, the same day: persistent crying with legs drawn up, blood in the stool, repeated vomiting, unusual pallor or floppiness, weight loss, fever alongside tummy pain, or pain that keeps returning to the same spot. With a baby under three months we're extra cautious as a rule — please don't hesitate to bring them in.

Only if none of these signs is present does the reassuring rule apply: most tummy pain in children is over quickly — often it comes from digestion, gas, a gastrointestinal infection, constipation, or even excitement and stress. As long as your child plays, eats and seems lively in between, you can wait it out with calm, warmth and a little time.

Two particular patterns deserve a closer look:

Intussusception — especially in the first year of life, often after an infection: sudden, wave-like severe tummy pain in which the child cries shrilly, draws up their legs and goes noticeably pale, often with vomiting. A redcurrant-jelly-like, bloody stool is a late warning sign — don't wait for it. If you see this, take your child straight to a children's hospital or call an ambulance on 144 (112 Europe-wide); caught early, it can often be resolved without surgery.
Appendicitis — especially in school-age children (about 6–12 years): the pain often starts around the navel and, over a few hours, moves into the right lower abdomen, with nausea, loss of appetite and a mild fever. A telltale sign is that any jarring hurts — jumping, coughing, walking. Increasing, migrating tummy pain like this should be checked the same day, because an inflamed appendix can eventually burst.

Outside our opening hours you can reach the after-hours doctor service (141) or the nearest children's emergency department; and if in doubt, get in touch with us.

My child has diarrhea — how do I tell if they're getting dehydrated?

Focus first on the signs of dehydration — they matter more than the number of loose stools: fewer than four wet diapers in 24 hours, dry lips and mouth, no tears when crying, a sunken fontanelle, or marked floppiness or listlessness. If any of these appears, have your child examined by a doctor. The same goes for blood in the stool, a high fever (around 39 °C or above), or diarrhea that lasts longer than about a week or isn't improving after two or three days. The younger your child, the sooner you should act: babies under three months with diarrhea should be seen the same day (especially if there's fever or vomiting too), because they dehydrate more quickly.

Diarrhea usually comes from a harmless gastrointestinal infection (a virus) and clears up on its own. What matters more than trying to "stop" it is replacing the lost fluids: breastfed babies simply keep breastfeeding; older children drink in small sips or by the spoonful, with short pauses in between. For more severe diarrhea, pharmacies sell an oral rehydration solution (ORS) — dissolve it in water only, not in juice, soft drinks or cola. Diluted cola, fruit juice or pretzel sticks aren't suitable for this, because the salt-and-sugar ratio is wrong and tends to make the diarrhea worse. An oral rehydration solution isn't plain water — it contains the right salts, which is why it's also the right choice for younger babies; if in doubt, check with us first. Your child may eat whatever they feel like — a strict diet isn't necessary. Over-the-counter "anti-diarrhea" medicines (e.g. loperamide) are not suitable for young children and should not be given without medical advice.

Call an ambulance immediately — 144 (Austria's emergency number); the Europe-wide number is 112 — if your child:
is no longer drinking and is becoming increasingly listless or hard to wake;
shows severe dehydration: no wet diapers for many hours, sunken eyes, and cold, pale-gray, mottled skin that doesn't turn pink even when warmed;
has bloody diarrhea with a high fever (around 39 °C or above) and is clearly unwell.
Outside our opening hours: the after-hours doctor service (141) or the nearest children's emergency department.

My child is vomiting — when is it an emergency?

You should have your child seen quickly — or right away, in these situations — don't wait:

green (bile-stained) or bloody vomiting — this can point to a bowel obstruction;
repeated vomiting after a fall or a blow to the head, especially if your child seems unusually drowsy, listless or confused;
any repeated vomiting in a baby under three months;
your child becomes increasingly floppy, won't drink any more, or shows signs of dehydration (fewer wet diapers, dry lips and mouth, no tears, a sunken fontanelle, listlessness).

Two warning patterns in young children are worth knowing. Projectile vomiting in a young baby (at around two to eight weeks of age) right after feedings — with the baby seeming hungry again straight away — can be a sign of pyloric stenosis and should be examined promptly, ideally the same day. And sudden colicky tummy pain with shrill crying, legs drawn up, pallor and periods of calm in between (later, possibly, a redcurrant-jelly-like stool) can point to intussusception — especially in the first year of life (possible up to about age 2). This one is time-critical: go straight to a children's hospital or emergency department, or call an ambulance on 144 (112 Europe-wide) — don't wait.

Otherwise, a child who is vomiting usually has a harmless gastrointestinal infection that passes quickly. What matters then is the same as with diarrhea: keep offering fluids in small sips — at first just a teaspoonful every few minutes, so their tummy doesn't turn again straight away, then slowly build up the amount. Breastfed babies keep breastfeeding. The vomiting usually settles within one to two days. Anti-nausea medicines are something for the doctor to decide, not for self-treatment.

Harmless spitting up isn't vomiting: in the first months it's normal for a baby to spit up small amounts or burp after a feed — the muscle at the entrance to the stomach is still immature, and often it's simply that too much air was swallowed. As long as your baby is thriving and content, there's no cause for concern. Real vomiting comes up more forcefully and in larger amounts, and the child often seems distressed or unwell.

Call an ambulance immediately — 144 (Austria's emergency number); the Europe-wide number is 112 — if:
the vomiting is green/bile-stained or contains blood (possible bowel obstruction);
it occurs after a fall or a blow to the head and your child is unusually drowsy, listless or confused;
your child is no longer drinking and is becoming increasingly listless or hard to wake.
Outside our opening hours: the after-hours doctor service (141) or the nearest children's emergency department.

Constipation — what helps, and when do I need to see the doctor?

A long gap between bowel movements doesn’t necessarily mean your child is constipated. Constipation means that their poo is hard, pooing hurts or they hold it in.

Take your child straight to a paediatric emergency department if:

your child’s vomit is green;

your child is constipated and keeps vomiting;

your child’s tummy is very swollen or feels hard and tight, and they seem unwell or lethargic;

your child has severe or rapidly worsening tummy pain;

their poo is black and tar-like, unless they’re taking iron drops, or there is blood mixed in with it;

your baby passed very little poo during the first few days of life and their tummy is becoming increasingly swollen;

your baby has blood in their poo and seems unwell or lethargic, or has a swollen tummy;

there is a lump in the groin or scrotum that cannot be gently pushed back in.

Book an appointment with us if:

it hurts when your child poos, or you notice blood on the outside of the poo, on the toilet paper or in the nappy;

your child holds their poo in or is afraid of going to the toilet;

your child has small smears of poo in their underwear or starts soiling themselves again;

your child starts wetting themselves again after having been dry, or suddenly needs to wee much more often;

the constipation lasts for more than two weeks or doesn’t improve after changes to your child’s diet;

your child isn’t gaining weight as expected;

your child passed hard stools during the first few weeks of life;

your child repeatedly passes stools that are unusually narrow, flat or ribbon-like, particularly during the first year of life.

If your child is under one year old, please tell us when you call.

During the first few months of life

Many babies strain, go red in the face and cry before passing a soft poo. This isn’t constipation. Your baby is still learning how to relax their pelvic floor while pushing. This is normal in young babies and usually settles on its own by around nine months.

Babies vary widely in how often they poo. From around six weeks of age, exclusively breastfed babies may go ten days or even longer without a poo. This can be normal as long as the poo is soft when it comes, your baby seems content and is gaining weight well. True constipation is rare in exclusively breastfed babies.

If your baby is having only breast milk or formula, do not give them water, tea or juice.
Make up formula exactly as instructed on the packaging. Never add extra powder.

From around six months

Some fruits naturally help to soften poo. These include pears, apricots, plums and peaches. Offer them mashed, grated or puréed, depending on your baby’s age. Fruit juice contains very little fibre. You can also include wholegrain cereals in your baby’s meals and offer a little water with meals.

During the first year of life, do not give your baby a laxative or try to make them poo without medical advice. Please have your baby checked first.

From one year of age

Three things can help:

Choose high-fibre foods: fibre is the part of plant foods that helps to keep poo soft. Good sources include porridge oats, wholemeal bread and pasta, lentils, beans, peas, raspberries, blackberries, kiwi fruit and broccoli.
Limit milk and sweets: from the age of one, around three small portions of dairy products a day are enough—for example, a small glass of milk, a small pot of yoghurt and a slice of cheese. Too much dairy can fill your child up, leaving them less hungry for vegetables, fruit and wholegrains. Offer water when your child is thirsty, rather than milk. Sweets can fill them up too, so avoid giving them before meals or using them as a reward.
Keep toilet time relaxed: do not pressure your child to use the potty or toilet. Use a footstool so that their feet are supported and their knees are higher than their hips. Encourage your child to sit on the potty or toilet twice a day, ideally around 20 to 30 minutes after a meal. Five minutes is enough.

After one painful poo, your child may become afraid that it will hurt again and start holding their poo in. Holding on can sometimes look like straining. They aren’t being difficult; they’re frightened. Please don’t pressure them.

Do not use a thermometer, suppository or enema to try to make your child poo. This can injure them and make them even more afraid of pooing.

When constipation looks like diarrhoea

If a large amount of hard poo has built up in the bowel, softer poo can leak around it, leaving small smears in your child’s underwear or nappy throughout the day. This isn’t diarrhoea; it’s overflow soiling. Your child usually won’t feel it happening and can’t control it. They aren’t doing it on purpose, and it doesn’t mean they’ve gone backwards with toilet training.

The situation is different if your child has watery poo several times a day but isn’t constipated in between. If they otherwise seem well and are growing normally, something else may be causing it. See: “My toddler keeps having diarrhoea but seems well.”

How constipation is treated

When constipation has been going on for a while, eating more fibre, drinking enough and staying active usually aren’t enough on their own. Clinical guidelines recommend macrogol as the first-line treatment for constipation in children. It’s one of the safest medicines we give children. Macrogol isn’t absorbed by the body. It holds water in the bowel, which softens the poo. Your child won’t become dependent on it, and it won’t make their bowel “lazy”.

It usually takes a few days for the poo to soften, so it’s normal if nothing happens on the first day. If a lot of poo has built up, your child may pass much more than usual at first. They may also feel bloated or seem unsettled at first, but this usually improves once the bowel has emptied.

Treatment usually needs to continue for several weeks, not just a few days. One common problem is reducing the dose too soon. Once the backlog starts to clear, the nappy may suddenly be very full. You may think the dose is too high and give less. The poo then becomes hard again, pooing hurts, and your child starts holding it in. The cycle starts all over again.

We can draw up a treatment plan for your child. Please follow it closely.

For a full step-by-step guide, see our blog post—link coming soon.

My toddler has constant diarrhea but seems well — what's behind it?

If a toddler passes loose stools several times a day but is otherwise thriving, drinking normally and showing no signs of dehydration, the cause is usually harmless "toddler's diarrhea": food simply moves through the gut more quickly, nights are typically undisturbed, and the child is lively and gaining weight — and it usually clears up by school age. A good way to tell it apart from an acute gastrointestinal infection: with toddler's diarrhea the child stays lively, whereas with an infection the child feels ill, often with fever or vomiting too, and it lasts only a few days.

A lot can be managed through diet. A simple mnemonic (a guide, not a strict rule) is the "four Fs": enough Fat (whole milk rather than reduced-fat), normal Fiber (neither very little nor a great deal), cutting right back on Fruit juice and heavily sweetened drinks, and not offering excessive Fluids across the day. Important: this applies only to this chronic, harmless toddler's diarrhea in a thriving child — with an acute vomiting-and-diarrhea illness it's the other way around, and plenty of fluids, or an oral rehydration solution, is exactly what matters (see "My child has diarrhea").

One common misconception to clear up: Teething is not an explanation for real or persistent diarrhea. Teething can bring sore gums, fussiness and more drooling, but not real diarrhea — so any lasting diarrhea should be assessed on its own, independently of teething.

Even so, any diarrhea that lasts longer than about four weeks (at which point we call it chronic) should be checked by us, to safely rule out rarer causes such as celiac disease or a food intolerance. Take note if your child loses weight or drops off the growth curve, if there's blood in the stool, if tummy pain or fever appears, or if signs of dehydration develop — then let us know.

Febrile seizures — what should I do, and how dangerous are they?

During the seizure

Stay calm and remain with your child. A febrile seizure looks frightening, but usually stops on its own after one to three minutes.
Prevent injury: place your child on a safe, soft surface, such as the floor or a carpet. Move hard objects out of the way and cushion their head. Do not restrain your child or try to stop the jerking movements.
Put nothing in their mouth — no fingers, spoon, bite block, water or medicine. Your child cannot “swallow” their tongue; objects in the mouth only cause injury.
Check the time and remember how long the seizure lasts. This is the most important information for us and for the ambulance team.
After the seizure, place your child in the recovery position to keep the airway clear. It is normal for your child to be sleepy, dazed or less responsive than usual afterwards, and this may last for a while.

Call an ambulance immediately on 144 (Austria) or 112 (throughout the EU) if:
the seizure lasts longer than five minutes,
this is your child’s first seizure,
your child has difficulty breathing or remains blue,
another seizure follows straight away,
your child does not wake fully or return to their usual level of awareness afterwards.

Take your child to a paediatric emergency department after every febrile seizure, even if it stopped on its own and your child seems well again.

The hospital team will look for the cause of the fever and rule out conditions including meningitis. This is particularly important in a baby under 12 months, after a complex seizure (see below), or if your child is slow to recover afterwards. Long-term medication is almost never needed after a febrile seizure. If your child is prone to repeated or prolonged seizures, we will discuss rescue medication for you to keep at home.

What to observe

Note how long the seizure lasts, whether it affects the whole body or only one side, how quickly your child recovers afterwards, and any other symptoms that may point to the cause of the fever.

What is a febrile seizure?

It is a seizure triggered by fever in a young child, without inflammation or disease of the brain itself. Febrile seizures affect around two to five in every 100 children, almost always between six months and six years of age, and most often at around two years. As frightening as they look, simple febrile seizures are usually harmless and cause no lasting damage.

How dangerous is it really?

Around 96 in every 100 children do not go on to develop epilepsy. After a simple febrile seizure, the risk is only slightly higher than it is for children in general. A simple febrile seizure does not increase the risk of death and has no proven adverse effect on your child’s intelligence or development.

Febrile seizures are classified as simple or complex. A simple febrile seizure affects the whole body, lasts less than 15 minutes and occurs only once within 24 hours. A complex febrile seizure lasts 15 minutes or longer, affects only one side of the body or occurs more than once on the same day. Complex seizures are less common and need more detailed assessment. The five-minute threshold above is not part of this classification; it is the point at which you should call an ambulance.

You did nothing wrong

Fever-reducing medicines do not prevent febrile seizures, so there is no reason to blame yourself for not bringing the fever down “in time”. In many cases, a febrile seizure happens as the temperature rises rapidly, sometimes before you have even noticed the fever. The good news is that children almost always outgrow febrile seizures by their sixth birthday.

How can I recognise a food allergy, and when is it an emergency?

Call an ambulance immediately on 144 (Austria) or 112 (throughout the EU) if, shortly after eating, your child:
has difficulty breathing, wheezes, gasps or develops bouts of coughing;
develops swelling of the lips, tongue, face or throat, or becomes hoarse;
suddenly becomes pale, limp or unresponsive;
vomits forcefully and develops hives across the body.

This is anaphylaxis, the most severe type of allergic reaction. Any one of these signs is enough; do not wait. In children, difficulty breathing is the most important warning sign. A severe reaction can occur without any rash at all.

Use an adrenaline auto-injector if one has been prescribed:
Press the pen firmly against the outer thigh, through clothing if necessary. Hold it in place for the length of time specified in the instructions for your device.
If in doubt, give it sooner rather than later. The greatest risk is giving adrenaline too late.
Lay your child flat with their legs slightly raised. If breathing is difficult, let them sit upright instead. Do not allow them to stand or sit up suddenly.
If your child is unconscious or vomiting, place them in the recovery position.
If there is no improvement after around five minutes and you have a second injector, give the second dose.
Always go to hospital, even if your child improves quickly. A second reaction can occur several hours later.

Most reactions are mild

The vast majority of allergic reactions are not dangerous. Typical signs include:

an itchy rash, redness or a few hives,
sometimes vomiting or diarrhoea.

These reactions often appear after repeated exposure to a food, not necessarily the first time.

If you notice the same signs repeatedly with the same food, we can assess them at the practice.

Redness around the mouth is usually harmless. The acids in tomato, strawberry and citrus fruit can irritate the skin. The redness remains localised, is rarely itchy and disappears on its own within about 15 minutes. It becomes more concerning only if your child also develops hives across the body, swelling, breathing problems or, particularly in a young child, redness around the mouth together with vomiting.

Do not deliberately avoid the common allergens. Introducing them helps prevent allergy. In practical terms:

Egg and fish: offer them regularly as soon as your baby starts solid foods, always thoroughly cooked.
Peanut: offer it only in a smooth form, such as smooth peanut butter or peanut paste. Never give whole nuts because of the choking risk.
Severe eczema: if your baby has severe eczema, speak to us before introducing peanuts.

Will my child outgrow the allergy?

Children can outgrow cow’s milk and hen’s egg allergies:

Many develop tolerance during the first few years of life.
It is not possible to predict reliably when this will happen.

We therefore review a diagnosed allergy regularly, so your child does not avoid a food for longer than necessary.

My child has fallen off the bed or the changing table — when do I need to act immediately?

Call the ambulance straight away — 144 (Austria's emergency number); the Europe-wide number is 112 — or drive at once to the nearest children's emergency department if, after the fall, your child shows any of these signs:
was unconscious (even briefly) or is unusually drowsy / hard to rouse / listless
is having a seizure
vomits repeatedly (more than once) or the vomiting is getting worse
has a worsening or severe headache, a change in how they are ("not their usual self"), or inconsolable, high-pitched screaming
has unequal pupils, disturbed vision, a new-onset squint, or weakness/paralysis in an arm, a leg or when walking
is losing blood or a clear, watery fluid from the nose or ear
has a visible dent in the skull or — in a baby under 1 year — a large lump or swelling (more than about 5 cm), especially at the side or the back of the head, or a tense, bulging fontanelle.
If your child is unconscious, hard to rouse, having a seizure or breathing abnormally — don't drive yourself, call 144; the ambulance will come to you. In these cases, don't wait and see.

Did your child hit their head? It makes a difference. A bump or swelling on the head is a clear sign of an impact. If you didn't see the fall yourself, or you're not sure, to be safe, assume the head was involved and watch your child especially closely for the signs above.

How high was the fall? A fall from the bed (roughly body height) is usually less serious than a fall from the changing table or a chest of drawers (often about twice the height, around 80 cm). Even if your child seems bright and shows no alarm signs, have them seen by a doctor the same day if they fell from changing-table or chest-of-drawers height, or are younger than 3 months — in these cases an assessment makes sense even without warning signs.

If your child fell from a lower height (for example from the bed) and quickly becomes fully themselves again — awake and alert, moving arms and legs equally on both sides, feeding and playing normally — and shows none of the signs above, then in all likelihood the fall did no harm. The great majority of falls from the bed turn out this way. You may then watch your child at home — you don't automatically have to go to the hospital.

What you can do at home:

Cool a bump (a cold pack wrapped in a cloth, not directly on the skin), keep your child calm and comfort them.
Watch your child closely for the next 24 to 48 hours — because, on rare occasions, a head injury shows up only some hours after the fall. For the first 24 hours, an adult should always stay with your child. Your child may well sleep during this time — you don't need to keep waking them. But do check now and again, once or twice even on the first night, that they are breathing normally and respond as usual to touch or gentle waking.
Offer food and drink as usual. A single bout of vomiting right after the fright can happen — watch whether it stays at that one time (repeated vomiting is one of the warning signs above). With a young infant, give us a quick call even after one bout of vomiting.
Make sure they can rest, with no rough play and no second fall. For the pain of the bump, your child may have paracetamol if needed (for dosing, see our question on fever medicines); this doesn't affect the warning signs above, so you can still watch for them.
If any of the signs above appears during the observation period, then it is an emergency again right away: ambulance 144 (Austria's emergency number); the Europe-wide number is 112, or the nearest children's emergency department.

Come to the practice soon — not as an emergency — if the bump keeps growing, becomes unusually soft or tense, or stays very painful, if your child complains of a persistent headache, or their behavior seems "not quite right" to you, without any of the alarm signs above being present. If you're unsure and there is no alarm sign, the 1450 health advice line (around the clock) can also help outside our opening hours — 144 (Austria) / 112 (Europe-wide) remains for the alarm signs.

To set your mind at ease: you have no reason to blame yourself — such falls happen in a flash, and to most parents at some point. For the future, one thing matters most: never lay a baby down unsupervised on a raised surface, and always keep one hand on your child. The higher the surface, the more this matters — a changing table is especially high; where you can, change your baby at floor level.

Practice or hospital — when do I need to go where?

Call the ambulance straight away — 144 (Austria's emergency number); the Europe-wide number is 112 — and don't phone anyone else first, if your child:
is struggling to breathe or has blue lips
is unconscious or cannot be properly roused
is having a seizure
is unusually drowsy or "not their usual self" after a fall
has an allergic reaction with breathing difficulty or swelling
is bleeding heavily and it will not stop
or — if it's a baby — seems so unwell that you would not want to move them
If a baby is too unwell to move, the ambulance comes to you.

A few things need a doctor promptly (the practice the same day, or 141 or the emergency department outside those hours), even without the emergency signs above: fever in a baby under 3 months (always, and don't wait until the next day), clear signs of dehydration with diarrhea or vomiting (dry lips, barely any wet diapers, listless), a white or pale, colorless stool, or a condition that is visibly getting worse.

For everything else, a simple rule of thumb: a child who is unwell but not in a life-threatening state is best looked after here at the practice — things usually go faster and more calmly than in a hospital emergency department, and the emergency departments stay available for the real emergencies. So you don't need to head to the hospital for every fever or every worry.

How to find the right route:

During the day, in our opening hours → the practice. Fever, infections, rashes, tummy ache, minor injuries, or simply uncertainty: call us — we see acute cases the same day. A quick call ahead helps us find the right appointment.
In the evening, at night, on weekends or on a public holiday, when it's urgent but not an emergency → the after-hours doctor service (141). In Vienna it runs from 7 pm in the evenings, all weekend and on public holidays, and it will also come to your home.
Not sure whether waiting is enough or it needs the hospital → the 1450 health advice line. Around the clock and free of charge, they will assess with you how urgent it is. That's a better first move than hours of Googling.
When your child needs medical care quickly and we are closed → a children's emergency department. For example, with a suspected broken bone, persistent vomiting with dehydration, or a bump to the head with warning signs. Vienna's children's emergency departments include the St. Anna Children's Hospital, the AKH, the Klinik Ottakring and the Klinik Favoriten.
If you suspect poisoning (medicines, cleaning products, plants) → the Poisons Information Center on 01 406 43 43, around the clock. Often a phone call is enough to establish whether there is any danger at all — have the packaging on hand.

The short answer: emergency signs → call 144 (112 Europe-wide) straight away. Urgent but not an emergency → the practice, or 141. Not sure → call 1450. When in doubt, it is better to get in touch with us once too early than too late — that is what we are here for.

Who can I turn to outside opening hours?

It depends on how urgent it is — these levels will help you judge, most urgent first:

1. A genuine emergency — your child is unconscious, not breathing properly, having a seizure, in severe respiratory distress or having a serious allergic reaction: call 144 (Austria's emergency number); the Europe-wide number is 112. Don't lose a minute calling us first.

2. A swallowed — or possibly swallowed — button battery is an emergency in its own right; don't call first. If a button battery lodges in the esophagus, it can cause serious burns within about 2 hours. At any suspicion, drive straight to the nearest children's hospital or emergency department or call 144 (Austria) / 112 (Europe-wide) — don't wait, and don't call the poison line first. As a stopgap on the way to the hospital, for a child aged 12 months or older who is awake and can swallow safely, honey can slow the burning: 2 teaspoons (10 ml) of honey every 10 minutes, no more than 6 doses — but only if the honey is immediately on hand and it does not delay the trip. No honey under 12 months (botulism), and none if there is difficulty swallowing or vomiting (choking risk). Afterward, nothing more to eat or drink, and don't try to make your child vomit.

3. Suspected other poisoning (medicines, cleaning products, plants): the Poisons Information Center on 01 406 43 43 — around the clock, and you speak directly with doctors trained in toxicology.

4. Unwell, and it can't wait until we are open again — but not a 144 case: call the 1450 health advice line or the after-hours doctor service on 141 (in Vienna, the two numbers connect to the same service at night and on weekends anyway). Trained staff assess the situation and point you to the right place — a home visit, the emergency department, or the reassurance that it's fine to wait until morning. If your child needs to be seen right away, the nearest children's emergency department is the place to go; for our area that is usually the Klinik Favoriten.

Anything that can wait is best sent by email to praxis@meinkinderarzt.wien — or left as a message on our answering machine. We usually pick messages up within a few minutes and reply the same day, often within the hour; anything left outside opening hours, we answer before the practice opens. The in-house patient chat at latido.at is also an option — but because Latido doesn't send an automatic notification of new messages, we recommend email for getting in touch. For anything very urgent or private we are of course reachable by phone too, and we usually give same-day appointments for acute cases.