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Wahlarzt & Costs
A Wahlarzt is a doctor in private practice with no direct contract with your statutory health insurer. The name says it all: you choose your own doctor. In other countries you’d just call this a „private doctor„.
Treatment isn’t billed through the e-card: you pay for the visit on the spot and we give you an invoice (Honorarnote). You then submit it to your health insurer and — if you have one — to your private top-up insurance. Your insurer refunds part of it, and the top-up insurance usually covers the rest. (More on this under „How does billing work?“.)
The biggest benefit is time. There’s little or no waiting, and if your child is acutely unwell you’ll usually get an appointment the same day. We plan our appointments so there’s room for a careful examination, clear explanations and plenty of time for your own questions. No sitting around in a crowded waiting room.
From walking through the door to real answers usually takes just 20–30 minutes. We do many important tests right here in the practice — hip ultrasound for newborns, ECG, urine tests, or a small finger-prick blood sample that gives us a full blood count and CRP within minutes.
The main benefit is financial — and let’s be straight about the money. In the first year you’ll be at the doctor’s with your child seven to ten times on average (Mother-and-Child check-ups, vaccinations, minor infections); with a Wahlarzt that soon adds up to more than €1,000. Set against that is the premium: a child’s top-up policy that refunds you around €2,000 in Wahlarzt fees a year is available for under €25 a month (about €300 a year).
There’s a simple reason this works out for the insurer: they deliberately price the early years low, hoping to keep you as a customer long-term. And because children fall ill less often from around their fourth year, you can cancel later — or keep it and know you can drop in over any worry without a second thought.
On top of that, you get free choice of doctor: with top-up insurance you can go to any Wahlarzt in Vienna — in the 1st district, in Döbling, or to us — and get your money back. You choose the doctor you trust. Depending on the policy, the coverage even applies abroad: if your child falls ill while you’re traveling, the private doctor’s costs are covered too.
What else is included depends on the policy. Some also refund medicines or private vaccinations — the cheapest policies, though, do not. Private-room coverage (Sonderklasse) in the hospital is a separate matter: it pushes the premium up considerably, and whether you need it is your call — in most Viennese hospitals you’re very well looked after without it. So for the pure Wahlarzt benefit, a low-cost policy is usually enough.
One tip: you don’t need a broker for this — compare the policies yourself at your leisure and pay no more than necessary. Look at the deductible and the annual cap, and whether medicines, private vaccinations and doctor’s costs abroad are covered.
You pay for the visit directly with us and receive an invoice (Honorarnote). You then submit it to your health insurer — depending on the insurer, online, via an app, by mail or in person (with the ÖGK, for example, through „Meine ÖGK“ using ID Austria). You have up to 42 months to do this, so there’s no rush.
How much comes back: your insurer refunds around 80% of the standard public rate — that is, what it would have paid a contracted doctor for the same service, not 80% of our invoice. Because the public rate is lower than the private fee, part of it stays with you. An example: a visit with us costs around €140 on average; of that, in our experience about €30 comes back, leaving roughly €110 with you.
For many families, this is exactly the remainder that the private top-up insurance covers — often in full. (More on this under „What are the benefits of private top-up insurance for my child?“.)
We see acutely unwell children the same day, in most cases. For planned appointments such as Mother-and-Child check-ups or vaccinations, you’ll usually get a slot within a few days.
Book easily online via our website, or call us at 01 60 61 088 and leave a message on the answering machine.
As a rule, no — little or no waiting is the norm here, not the exception. Our appointment system is built precisely for that: you and your child should be seen promptly, and we deliberately avoid full waiting rooms. Only on days when a lot of children are sick at once might it occasionally take 10 to 20 minutes.
If you’re coming with a newborn or young baby, we’ll give you an appointment first thing in the morning — the practice has just been aired out and is empty, and the risk of infection is at its lowest (more on this under „Separate waiting areas“).
For every appointment we need three things: your child’s e-card, the Mother-and-Child Health Booklet (Mutter-Kind-Pass) and the vaccination record. For an urgent appointment the e-card alone will do in a pinch — better to come quickly than perfectly prepared.
Depending on the reason, a few more things help. For discussing test results, it’s best to send them to us the day before — by email to praxis@meinkinderarzt.wien or uploaded via your patient account at latido.at — and bring the originals to the appointment. That way, instead of scanning and reading during the visit, we can put them straight to use in talking things through. For an unwell child, a short note of what you gave or measured, and when (temperatures, medicines with the time and dose) helps — it makes the examination quicker and the dosing more accurate. For babies, a spare diaper and bodysuit are always handy; we do the weighing and measuring here anyway.
Very easily — leave a message at 01 60 61 088, email praxis@meinkinderarzt.wien, or cancel online in Latido. Please let us know at least 24 hours in advance if you can: that way we can give the free slot to another child who urgently needs one.
If you cancel the same day, or simply don’t show up, we have to charge a missed-appointment fee of €80 — not to be difficult, but to protect the time we set aside exclusively for your child. And of course, if an emergency comes up at home, we’ll talk it through like human beings; just give us a call.
We deliberately keep the risk of infection low: unwell and healthy children wait in separate areas. That way your healthy child doesn’t catch anything from a coughing child next to them at a routine check-up.
For the littlest ones we go a step further: we schedule appointments for newborns and young babies for first thing in the morning, when the practice is empty and newly aired out. In the first months especially, before the first vaccinations take effect, they should come into contact with as few germs as possible.
Yes — and for many things it’s the quickest way. Things that are easy to handle by phone or email include queries about a test result or a treatment, uncertainty over dosing, follow-up questions („better since yesterday, but…“) and the classic „do we need to come in with this?“. That’s exactly what we’re here for — when in doubt, it’s better to ask one time too many than one too few.
This is the best way to reach us: send an email to praxis@meinkinderarzt.wien — ideally with your child’s name and social-insurance number — or call and leave a message on the machine. We usually get back to you within half an hour; if it’s not urgent, we deal with it before we close for the day.
There’s one honest limit: we can’t responsibly treat a new, acute illness from a distance in a child we haven’t examined — for that we need to see them. This is especially true of skin rashes: they can’t be judged reliably by email or phone, so we need to look at your child in the practice. We also issue prescriptions for a new problem only after an appointment; repeat prescriptions for known, ongoing treatments are usually straightforward after a quick word.
Just a few steps away — right around the corner — is the Rotenhof pharmacy, so you can fill prescriptions right after your appointment.
At night and on Sundays and public holidays, the pharmacies on duty rotate on a fixed schedule. You’ll find the duty pharmacy currently open near you at nachtapotheke.wien, via the Austrian Pharmacists’ Chamber’s out-of-hours calendar, or by phone through the 1450 health advice line. One small heads-up so there’s no surprise at the counter: a small statutory out-of-hours fee is charged during night service.
In the first week of life after the birth you should arrange a check-up with the community pediatrician. At this we do a hip ultrasound, measure the bilirubin level painlessly through the skin (photometry) and discuss how the weight is developing.
The second appointment with us is around the 7th week of life: 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: full receipt of the 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.
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 yellow level (bilirubin) here, painlessly through the skin, with no prick at all. Jaundice can’t be judged reliably over the phone. With marked signs, 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 show us your baby.
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. 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 strongly — 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. Stopping breastfeeding is almost never necessary — on the contrary, frequent feeding helps. If your baby is still clearly yellow after about two weeks, do have them looked over by us.
What you should NOT do: put your baby in sunlight as a treatment. It’s neither effective nor safe — it risks sunburn, overheating and fluid loss, and behind window glass the light does nothing anyway. The actual treatment (a special light therapy) 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 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: a disorder of the bile ducts can lie behind it.
In short: from the 2nd week of life your baby gets 400 international units (IU) of vitamin D daily — in Austria usually as Oleovit drops, 1 drop a day — and this carries on until their second early summer (depending on the birth month, roughly to 12–18 months). It applies to breastfed and formula-fed babies alike.
Why at all? Vitamin D is what lets calcium be built into the bones. If it’s lacking in the first year, rickets and soft bones can follow. Breast milk contains too little vitamin D, and a baby makes barely any through the skin, because they’re deliberately kept out of direct sunlight.
How to give it:
- 1 drop (= 400 IU) daily straight into the mouth or on a small spoon with a little milk/water. In certain situations we recommend double the amount (2 drops = 800 IU) — for example with premature babies, with very dark skin, with a marked vitamin D deficiency in the mother, or if your child gets very little daylight.
- All year round — don’t pause even in summer.
- Over the winter in the second year of life the dose is usually continued through the low-sun season.
- Fluoride we give not as a tablet but through toothpaste from the first tooth. If you do use a combined vitamin D–fluoride tablet, do not give Oleovit drops as well.
What about overdosing? With 1 drop (400 IU) a day there’s nothing to worry about. The one thing that matters: don’t give several vitamin D preparations at the same time. We advise against high-dose „bolus“ products from the internet. More does not help here.
Forgotten a dose? No problem — just carry on as usual the next day, and don’t double up. Vitamin D is stored in the body.
At the practice: we work out the dose and duration at the Mutter-Kind-Pass check-ups; Oleovit is prescription-only in Austria.
The short answer: most rashes in the first weeks of life are completely harmless and clear on their own — no cream, no treatment. Usually all you need to do is watch and wait.
The commonest 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. Please don’t squeeze and don’t use adult acne products.
- Newborn rash (erythema toxicum): very common, in the first days of life; reddened blotches with a yellowish dot in the middle. Harmless, gone after a few days.
- Heat spots (miliaria): small red or clear blisters when the baby is too warm. What helps: don’t overheat, one layer less.
- 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.
When NOT to wait and see: if your baby develops blisters and seems unwell with it — floppy, feeding poorly, feverish — or if clustered blisters on a reddened base appear, then please have it reviewed by a doctor straight away. In very young babies an infection can lie behind it (e.g. with herpes viruses) that needs prompt treatment — and a fever isn’t always present. Also have reviewed: 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.
In short: what most parents call „cradle cap“ is usually the harmless, greasy kind — yellowish, greasy, firmly stuck scales on the scalp. This is harmless, doesn’t itch and clears on its own.
Two things that often get confused:
- Cradle cap (seborrheic eczema): yellowish, greasy, firmly stuck scales and crusts on 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.
- 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.
What helps with cradle cap: soften gently — dab a little 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. Don’t scratch it off — that injures the skin and can encourage infection. And patience: it’s purely cosmetic, and even if you do nothing at all it disappears in time.
When to come into the practice? If the patches are weeping, strongly red, itchy or your baby scratches at them — then we’ll look at whether atopic dermatitis is behind it. Also, if the cradle cap spreads a lot or looks inflamed, just drop in.
First things first: 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. 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.
How to care for the navel:
- Keep it dry: fold the top of the diaper down at the front so the stump lies free.
- 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.
- No powder, no oil, no ointment on the stump — damp coverings tend to encourage infection.
- Bathing: in the first days a wash with the washcloth is enough. A short bath is fine as long as you dry the navel well afterwards.
- Let it fall off on its own: please don’t pull at it, 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. With 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 if a baby under 3 months develops a fever of 38.0 °C or more (rectal) with it: have it seen at once, even at night.
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.
Still not off after three weeks? Usually that’s harmless too — we’ll look at it at the next check-up.
In short: 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 favored side. This is usually harmless, easy to influence and improves on its own as they become more mobile.
Why does it happen? Since babies have been put to sleep on their back, sudden infant death has fallen sharply. One side effect is that the soft baby head can become a little flatter under the pressure. Important: this is no reason to move away from sleeping on the back — that stays right for sleep.
What you can do:
- Tummy time while awake: several times a day, put your baby on their tummy while awake and supervised. (For sleep, they stay on their back.)
- Reposition and vary the stimuli: switch which way the head faces in the crib, offer interesting things 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.
Does my baby need a helmet? In the vast majority of cases no. Studies show that helmet therapy for moderate deformity brings no better result than the natural course with repositioning.
When to have it looked at by a doctor: the favored side is very fixed and your baby can’t turn the head well to the other side (a shortened neck muscle — muscular torticollis — usually well treated with early physiotherapy); the deformity doesn’t improve despite repositioning, or gets worse, you feel a bony ridge, or the head shape seems unusual; or the face looks strikingly 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.
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. If in doubt, photograph the stool in daylight 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.
Also quick to check are blood in the stool, a black, tarry stool after the first days of life, and a hard, pellet-like stool with pain (constipation).
And now to put your mind at ease — 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; if in a term baby it fails to appear for longer than 48 hours, this should be checked.
- After that, for a week or two, comes a greenish transitional stool, later yellow to mustard-colored in breastfed babies, firmer and light brown in bottle-fed babies.
- Green, mucousy or color-changing stools are usually harmless.
- The frequency, too, varies widely: a fully breastfed baby can go anywhere from several times a day to only once in one to two weeks. As long as it drinks well, thrives and the stool is soft, there’s no cause for concern.
The short answer: color and rhythm may be colorful and irregular — what matters is a soft stool, a content, well-thriving child, and the warning signs above.
The short answer: 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 reading is that you don’t dress or cover your baby too warmly.
Why cooler rather than warmer? Overheating is one of the risk factors for sudden infant death. So keep the bedroom on the fresh side, with a sleeping bag instead of a thick duvet.
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 and are not a reliable guide. It’s too warm if your baby is sweating, has damp hair at the neck, or develops heat spots.
Clothing — the simple rule of thumb: your baby needs at most one layer more than you in the same room. For sleep, a sleeping bag instead of a duvet, and no hat indoors. Hats are for outdoors.
One more practical point: air the room regularly, don’t let the air get too dry, and keep the bed away from direct heat from radiators or sun. Premature and very small babies cool down and overheat more quickly.
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.
In short: healthy babies born at term may fly in principle — there’s no fixed medical minimum age. For equalizing the pressure in the ears there’s a simple, effective rule: let your baby suck or feed at take-off and landing. Swallowing opens the Eustachian tube and equalizes the pressure.
From what age? Medically, nothing fundamental speaks against it in a healthy term baby. That said, airlines set their own age limits, 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.
How to equalize the pressure: on the climb and descent give your baby something to suck — breast, bottle or pacifier. Keep the baby awake at take-off and landing. Special earplugs aren’t needed — swallowing is what counts.
If your baby has a cold: with a blocked nose, and especially with a middle-ear infection, the Eustachian tube is swollen — equalizing can then be painful. Please discuss the flight with us beforehand; sometimes it’s better to postpone. No essential oils in babies.
On board: the cabin air is dry — offer the breast/fluids often.
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.
First things first: the most reliable sign is that your baby is putting on weight steadily and growing along their growth curve — that’s what we check at the Mother-and-Child Health Booklet (Mutter-Kind-Pass) check-ups. All the other signs (wet diapers, a contented baby) are helpful rules of thumb, but the growth curve is the real measure.
How often is normal? Feed on demand, day and night — in the first weeks that’s often 8 to 12 feeds in 24 hours. It’s completely normal that your baby sometimes wants to feed again and again at short intervals (especially in the evening — so-called cluster feeding), and it’s not a sign of too little milk; it’s what drives your milk supply.
Good everyday signs that enough is getting through: from the 4th–5th day of life, around five to six wet diapers a day with pale urine; and after a feed your baby seems content and settled, swallows audibly, and the breast feels softer afterward.
Almost every baby loses weight to begin with — up to around 7% of their birth weight in the first few days is normal. As a rule, the birth weight should be back within about two weeks.
Spot hunger early: your baby shows hunger before they cry — rooting with the mouth, bringing their hands to their mouth, smacking their lips or getting restless. Crying is a late sign of hunger.
When to come in — and when sooner: do come to us for advice with any uncertainty. You should bring your baby in quickly if they have distinctly fewer than four to five wet diapers a day from the 5th day on or very dark urine; haven’t regained their birth weight after about two weeks, or are still losing; are strikingly sleepy, hard to wake or feeding poorly; or show signs of dehydration (dry mouth, sunken fontanelle, no tears) or an increasing yellowing of the skin.
The short version: feed on demand, not by the chart. A healthy baby can regulate its own needs within certain limits — the best guides are its hunger and fullness cues and its weight gain. Never force your child to „finish“ the bottle.
And roughly how much is that? As a very rough rule of thumb (not a fixed rule), you can figure a daily amount of about one sixth of the body weight — so at around 4,800 g, roughly 800 ml spread across the day. What tells you whether the amount is right isn’t the markings on the bottle, but a contented, thriving child with enough wet diapers.
Feeding in a baby-friendly way (paced feeding): with a bottle the milk flows on its own — unlike at the breast, where your baby controls the flow. That makes it easy to overfeed, so hold your baby half upright and the bottle fairly level, take breaks, and watch for signs of fullness. Stop when your baby seems full — never „empty the bottle“.
Which formula — Pre, stage 1 or stage 2?
- First infant formula (Pre): contains — like breast milk — lactose as its only sugar, is thin, and can be fed on demand. It’s suitable from birth and for the whole first year.
- Stage 1 formula: may additionally contain starch, which makes it thicker. It isn’t needed.
- Stage 2 (follow-on) formula: at the earliest from the start of solids. There’s no need to switch — follow-on milk brings no proven benefit.
Our advice: stay happily on a first infant formula (Pre) throughout.
Even with a family tendency to allergies, you don’t need a special formula: hydrolyzed formula (HA) does not, as far as we know today, prevent allergies — even at higher risk, an ordinary first infant formula (Pre) is enough.
Preparing it safely: milk powder is not sterile — prepare it fresh, just before the feed, throw leftovers away, and don’t keep it warm. Measure exactly as instructed: level off the scoop, don’t overdose and never dilute the formula with water. Use fresh water that has been boiled and cooled again; in the first months, clean bottles and nipples well.
The short answer: yes, for most babies the saying holds true. A baby letting small amounts of milk run back out after a feed is usually completely harmless — as long as your child is thriving, content and feeding normally.
Why does it happen? The muscle at the entrance to the stomach is still immature, the food is liquid, and little ones spend a lot of time lying down. It’s very common: about half of all healthy babies spit up regularly, most of all around the fourth month. In about nine out of ten children it resolves on its own by the first birthday.
Spitting up isn’t the same as vomiting: spitting up is small amounts that run back out passively, with the baby quite unbothered. Real vomiting comes with more force, in larger amounts, and the child looks strained or unwell.
What helps day to day: smaller but more frequent feeds; burp them thoroughly and keep your baby upright for a while after a feed — but only while they’re awake. For bottle-fed babies, a thickened formula can reduce the visible spitting up — but please only after checking with us.
Important for sleep: despite the spitting up, always put your baby to sleep on their back. Lying on the stomach or side, or raising the head of the crib, does nothing against reflux and increases the risk of sudden infant death.
Call the emergency services at once — 144 (Austria’s emergency number); the Europe-wide number is 112 — for green (bile-stained) or bloody vomit (a possible bowel obstruction), or if your child becomes increasingly listless/hard to wake.
Come to the practice or a children’s emergency department quickly if your baby vomits forcefully, „arcing across the room“, especially at around 2 to 8 weeks of age; gains weight poorly or loses weight; under three months vomits repeatedly; shows fever, unusual sleepiness or signs of dehydration; or if the vomiting starts newly only after the 6th month.
As far as we know today, no — not even for children at higher allergy risk. Hydrolyzed formulas contain industrially split-up proteins — the „HA“ today stands for „hydrolyzed“ (it used to stand for „hypoallergenic“). Current studies and guidelines (AWMF S3 Allergy Prevention 2022, EAACI, Cochrane 2018) show no benefit: at present there is no hydrolyzed formula with a proven preventive effect.
The best-known protection against allergy remains breastfeeding. If breastfeeding isn’t possible, or not fully, your child — even at higher allergy risk — is given an ordinary first infant formula (Pre) like any other child.
What actually helps prevent allergy is not the choice of milk but the early, regular introduction of the typical allergens with solids: well-cooked egg, fish and — in a soft form — peanut (never whole nuts, choking risk).
An already diagnosed cow’s-milk-protein allergy is something quite different: for that we specifically prescribe a heavily split-up or an amino-acid formula. That’s a treatment, not prevention — and belongs in a doctor’s hands.
The short version: solids can be started between four and six months. We suggest easing in gently from around five months and having one purée meal firmly in place by six months at the latest. But more important than the calendar are your child’s own signs of readiness.
Too early isn’t ideal: before around four months a baby simply isn’t there yet — the kidneys, the gut and the mouth muscles all need that time.
How to spot that they’re ready: your child sits with support and holds their head steady; the tongue-thrust reflex has faded; and your child reaches for food on purpose and brings it to their mouth, showing interest when the family is eating.
When these signs are all there together, your child is ready. A single sign on its own isn’t enough — curiosity alone isn’t the same as being hungry for purée.
Worth knowing: solids are meant to come alongside milk, not replace it. Breast milk or first infant formula (Pre) stay the main food to begin with. That first spoonful doesn’t mean the end of breastfeeding — you can carry on for as long as you and your child both want to.
At the practice: at the Mother-and-Child check-ups we look at how your child is developing anyway, and we’re glad to talk through the right time to start solids — especially if your child was born prematurely (in which case it’s the corrected age that counts).
The short answer: best of all with a mild vegetable at the midday meal — carrot, parsnip or pumpkin work well, because they’re soft, slightly sweet and easy to digest. Milk follows afterward as usual. Little by little you add an afternoon/evening meal and a morning one; you don’t need to introduce a new vegetable strictly every single week.
Later, that plain vegetable becomes a vegetable-potato-meat purée — the meat (or another source of iron) matters, because iron needs rise from the 6th month on.
Three ground rules for the first year: no sugar in cereal or fruit purée, no added salt (the kidneys aren’t mature enough yet), and no honey (it can cause infant botulism).
And one important point about allergies: don’t avoid the classic allergens. Well-cooked egg and fish belong in the diet regularly from the start of solids — this does more to prevent an allergy than to cause one. Peanut, too, doesn’t need to be avoided and can be there from the very start of solids, but only in a soft form (smooth peanut butter, thinly spread or stirred into the purée).
To keep them safe from choking: Whole nuts and popcorn not at all until the 5th birthday — they can’t reliably be made safe by chopping them up. Hard, smooth or round pieces (raw carrot, whole grapes, cherry tomatoes, hard candies): at least until the 4th birthday, only safely prepared — quarter grapes and cherry tomatoes lengthwise (not halved across the middle), cook carrot soft or grate it finely, and give nuts only finely ground or as a smooth butter. Raw egg stays off the menu in the first year because of the risk of germs. Your child always eats sitting down and supervised.
Baby-led weaning (your baby feeds themselves finger food right from the start) fits well with all of this — as long as the pieces are soft and shaped appropriately for their age and the high-risk foods above are left out.
One special case: if your baby has marked eczema (atopic dermatitis), talk to us before introducing peanut — we’ll work out whether an allergy test first makes sense before you start at home.
No honey in the first year — not in tea, not in purée, not off the spoon, and no maple or corn syrup either. Honey can contain spores that cause infant botulism in a baby, a rare but serious illness. A baby’s still-immature gut can’t fend those spores off. From the first birthday honey is no longer a botulism risk — though as a sweetener the same rule applies as for any sugar: sparingly. If your baby has had honey already: no need to panic, but over the next days to weeks keep an eye out for possible early signs — stubborn constipation, weak feeding/sucking, strikingly floppy muscles or a feeble cry. If anything like that shows up, please have your child seen by a doctor.
Salt stays out of the food in the first year: the kidneys aren’t yet mature enough to clear much sodium. When you cook for the family, simply take out the baby’s portion before salting.
Mild spices and herbs — cinnamon, caraway, basil or a little vanilla, say — are fine from the start in small amounts as part of the cooking. They do no harm and even help build a taste for variety; it’s only hot, spicy seasonings you’re better off leaving out.
Gluten (in wheat, spelt, rye, oats, barley) doesn’t need to be avoided or especially delayed. It belongs in normal solids — best introduced gradually from the start of solids and in small amounts at first, rather than a big portion all at once.
First things first: before solids, a healthy baby doesn’t need any extra water — breast milk or first infant formula (Pre) fully cover their fluid needs, even in summer heat. Topping up with water isn’t necessary during this time.
Once solids are under way (from around the 6th month), you can happily offer a few sips of water with meals, ideally from an open cup or a training cup, so your child gets used to drinking. By the third purée meal at the latest, a drink belongs with it. The best choices are water or unsweetened tea — sweetened drinks don’t belong there, and juices have no place in the first year.
Two things just for safety: Don’t offer large amounts of plain water while your child is still very small, and never dilute the milk with water.
The short version: as a drink, only after the first birthday. In the first year, its high protein content is hard on the still-immature kidneys, and cow’s milk provides too little iron. Until then, breast milk or first infant formula (Pre) stay the basis.
Two amounts often cause confusion, so let’s keep them clearly apart: In purée, a small amount of cow’s milk may be used in the cooking from the 6th month — up to a maximum of around 200 ml a day (in a milk-and-cereal purée, for instance). That’s cooked into the food, not meant as a drink. After the first birthday, your child may drink cow’s milk. A good rule of thumb is then around 300 ml of milk and dairy products in total per day — milk, yogurt and cheese all counted together. Much more than that can interfere with iron absorption and crowd out the appetite for other foods.
Which milk? Choose whole milk with 3.5% fat, because your little one needs the energy and the fatty acids — not reduced-fat milk. Raw milk (straight from the farm, unpasteurized) stays off-limits because of the risk of germs.
A common misconception: plant drinks (oat, almond, rice or soy drink) are no substitute for breast milk, cow’s milk or first infant formula (Pre) — they don’t provide the right nutrients and proteins. Rice drink in particular is unsuitable for small children because of its arsenic content.
The short answer: usually yes — and often it’s simply part of how they’re developing. After the first birthday, growth slows, the appetite gets smaller and swings from one day to the next. On top of that, somewhere between about one and three years there’s a phase where many children turn their nose up at anything new — that’s normal and no sign of a problem. As long as your child is well and growing steadily along their growth curve, you can stay relaxed; taken over a whole week, the amount usually evens out.
The single most useful rule of thumb: you decide what is served and when — your child decides how much. What helps day to day: eat together and without distractions (no screen), small portions rather than an overloaded plate, keep offering new things without pressure (it often takes eight to ten tries or more), don’t force them to clear the plate and don’t use dessert as a reward, set mealtimes with one or two snacks rather than constant nibbling, and not much that’s heavily sweetened.
You should pay attention if your child loses weight, drops away noticeably on the growth curve, flatly refuses whole food groups, frequently gags/vomits while eating, or has trouble swallowing. Then, at the next check-up, we’ll look at the percentiles together and work out whether there’s more to it.
For a baby under three months, any fever of 38.0 °C (rectal) or above needs to be seen the same day — ideally straight to a children’s hospital or emergency department, and don’t wait. At this age a fever can hide a serious infection that’s hard to spot at first. One important point: very small babies can be seriously ill without running a high fever — so keep an eye on how your child is feeding, how they seem, and how they’re breathing.
Call 144 (Austria’s emergency number); the Europe-wide number is 112 — whatever the age — if your child is visibly struggling to breathe (retractions between the ribs or at the neck, nasal flaring, grunting with every breath), goes blue around the lips, or has pauses in breathing; is very drowsy, hard to wake or strikingly listless; has a seizure; has a stiff neck, or pinpoint skin bleeds that don’t fade when pressed with a glass; as a baby, when calm and upright, has a bulging, tense fontanelle, or cries shrilly, differently from usual and can’t be settled; looks gray and ashen and stays pale even when warmed, or the skin takes longer than 3 seconds to turn pink again after a brief press; stops drinking altogether and grows more and more listless, or shows severe dehydration.
One reassuring note: fine, cool, mottled skin that turns pink again on warming is harmless — and what’s meant above is the bulging fontanelle; a sunken one is a sign of fluid loss, not of pressure in the head.
Between three and six months you still measure rectally and stay a bit more cautious: it’s better to have your child looked at sooner — especially if the temperature reaches 39 °C, the fever hangs on, or your child seems limp or is drinking poorly.
From around six months it’s the general condition that matters more than the number: a child who drinks despite the fever, is alert, and plays now and then usually has a harmless viral infection.
Make an appointment at the practice if the fever lasts longer than about three days or is still there from the fifth day on; if it comes back after a day or two fever-free; if your child stays limp or drinks poorly even once the fever is down; or if new complaints appear (earache, rash, repeated vomiting, tummy pain, a stubborn cough). If early signs of dehydration appear, have your child seen the same day.
To put it in context: fever isn’t an illness but the body’s defenses at work. You don’t have to bring it down at all costs, only when your child is visibly suffering; with an infection, no temperature is harmful in itself simply for being „too high“. Overheating from outside (a hot car, being wrapped up too warmly) is a different story. Above all, it matters that your child drinks enough.
The most reliable spot in a baby is the bottom (rectal) — and above all it matters that you measure objectively with a thermometer, not with a hand on the forehead.
For babies under six months, measure rectally: at this age it’s the most reliable method. Ear thermometers are still inaccurate in children this small — the ear canal is too narrow, and at this age an ear reading often misses a fever. Put a little lubricating jelly on the tip of the thermometer, insert it only a short way, hold your child still, and wash your hands before and after.
From around six months, an infrared ear thermometer is reliable, quick, and handy for everyday use. Forehead thermometers are convenient but less accurate; with a child who seems unwell, it’s better to re-check rectally.
Worth knowing: readings taken in the ear can come out slightly lower than rectal ones. A fever is generally a temperature of 38.0 °C or above. Because ear measurement tends to underestimate a fever, the rule is: if your child seems unwell or the ear reading is borderline, re-check rectally if in doubt — especially in a baby under three months.
And to put it in context: body temperature shifts through the day by about half a degree — lowest in the morning, highest in the late afternoon and evening. A slightly raised evening reading (around 37.5 °C) in a lively child is therefore usually normal and not yet a fever.
First, some reassurance: eight to ten, sometimes up to twelve infections a year are completely normal in toddlers and preschoolers. The immune system is busy learning — every infection is a training run, not a weakness. They pile up especially in the first months of daycare, and they settle down with time.
The „immune boosters“ in the advertisements don’t deliver what they promise — not one is proven. The same goes for vitamin C supplements: they don’t cut the number of colds; what helps instead is the unspectacular stuff — a varied diet, enough sleep, exercise and fresh air, regular hand-washing, a smoke-free home, and an up-to-date vaccination status.
A genuine immune deficiency, by contrast, is rare. What should catch your attention is less the number of ordinary infections than a striking pattern. The three most telling signs are: faltering growth or failure to thrive, a known immune deficiency in the family, and severe infections that could only be controlled with intravenous antibiotics. Also worth noting are infections that sit unusually deep or keep coming back — repeated pneumonias, deep or recurring abscesses, or a stubborn fungal infection beyond infancy. Frequent colds, middle-ear or sinus infections on their own, by contrast, do not point to an immune deficiency.
Paracetamol and ibuprofen are pain and fever medicines in one. Give them when your child is in pain — with teething, earache or a sore throat, a headache or a sore vaccination site — or when they’re visibly suffering from the fever. Not, though, because of a particular number on the thermometer.
From what temperature should I bring the fever down? There’s no fixed number — a lively child who’s drinking and playing often needs no medicine at all, even at 39 °C. Fever isn’t an illness but a useful defense reaction. The widespread worry that from around 40 °C there’s a risk of brain damage is not backed by evidence. The medicines usually bring the temperature down by about one to one and a half degrees — and they don’t prevent a febrile seizure.
One important exception: in a baby under 3 months, any fever of 38 °C rectal or above — don’t bring it down yourself, but have it checked quickly.
We’ll give you the right medicine and the right dose. The first-choice medicine is paracetamol (Mexaratio or ben-u-ron). We usually give you the first suppository when your child comes in at 7 weeks for the check-up and vaccination — so you’ve got something at home in case a fever appears after the vaccination (normal in the first 48 hours). We prescribe ibuprofen syrup when needed from around 4 months.
- When and how often: only give it when your child is really suffering — and then no sooner than about every 6–8 hours.
- No aspirin (acetylsalicylic acid) — it can trigger the rare but life-threatening Reye’s syndrome.
One medicine not enough? Usually one preparation is enough. But if the fever climbs above 39 °C and won’t come down far enough, or comes back within a few hours, get in touch with us. As a stopgap you may then give the two alternately, about every 4 hours — that way each medicine stays within its safe interval.
Without medicine, it also helps to: offer drinks regularly, not wrap the child up too warmly but not let them get cold, and let them sleep. Calf compresses only for an older child with warm hands and feet — never for young babies, and body-warm rather than cold.
Seek medical help at once / call 144 (Austria’s emergency number); the Europe-wide number is 112 if your child seems seriously unwell, is visibly struggling to breathe, has pauses in breathing or blue lips, goes blue/gray/pale, isn’t properly responsive, has a seizure, or shows a stiff neck or pinpoint skin bleeds that don’t fade under pressure.
In short: the most important thing with a middle-ear infection (otitis media) is good pain relief — an antibiotic is usually not needed. The great majority clear up on their own, often within about three days.
What you can do at home: Give pain and fever medicine regularly and at the right dose for your child’s age (paracetamol or ibuprofen). See to rest, fluids and sleep; lying with the head slightly raised is often more comfortable. Don’t poke about in the ear, no cotton swabs, no oil in the ear. Decongestant nose drops and antihistamines have been shown to do nothing for a middle-ear infection.
Why often no antibiotic? Studies show that in most children an antibiotic barely shortens the pain but more often causes side effects such as diarrhea. In certain cases the doctor will advise one sooner — for instance in children under two with infection in both ears, with a discharging ear, or in a child who is clearly seriously unwell.
Timing: if the pain doesn’t ease with pain relief after about three days, or gets worse, come and see us.
See a doctor at once / call for an ambulance — 144 (Austria’s emergency number); the Europe-wide number is 112: redness, swelling or tenderness behind the ear, or an ear that sticks out (a warning sign of mastoiditis); a stiff neck, drowsiness or reduced responsiveness, a seizure, or one side of the face drooping; any baby under three months with a fever.
First things first: the essentials are sleeping on the 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, one by one:
- Always put your baby down on the back — for daytime naps as well as at night, until your child reliably rolls both ways on their own. Lying on the 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, 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. 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 or weighted sleeping bags/swaddles. Instead of a duvet, 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, go one layer too few rather than too many, and use no hat indoors. To check whether your child is too warm, feel the back of the neck between the shoulder blades, not the hands.
- Breastfeeding adds protection, as does a pacifier at settling time (no need to force it).
- Swaddling calms some babies — if you do it, always put them down on the back and stop by the time they first try to roll.
- Vaccinations on the Austrian schedule lower the SIDS risk rather than raising it.
On having your baby in your bed: 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.
What you don’t need: heart-and-breathing monitors, „smart socks“ and baby monitors with breathing surveillance do not prevent SIDS — there’s no evidence they do.
And during the day: while your child is awake and supervised, do lay them on their tummy now and then („tummy time“) — building up by around the 7th week of life to a total of roughly 15–30 minutes a day. Lying on the tummy is only a risk for sleep.
Call 144 (Austria’s emergency number) / 112 (Europe-wide) at once if your child is not breathing, unresponsive or blue/gray — call for help and, if you’ve been trained, start resuscitation immediately.
In short: yes — newborns sleep a great deal, around 16 to 18 hours a day, spread across many short naps around the clock. All that matters is that your baby wakes regularly to feed (or is easy to rouse) and thrives well.
What’s normal: newborns often sleep only one to four hours at a stretch and then wake to feed — day and night. 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 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 — the low point is usually around the 3rd–4th day. 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.
Warning signs — please contact us: your baby is too sleepy to feed, skips feeds, or feeds only weakly; is barely rousable or seems floppy; shows signs of fluid shortage (fewer than about 4 wet diapers in 24 hours, dark urine, dry mouth, a sunken fontanelle, no tears); isn’t gaining or is losing weight, turns yellow and feeds poorly with it, or has a fever or a strikingly low temperature.
If a baby deteriorates acutely — not rousable, floppy, blue, breathing problems — call 144 (Austria’s emergency number) / 112 (Europe-wide) at once.
„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.
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 a process of maturing, not a parenting goal.
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. 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 gives a sense of security. Make day and night distinct: by day bright, active, normal noise; at night quiet, dim light, little interaction. Put your baby down tired but still awake, so that over time they learn to find their own way back to sleep. And stay realistic: we don’t think much of rigid „sleep training“ programs — in the first months they’re demonstrably of little use.
Safe sleep space (always, please): on the 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.
When there might be more behind it: 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/has pauses in breathing — then do talk to us.
Important for you yourself: 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.
First things first: some babies cry a great deal in the first months even though they’re healthy and thriving. It’s exhausting but temporary: it usually begins around the 2nd week of life, peaks around the 6th week and eases on its own by the 3rd–4th month. You’re doing nothing wrong.
What lies behind it: all this crying usually has no identifiable illness behind it. The baby’s nervous system first has to get used to the world. 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 it weighs on you.
What can help your baby: closeness and movement (carrying, gentle rocking, skin contact); warmth and a gentle tummy massage (clockwise), a warm bath; turn the stimulation down; predictability through similar routines; swaddling calms some babies — always on the back, and stop as soon as your baby starts to roll.
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 the most severe, lasting brain damage.
Come into the practice if your baby has fever, vomiting (especially green/bilious or bloody), blood in the stools, poor weight gain, a sudden change to the crying or a shrill cry, refuses to feed, or seems unwell overall.
You are not alone. These Viennese services will support you:
- Baby-Care-Ambulanz, Klinik Favoriten — specializing in crying, feeding and sleep problems. Appointments: +43 1 60191 72680, Mon–Fri 8am–3pm.
- Frühe Hilfen — free, confidential support, at your home if you wish, in several languages.
- Familienzentrum Katharinengasse (10th district) — free parenting and psychological advice. +43 1 4000-10894.
- Nanaya – „Die Schreierei“ — an open drop-in group, no appointment needed. 01 523 17 11.
- Emotionelle Erste Hilfe (frau.kinder.mann) — private one-to-one support. +43 680 558 5518.
And any time: just call us — we’re glad to point you to the right service.
In the first months of life, gas and crying spells are very common — the digestive system hasn’t matured yet, and this has nothing to do with any mistake in care or feeding. The crying typically peaks around the sixth week of life and then improves on its own — usually around the third to fourth month.
What you can do straight away:
- Carry your baby a lot and give plenty of skin contact.
- Gentle tummy massage clockwise and bicycle movements with their legs.
- Warmth on the tummy (body-warm, not hot).
- After every feeding, let them burp.
- 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:
- Simeticone (e.g. Anti-Flat) binds the small gas bubbles. In studies it works no better than a placebo, but some parents notice clear relief.
- Caraway suppositories — a mild, tried-and-tested remedy.
- Probiotic drops with Lactobacillus reuteri (e.g. Bellybiom): among these options, these have the best evidence, especially in breastfed babies.
Talk to us — together we’ll find what suits your child. What we advise against: fennel tea — the European Medicines Agency explicitly advises against it for children under 4.
If it all becomes too much, that’s only human — and then one rule applies without exception: never shake your baby. Instead, lay your baby safely on their back in the crib, leave the room for a moment, take a breath and get help.
As long as your child drinks well, gains weight and also has calm, contented times between the crying spells, 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 fiercely crying baby should be examined the same day.
In the first year of life a simple, clear rule applies: no direct sun. The best protection for a baby is shade, together with light clothing that covers the body and a sun hat with a neck flap — and that holds true even when it’s cloudy (clouds let through up to 80% of UV radiation). Avoid the midday sun (roughly 11am to 3pm) altogether. Sunscreen at this age is secondary and goes only on the small areas you can’t protect any other way — the face and the backs of the hands.
For dedicated UV-protective clothing, look for the UPF 30 label or the UV Standard 801 test seal. For baby skin, mineral sunscreens (with zinc oxide or titanium dioxide) are preferred, as they are usually better tolerated. With chemical filters you’ll often hear the worry that they’re absorbed through the skin: individual filters can be detected in small amounts in the blood — but no actual harm to health has been shown, and the filters approved in the EU are considered safe when used as directed.
As your child gets older, the order stays the same: avoid the midday sun, shade and UV clothing first, and on the exposed areas a water-resistant sunscreen with SPF 50 (apply generously, and reapply after swimming and sweating). At a UV index of 3 and above, a hat, sunglasses and sunscreen are all a must.
Why the effort? Sunburn in childhood is an important risk factor for skin cancer later in life. On hot days, also watch for overheating — a baby should never be in the blazing sun or under an airtight stroller cover. If there’s a high fever, vomiting, very red hot skin or listlessness after sun or heat, don’t hesitate and call 144. If a baby in the first year of life gets a genuine sunburn — especially with blisters, marked redness, fever or clear distress — please have them checked at the practice.
Start brushing as soon as the first tooth appears — usually in the 6th to 8th month, but earlier or later is just as normal. From then, twice a day with a soft children’s toothbrush, and the evening brush matters most of all. Baby teeth aren’t a „throwaway set“: they too can get decay, and they hold the space for the permanent teeth.
With fluoride — the substance that makes tooth enamel more resistant — we follow the usual Austrian approach: fluoride comes via the toothpaste, as soon as the first tooth is through — a daily fluoride tablet isn’t needed for this.
- Until the first tooth: fluoride isn’t 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 become pea-sized.
If there’s a particular risk of decay in your family, we’ll discuss additional fluoride with you individually.
The short answer: diaper rash comes mainly from moisture, friction and irritation from urine and stools. You prevent it best by changing often, cleaning the bottom gently, letting it air-dry now and then, and applying a zinc paste as a barrier. Most redness clears up this way within a few days.
Why does the bottom get sore? Inside the diaper it’s warm and damp; delicate baby skin softens and turns sensitive. This is very common and affects most babies at some point, especially around teething and when the stools turn looser.
What you can do:
- Change often, as soon as the diaper is full — with a sore bottom, all the more often.
- Clean gently: best with lukewarm water and a soft cloth or washcloth. Use wipes sparingly and ideally free of fragrance and alcohol.
- Air to the bottom: several times a day, let your baby kick around for a few minutes without a diaper. Dry, airy skin heals faster.
- Protect with zinc paste: a thin layer of a zinc-oxide barrier cream sits over the skin like a protective film. You don’t have to scrub off every last trace when cleaning.
- No powder/baby powder: talc can be inhaled and clumps together with moisture.
When is it not simple diaper rash but thrush (diaper candida)? If the redness is strong and sharply bordered, sits in the skin folds too, and small red dots/pustules appear at the edge („satellites“), there’s often a yeast (Candida) behind it. That needs a special anti-fungal cream — do come into the practice.
Come into the practice if: the bottom is no better after 2–3 days despite consistent care; the skin is weeping, has blisters or open areas; thrush is likely; or a fever comes with it.
In the first weeks and months, once or twice a week is enough — 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 kept short (5 to 10 minutes).
You’ll rarely need soap or shampoo — and when you do, a small amount of a mild product, free of fragrance and preservatives. Bath additives and oils are usually unnecessary and can irritate. After the bath, dry well, including in the skin folds; if the skin is dry, an emollient moisturizer afterwards helps. With babies the rule is: less is more.
One safety point that 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.
Usually not before the fourth to sixth week of life. In the first 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 tissue — so it’s easy to cut too deep. Until then, it’s better to file them with a soft emery board. If your child is scratching themselves, cotton scratch mittens help for a short while.
When the time comes: 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 calmest during sleep or after a feeding. Hold the hand firmly, gently press the fingertip away, and cut in several small steps rather than one big snip.
If a nail bed goes red, swells or oozes pus, we’ll take a look at it at the practice.
Cotton swabs don’t belong in the ear canal — that’s the clear rule. They tend to push the earwax deeper in (which then forms a plug) and can injure the delicate skin or even the eardrum.
And there’s really no need for it: earwax isn’t dirt, it’s protection. It keeps the skin in the ear canal supple, traps dust and germs, and is carried outwards all on its own by the ear’s self-cleaning. The ear canal cleans itself — you don’t need to, and shouldn’t, „help it along“ in there.
The only thing to clean is the outer ear: the pinna and the area behind the ears — with a slightly damp washcloth or cotton pad, then dry well. Don’t push water into the ear canal, and no ear candles. If a visible wax plug appears or your child is hearing less well, please don’t go digging it out yourself — we’ll take a look and gently remove it if needed.
An 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 discharge/pus is coming from the ear, there’s often a middle-ear infection involved — in which case do come to 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 also be checked by a doctor.
Remove the tick quickly and calmly: grip it with fine tweezers or a tick card as close to the skin as possible and pull it straight out, evenly. Don’t squeeze it, and use no oil, glue or nail polish — „suffocating“ it does no good and can even push more pathogens into the wound. The direction of rotation doesn’t matter. Afterwards, clean the spot with a skin disinfectant. If a tiny remnant of the mouthparts stays in the skin, that’s usually harmless.
Make a note of the date and the spot (a photo will do) and watch the bite site for 3 to 30 days. Come to us if a ring-shaped, expanding redness develops or your child comes down with fever and fatigue — this can be Lyme disease (borreliosis), which responds well to antibiotics. The sooner a tick is removed, the lower the risk, because transmission usually takes many hours of feeding. A precautionary blood test right after the bite isn’t worthwhile.
As for tick-borne encephalitis (TBE, FSME): removal doesn’t protect against it — only vaccination does, because the TBE virus can be passed on the moment the tick bites. The whole of Austria is a risk area; no province is free of it. The TBE vaccination is recommended from the first birthday onwards (a primary course of three doses). Important to know: the TBE vaccination does not protect against Lyme disease.
And to reassure you: the vast majority of tick bites cause no problems at all. Remove it quickly and correctly, keep an eye on the spot — that’s almost always enough.
Children develop at their own pace, and not every step comes in the same order. A child doing something a little later than the neighbor’s child is usually perfectly normal — an early step is no head start, and a later one within the usual range is no delay.
To give us a reference point all the same, we work with „limit steps“ (Grenzsteine). A limit step is the age by which about 90 to 95% of all children have mastered a particular skill — so it’s an early-warning system, not a school report and not a diagnosis. As a rough guide: sitting unsupported falls at around 10 to 12 months, walking unaided at about 18 months, first words around the first birthday, and two-word phrases around 24 months.
Come and talk to us if your child clearly passes one of these limit steps without showing the skill, if they are plainly falling behind in one area (movement, fine motor skills, speech, contact) — or just because you have an uneasy feeling. A parent’s worry is a sign to be taken seriously, not „being overanxious“. One warning sign that always needs prompt attention is when your child loses a skill they already had.
One important special case: premature babies are assessed by their corrected age (counted from the due date, not the actual birthday) — up to about the second birthday. Otherwise a false suspicion of delay can easily arise.
The good news: here in Austria we look at development together anyway, regularly, at the Mother-and-Child (Mutter-Kind-Pass) check-ups.
Autism usually shows itself in several areas at once and over time — not in a single feature. Typical are difficulties with social contact (little eye contact, little interest in other children), with communication (delayed or unusual speech), in repetitive patterns of behavior and a rigid insistence on routines, along with a particular sensitivity to sounds, light or touch.
As 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; around 12 months no babbling, no gestures such as waving; around 14–18 months doesn’t point to share something interesting with you; 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.
Worth keeping in perspective: almost every child shows one of these features at some point. What matters is the combination of several signs over time. There’s also a simple parent questionnaire (M-CHAT-R/F) for children between about 16 and 30 months. A concerning result is not a diagnosis, but a reason to look more closely together.
Two things to set your mind at rest. Autism is there from the very beginning — it is not triggered by vaccinations. And an early assessment is not a catastrophe but an opportunity — early support makes a real difference.
With speech, too, the range is wide. As a rough guide: babbling 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. By three to four years your child becomes easier and easier for strangers to understand too.
Do take note — and talk to us — if your child at about 18 months still says not a single word, at 24 months has fewer than 50 words or puts together no two-word phrases, if at 3–4 years they are barely understandable to strangers, if they don’t respond when spoken to — or if they are losing a skill they already had. Some children are simply „late bloomers“ and catch up on their own; but a good number do not fully catch up.
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 — 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. When something is said wrongly, just repeat it correctly. And: less screen time. If a clear delay shows itself, we’ll work out together whether speech and language therapy would help.
Two reassurances first. Crawling is not a must — some children never crawl but scoot on their bottom or pull straight up to standing, and then walk perfectly normally. And 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.
On children’s feet: almost all toddlers have flat feet with a slight inward roll (Knick-Senkfuß). At this age that’s the normal state and not a fault: the arch forms by itself over the first few years. A foot like this that is painless and flexible needs no insoles and no treatment. Come to us if the foot looks stiff, hurts, is unusual on one side only, or if the child is also floppy.
And the shoes? Children’s feet develop best barefoot. „First-walker shoes“ are neither needed nor helpful. The first proper shoe only makes sense once your child walks confidently outdoors — and then as protection, not as support. Look out for: light and flexible, a thin, pliable sole, a wide toe box, and about a thumb’s width of room in front of the toes.
One more common topic: walking on tiptoe. During the learning-to-walk phase this is usually harmless. Do 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 looks shortened or stiff.
First off, and with no finger-wagging: screens are part of family life today, and a child who watches something now and then comes to no harm. It’s that in the early years movement, real play, attention and sleep matter most, and screen time shouldn’t crowd those out.
As a guide, the WHO and the American Academy of Pediatrics (AAP) lay out a clear scale: under 18 months ideally no screen media — exception: video calls, which are real social interaction; about 18–24 months, if at all, then only high-quality content and together with you; 2 to 4 years: at most about 1 hour a day, good quality — and less is better.
Why the caution? Children who spend a lot of time in front of a screen early on, and above all alone, tend on average to find speech a little harder. The links are real but small — and it matters less how much time than what, how and with whom is watched: watching together and talking about it is genuinely good for them.
Two practical rules have proved their worth: no screens at meals and no screens around sleep — devices don’t belong in the bedroom. And because children learn from what they see: how you handle your own phone often counts for more than any rule about minutes.
The clear answer: no. Growing up multilingual does not harm speech development and does not cause a speech disorder. Children are made for several languages. Your child reaches the speech milestones within the normal timeframe.
A few things that often cause worry but are completely normal: the vocabulary is spread across several languages — count both languages together and it’s on a par with that of monolingual children, which is why we always assess speech across all their languages together. Mixing languages is not a sign of confusion but of competence. And there is no one right method — more important than any rule is that your child hears and uses each language plentifully and vividly. Do keep up your heritage language; it’s a gift, not a disadvantage.
And if a genuine speech delay does come into question? A true speech development disorder shows up in both languages — multilingualism is then not the cause, and it would be wrong to drop a language because of it. Do talk to us 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.
Getting dry is a step in maturing, not a parenting achievement — it can’t be trained before body and mind are ready. So readiness matters more than age. Signs it can begin: your child stays dry for about two hours at a stretch, shows an interest in the toilet, can pull their trousers down themselves, can follow simple instructions, and can let you know that they „need to go“.
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. What matters is the order: daytime first, night-time much later. A child who is already dry in the day but still needs a diaper at night is completely normal — night-time dryness isn’t expected until about 5 years.
The most important advice: no pushing. Pressure, telling off, or too early a start can lead a child to hold in their stool and develop constipation. Setbacks are normal, especially at times of upset — that’s not a relapse and not a failure. Praise small successes, stay relaxed, and if there’s resistance feel free to take a break for a few weeks.
Do talk to us if your child is still not dry in the daytime at about 5 years, if they start wetting again after a longer dry spell, if the wetting comes with pain/burning or signs of a urinary tract infection, or if they are drinking noticeably a lot and wetting.
The head circumference is measured at every check-up and plotted on a percentile curve in the Mother-and-Child booklet (Mutter-Kind-Pass) — because it tells us how the brain is growing. A value on the 3rd or the 97th percentile is, on its own, not yet a reason to worry.
The most important thing first: the trend matters more than the single value. A child growing steadily along their own curve is usually entirely unremarkable. We take note if the curve jumps across lines. And we always look at your own head circumference too — a large or small head very often just runs in the family.
With a large head (macrocephaly), by far the commonest explanation is exactly that: familial and harmless. We look into it more closely — often with a harmless ultrasound through the still-open fontanelle — if the head grows too fast across the curves, if the fontanelle is bulging/tense, if signs such as vomiting, unusual sleepiness or irritability come with it, or if development stalls.
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.
In short: a single borderline value is rarely a problem. What matters is the trend of the curve, your child’s development, and the head circumference in the family.
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 head off serious illness — whooping cough in a baby, meningitis, measles and its complications. That’s why we recommend the important childhood vaccinations wholeheartedly.
The recommended childhood vaccination program in infancy and early childhood includes, among others:
- Rotavirus — an oral vaccine against severe vomiting-and-diarrhea illness, from the 7th week of life.
- The 6-in-1 vaccine (diphtheria, tetanus, whooping cough, polio, Hib, hepatitis B) — with us in three doses: at the Mother-and-Child check-up in the 7th week of life, 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 the 10th month of life, the second some time after that, at the latest before your child starts a childcare setting.
- At around five years, the 4-in-1 booster against diphtheria, tetanus, whooping cough and polio — the early protection fades over time, so it gets a top-up.
- Later, the HPV vaccination (free from the 9th birthday).
Are these the same vaccinations everywhere? At their core, 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 — 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’re coming from abroad, just bring your existing vaccination record — we’ll check it against the Austrian immunization schedule.
How does it work here? Nice and convenient: most vaccinations line up with the Mother-and-Child check-ups — so we vaccinate at the appointment you’re coming to anyway.
Private vaccinations — recommended, but paid for yourself and not in the free program for the little ones: meningococcal B and meningococcal ACWY, the chickenpox (varicella) vaccination, and the tick-borne encephalitis (TBE) vaccination. „Paying yourself“ doesn’t mean „unimportant“.
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 better protected too are those still too small to be vaccinated. You don’t have to decide everything at once — take your time and raise any open questions with us.
Let me be clear: No. Vaccinations — including the MMR vaccine against measles, mumps and rubella — do not cause autism. This has been studied as thoroughly as almost any question in medicine, 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 came out that data had been falsified. The doctor behind it lost his medical license. So the claim wasn’t merely a mistake — it was a disproven fraud.
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 through a sibling.
- A pooled analysis of studies covering more than 1.2 million children reached the same conclusion.
- The independent Cochrane review confirms it too: no autism from MMR — and, at the same time, 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 doesn’t mean one causes the other. Autism is largely there from the start, long before any vaccination.
If you’re unsure, that’s entirely understandable — the story has worried a great many parents. Do talk to us; we’ll go through your questions calmly.
In short: the vast majority of vaccine reactions are harmless and short-lived. With the „ordinary“ shots 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. Here fever is no harm — it’s the immune response.
- 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).
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’re genuinely affected. As a precaution — „just in case“ before or right after the vaccination — you should give no fever medicine; it isn’t needed and 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. The benefit of the vaccine clearly outweighs this: real measles can lead to inflammation of the brain — which is exactly what the vaccine prevents.
Call 144 (Austria’s emergency number); the Europe-wide number is 112 immediately 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 (of the order of 1 in a million), and that’s exactly why you stay in the practice for about 15–20 minutes after the vaccination for observation.
Into the practice — not as an emergency, but soon — if the fever lasts more than about 2 days or is very high, the injection site turns bigger and warmer rather than healing, your child is unusually drowsy or shrill in their crying, or you simply have the feeling that „something isn’t right“.
The short answer: a mild infection is usually no reason to cancel, and a missed vaccination is nothing to worry about — we simply catch it up, without starting over.
Your child has a cold — vaccinate or postpone? Ordinary infections are no obstacle: a runny nose, a slight cough or a mildly raised temperature up to 38.5 °C are not reasons against vaccinating. Postpone if there’s a genuine feverish illness (from 38.5 °C) or your child is acutely, seriously unwell. Then we wait for recovery and catch the vaccination up soon afterwards. You don’t have to make this call yourself: we’ll look at your child at the appointment and tell you whether it’s fine.
A vaccination missed or overdue? The reassuring rule is: every dose counts. A primary course that’s been started is not restarted, however long the gap — some doses are still missing, and we catch those up. There’s no interval that’s „too long“. The only downside of a delay is the longer stretch without full protection.
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.
First things first: the best travel protection is, above all, the up-to-date standard vaccinations — MMR foremost 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 — bring the standard vaccinations up to date. 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 Hepatitis A (for children from their first birthday), Typhoid, Yellow fever (in some cases compulsory with an international certificate; only at authorized vaccination centers and only from the 9th month of life), and depending on the trip also rabies, Japanese encephalitis, meningococcal disease or 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 yourself.
In practice: arrange a travel-medicine consultation early and bring your vaccination record and your exact route. Very small babies can’t yet have some vaccinations because of their age — we factor that into the planning.
First things first: for a baby with a blocked nose, saline nose drops and gentle suction are the treatments of choice — simple, safe and effective. Decongestant nose drops and essential oils, on the other hand, are off-limits in babies, or allowed only after discussing it with a doctor.
Why the nose matters so much in a baby: in the first months, babies breathe almost entirely through the nose. When it’s blocked, they find feeding and sleeping especially hard, because they can’t draw air well through the mouth while sucking.
What’s allowed and sensible: Saline nose drops (physiological saline, 0.9%) — a few drops per nostril, ideally just before a feed; they loosen the stuck mucus and have no side effects. Gentle suction with a nasal aspirator — only light suction, briefly, at the outer nostril. Raise the upper body slightly, feed/offer fluids often, and keep the room air from getting too dry.
Only after checking with us: Decongestant nose drops (e.g. with xylometazoline) may be considered in babies at most in the special infant concentration, only briefly and only after checking with us — ordinary (adult) products can be dangerously overdosed in babies.
What you should NOT use: Essential oils (camphor, menthol/peppermint, eucalyptus) are to be avoided in children under 2 — as a rub, in the bath, in a diffuser or for inhaling. Even a few drops in the nose-and-throat area can trigger a spasm of the larynx and breathing problems in small children.
Warning signs in a baby — please let us know: if your baby can no longer feed properly because of the blocked nose, or has noticeably fewer wet diapers; or if they develop a fever — in babies under 3 months every fever (from 38 °C rectal) must be reviewed at once.
Call 144 (Austria’s emergency number) / 112 (Europe-wide) at once for breathing difficulty: drawing-in between/below the ribs, flaring nostrils, labored breathing, pauses in breathing or blue lips. This can be a sign of a deeper airway infection (e.g. RSV/bronchiolitis), especially in young babies.
A simple cold with a clear nose, where your baby is otherwise feeding well and lively, can be managed at home — get in touch if you’re unsure.
How you should act depends above all on how your child is breathing and how they seem — not on how bad the cough sounds. A loud cough can be quite harmless; the real warning sign is labored breathing.
Call for an ambulance immediately — 144 (Austria’s emergency number); the Europe-wide number is 112 — if there is: Respiratory distress (visible retractions between or below the ribs or at the neck, nasal flaring, grunting, labored breathing, pauses in breathing — or a child so short of breath they can barely speak, drink or cry); bluish lips or skin; a strikingly listless child who is hard to rouse; or any suspicion that a foreign body or food has been inhaled.
Very young babies are an exception: a child under three months with a cough and a fever doesn’t belong in the practice but should go straight to a children’s hospital or children’s emergency department — just as with a fever.
If none of these warning signs is there, the practice is usually the right place. A cough is a protective reflex that clears the airways, and after an infection it often lingers for weeks.
Come to the practice soon for: a cough with a high fever (from about 39 °C) and your child clearly unwell — ideally the same day, especially if the fever lasts longer than three days; new wheezing (without acute respiratory distress); repeated bouts of bronchitis or pneumonia; an acute cough showing no sign of improving after 7–10 days; a cough lasting longer than four weeks.
To put the timing in perspective: an acute cough lasts up to three weeks; as an after-effect of an infection it can drag on for up to eight weeks. So we take it in stages: from about four weeks, get in touch so we can keep an eye on things; if it lasts beyond eight weeks (a chronic cough), we’ll actively look into it.
Unsure? Give the practice a call — that’s exactly what we’re here for. Outside opening hours, the after-hours doctor service on 141 can help.
Usually, waiting is the better course. In children, no cough syrup has been shown to shorten the illness — contrary to what’s often assumed based on adults. Because there’s no proven benefit but the risk of side effects remains, cough syrups have been dropped from the airways guidelines.
What really helps is unglamorous: plenty of fluids, so the mucus stays thin, moist air in the room, and a little patience. From the first birthday, a little honey can ease the tickle in the throat — but not before then, because of the risk of infant botulism.
For a distressing, dry, tickly cough, the active ingredient noscapine can be tried for a short while. It’s considered relatively safe, though the evidence for how well it works is modest. So only after talking it through with us and — more cautiously than the license allows — ideally not before the first birthday.
When to come to the practice: if your child is also struggling for breath, has a high fever (from about 39 °C) and is listless, or if the cough won’t settle.
No — in children under two, camphor, menthol and eucalyptus have no place, neither rubbed onto the face nor for inhaling. What feels soothing to an adult can, in a small child, trigger a spasm of the larynx that stops the breathing; even small amounts on the nose or face can be enough. This isn’t about „sensitive skin“ — it’s about breathing, and that’s why the answer is a clear no.
For a blocked nose in babies and toddlers, saline drops and moist room air are all you need.
Call for an ambulance immediately — 144 (Austria’s emergency number); the Europe-wide number is 112 — if, after contact with such oils, your child has breathing problems, a coughing fit, or becomes drowsy or less responsive. For swallowing, or suspected poisoning without acute respiratory distress, the Poisons Information Center is there around the clock: 01 406 43 43.
First, watch how your child breathes at rest.
Call for an ambulance immediately — 144 (Austria’s emergency number); the Europe-wide number is 112 — if: at rest you can hear stridor (a harsh, rasping sound as the child breathes IN) — not only when crying or straining; your child is in respiratory distress (visible retractions, labored breathing, nasal flaring); the lips or skin turn pale or bluish; or your child becomes strikingly listless, can no longer drink or swallow, or is drooling heavily.
If none of these signs is there, croup is usually well manageable. The barking cough with hoarseness (like a seal or a dog) typically comes on suddenly in the evening or at night, often with a mild fever, and is almost always viral and harmless. It may come back over a night or two.
What helps now: Stay calm — agitation makes the breathing worse. Hold your child upright in your arms and soothe them. Cool, moist air: by an open window, out in the cool night air, or in a cool hallway. Let them keep sipping fluids.
If this brings no quick improvement, or the breathing worries you, have your child seen by a doctor. If needed, we can give a corticosteroid — a single dose reliably eases croup.
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 tummy, 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 drawn-up legs, blood in the stool, repeated vomiting, unusual pallor or floppiness, weight loss, fever together with tummy pain, or pain that keeps coming back in the same spot. With a baby under three months we’re more cautious on principle — 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 are worth knowing:
- 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 turns strikingly pale, often with vomiting. A redcurrant-jelly-like, bloody stool is a late warning sign — don’t wait for it. In this situation, take your child straight to the children’s hospital or call 144; 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 moves over hours into the right lower abdomen, with nausea, loss of appetite and a mild fever. Typically every jolt hurts — jumping, coughing, walking. Such increasing, migrating tummy pain should be checked the same day, because an inflamed appendix can burst over time.
Outside our opening hours you can reach the after-hours doctor service (141) or the nearest children’s emergency department.
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 striking floppiness/listlessness. If any of these shows up, have your child seen by a doctor. The same goes for blood in the stool, a high fever (from around 39 °C), or diarrhea that lasts longer than about a week or isn’t improving after two or three days. The younger your child, the sooner — babies under three months with diarrhea should be seen the same day.
Diarrhea usually comes from a harmless gastrointestinal infection (a virus), and it clears up on its own. More important than „stopping“ the diarrhea is replacing the lost fluids: breastfed babies keep breastfeeding; older children drink in small sips or by the spoonful with short pauses in between. For more severe diarrhea, the pharmacy sells an oral rehydration solution (ORS) — dissolve it in water only, not in juice, soft drinks or cola. Diluted cola, fruit juices or pretzel sticks won’t do for replacing fluids, because the sugar–salt balance is wrong and tends to make the diarrhea worse. Your child may eat whatever they like — a strict diet isn’t necessary. Over-the-counter „anti-diarrhea“ medicines (e.g. loperamide) are not suitable for young children and aren’t something to give on your own.
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, cold, pale-gray mottled skin); or has bloody diarrhea with a high fever and looks obviously unwell.
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; or your child becoming increasingly floppy, refusing to drink, or showing signs of dehydration.
Two warning patterns in young children are worth knowing. Projectile vomiting in a young baby (roughly the 2nd to 8th week of life) right after feedings — with the baby seeming hungry again straight away — can be pyloric stenosis and needs to be examined promptly, ideally the same day. And sudden colicky tummy pain with shrill crying, drawing up the legs, pallor and calm spells in between (later possibly a redcurrant-jelly-like stool) can point to intussusception — especially in the first year of life. This is time-critical: go straight to the children’s hospital / children’s emergency department or call 144.
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 only a teaspoonful every few minutes, then slowly build up. Breastfed babies keep breastfeeding. Usually the vomiting settles within one to two days.
Harmless spitting up isn’t vomiting: it’s normal for a baby in the first months to bring up small amounts after a feeding. As long as your baby is thriving and content, there’s no cause for concern.
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; if it occurs after a fall or blow to the head and your child is unusually drowsy or confused; or if your child is no longer drinking and is becoming increasingly listless.
First, to put your mind at ease: Not every gap between bowel movements is constipation. What decides it is the consistency, not the frequency — we call it constipation when the stool is hard and passing it is difficult or painful.
- Fully breastfed baby (under about 6 months): the frequency varies especially widely — several days, and in some babies up to one or two weeks, can pass without a stool. As long as the stool is then soft and your child is content and gaining well, this is normal. At this age, no water, no tea and no juice. If the stool really is hard or your baby is visibly distressed, do speak to us.
- From weaning age (~6 months): water-rich fruit such as pear, apricot or plum, whole grain in the puree, and a little age-appropriate water with meals.
- Toddler and older: a normal, balanced diet with fiber and normal drinking through the day. You do not need to push „extra“ fiber or fluids. It helps more to cut back on white bread and sweets. If your child drinks a lot of milk, limit dairy to about one portion a day. Often underestimated: a relaxed, unpressured time on the toilet, ideally with a footstool under the feet.
With constipation that has already been going on for a while, diet alone usually isn’t enough. In that case we first clear the backed-up stool and then, over several months, keep the stool soft and pain-free with a gentle medicine (macrogol/PEG). It isn’t absorbed into the blood and is not habit-forming. Don’t wait too long, because constipation can otherwise build into a vicious cycle of pain and holding back.
You should have it checked quickly if the constipation lasts longer than about two weeks, if your child has severe tummy pain or is vomiting, if there’s blood in or on the stool, or if they’re not gaining weight. Especially important: if your child has had problems from birth, or if the first stool passed only more than two days after birth.
If a toddler passes loose stools several times a day but is otherwise thriving, drinking normally and showing no signs of dehydration, the harmless „toddler’s diarrhea“ is often behind it: food passes through the gut more quickly, nights are typically quiet, the child is lively and gaining weight — and it usually clears up by school age.
A lot can be handled through diet. A simple mnemonic is the „four Fs“: enough Fat (whole milk rather than reduced-fat milk), normal Fiber, 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.
One common misconception: Teething is not an explanation for real or persistent diarrhea.
Any diarrhea lasting longer than about four weeks should be checked once by us — to safely rule out rarer causes such as celiac disease or a food intolerance. Do 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.
In the moment of the seizure — the most important things first:
- Stay calm and stay with your child. Most febrile seizures stop on their own, usually within 1 to 3 minutes.
- Protect them from injury: lay your child on a safe, soft surface, move hard objects out of the way, cushion the head. Don’t hold your child down and don’t try to stop the jerking.
- Nothing in the mouth — no finger, spoon, bite guard, water or medicine. Your child can’t „swallow“ their tongue.
- Look at the clock and note how long it lasts — that’s the most important information for us or the ambulance.
- After the seizure, put them in the recovery position. It’s normal for your child to seem drowsy or dazed afterwards.
Call the ambulance at once — 144 (Austria’s emergency number); the Europe-wide number is 112 — if: the seizure lasts longer than 5 minutes; it’s your child’s first seizure; your child has trouble breathing or stays blue; another seizure follows straight away; or your child doesn’t come round properly afterwards.
What a febrile seizure is: a seizure triggered in young children by fever, without the brain itself being inflamed or diseased. It affects about 2 to 5 in 100 children, almost always between 6 months and 6 years of age. Frightening as it looks, a simple febrile seizure is as a rule harmless and leaves no lasting damage.
How dangerous is it really? In about 96 in 100 children, no epilepsy develops afterwards. A simple febrile seizure does not raise the risk of death and has been shown to harm neither your child’s intelligence nor their development. We distinguish the simple febrile seizure (whole body, under 15 minutes, once within 24 hours) from the complex one (15 minutes or longer, one side only, or more than once the same day).
You’ve done nothing wrong. Fever medicines do not prevent a febrile seizure — so there’s no need to blame yourself for not having „brought the fever down in time“.
After a febrile seizure: go to the emergency department. Even if the seizure stopped on its own and your child is well again, have them checked at a children’s hospital or emergency department after every febrile seizure. This is especially important in a baby under 12 months, after a complex seizure, or if your child is slow to come around.
And the good news: after the 6th birthday, febrile seizures are practically „outgrown“.
Call the emergency services at once — 144 (Austria’s emergency number); the Europe-wide number is 112 — if, shortly after eating, your child struggles to breathe, wheezes or gasps when breathing, or coughs in fits and can’t stop; swells at the lips, tongue, face or throat, or sounds hoarse or muffled; suddenly turns pale, floppy and listless, or grows confused or less responsive; or vomits violently and comes out in hives all over the body.
These are signs of anaphylaxis. Any single one of these signs is enough — don’t wait to see whether it gets better „on its own“. If your child has been prescribed an adrenaline auto-injector, use it right away. In children, difficulty breathing is the most important warning sign. A severe reaction can also run entirely without a skin rash.
How to use a prescribed adrenaline auto-injector: press it into the outer side of the thigh (through clothing if need be) and hold it there as your device’s instructions say. When in doubt, better too early than too late — giving it late is the greatest danger. Lay your child flat with the legs slightly raised (if they’re struggling to breathe, better sitting upright), don’t let them stand up. No improvement after about 5 minutes and a second pen on hand? Give the second dose. Always go to the hospital — even if it quickly gets better; a second reaction can occur hours later.
The great majority of allergic reactions, though, are mild: an itchy rash, redness, the occasional welt, sometimes vomiting or diarrhea. They often appear not on the first contact with a food but only on repeated contact. If you notice something like this more than once with the same food, we’ll look into it calmly at the practice. And a positive test on its own is not yet an allergy.
Usually harmless — redness around the mouth: after tomato, strawberry or citrus fruit, redness around the mouth is usually not an allergy but a harmless irritation from the fruit acid — locally confined, barely itchy, and gone on its own within a quarter of an hour. You should only be concerned if hives all over the body, swelling, breathing problems, or — in small children — such redness together with vomiting appear as well.
To prevent allergies, deliberately do not avoid the classic allergens: well-cooked egg and fish belong in the diet regularly from the start of solids, and peanut too doesn’t need to be avoided — only in a soft form, never whole nuts (choking risk).
Something reassuring: cow’s milk and hen’s egg allergies „grow out“ again in many children — a hen’s egg allergy often by school age, a cow’s milk allergy frequently a little later.
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 your child shows any of these signs after the fall: was unconscious (even briefly) or is unusually drowsy / hard to rouse; is having a seizure; vomits repeatedly; shows worsening or severe headache, a change in how they are, or inconsolable, high-pitched screaming; has unequal pupils, disturbed vision, new-onset squinting, or weakness/paralysis; 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 (more than about 5 cm) 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.
Did your child fall on their head? If you didn’t see the fall, to be safe, assume the head was involved.
How high was the fall? A fall from the bed is usually more harmless than a fall from the changing table (from about 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 height or are younger than 3 months.
If your child fell from a lower height and quickly goes back to being fully themselves — awake and alert, moving arms and legs equally, feeding and playing normally — and shows none of the signs above, the fall has very probably ended lightly. You may then watch your child at home.
What you can do at home: cool a bump (a cold pack in a cloth, not directly on the skin) and keep your child calm. Watch closely for the next 24 to 48 hours — for the first 24 hours an adult should always stay with your child. Your child may well sleep — you don’t need to keep waking them, but do check once or twice that they are breathing normally and respond as usual. Offer food and drink as usual; a single episode of vomiting right after the shock can happen. Make sure they can rest, with no rough play. For the pain, your child may have paracetamol if needed.
Come to the practice soon — not as an emergency — if the bump keeps growing, becomes unusually soft or stays very painful, or your child seems „not quite right“. If you’re unsure and there’s no alarm sign, the 1450 health advice line can also help outside our opening hours.
To set your mind at ease: you have no reason to blame yourself — such falls happen in a flash. For the future: never lay a baby down unsupervised on a raised surface, and always keep one hand on your child.
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 can’t 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 won’t stop · or, as a baby, seems so unwell that you would no longer move them.
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.
How to find the right route:
- During the day, in our opening hours → the practice. Fever, infections, rashes, tummy ache, minor injuries, uncertainty: call us — we see acute cases the same day.
- 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), which also comes to your home.
- You’re not sure whether waiting is enough → the 1450 health advice line. Around the clock, free of charge.
- When your child needs medical care quickly and we’re closed → children’s emergency department. Vienna’s include the St Anna Children’s Hospital, the AKH, the Klinik Ottakring and the Klinik Favoriten.
- If you suspect poisoning → the Poisons Information Center on 01 406 43 43, around the clock. Have the packaging to hand.
A few things that need a doctor promptly, even without the emergency signs above: fever in a baby under 3 months (always), clear signs of dehydration with diarrhea/vomiting, a white or pale, colorless stool, or a state that is visibly getting worse.
The short answer: emergency signs → call 144 straight away. Urgent but not an emergency → the practice, or 141. Not sure → call 1450.
It depends on how urgent it is — here’s how to judge:
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.
2. Unwell, and it can’t wait until we’re open again — but not a 144 case: call the 1450 health advice line or the after-hours doctor service at 141. Trained staff assess the situation and point you to the right place. If your child needs to be seen right away, the nearest children’s emergency department is the place to go; for our area that’s usually the Klinik Favoriten.
3. 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. If there’s any suspicion, drive right to the nearest children’s hospital / emergency department or call 144 — don’t wait, and don’t call the poison line first. As a stopgap on the way, for a child over 12 months who is awake and can swallow safely, honey can slow the burning: 2 teaspoons (10 ml) every 10 minutes, no more than 6 doses — but only if the honey is immediately on hand and it doesn’t delay the trip. No honey under 12 months (botulism) and not if there’s difficulty swallowing or vomiting; afterward, nothing more to eat or drink, and don’t try to make your child vomit.
4. Suspected other poisoning (medicines, cleaning products, plants): the Poison Information Center at 01 406 43 43 — around the clock, and you speak directly to doctors trained in toxicology.
Anything that can wait, send us by email to praxis@meinkinderarzt.wien — or leave it on our answering system. 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.