General Paediatrics Services

Acute vomiting and diarrhea (loose and frequent stools) are very common in children. It is usually caused by a viral or bacterial infection in the gastro-intestinal tract, called Gastroenteritis (or ‘stomach bug’) or could be a presentation of food poisoning. Infants and children are at risk of dehydration as they lose a significant amount of fluids, especially if the illness lasts for more than 24 hours. It is even more crucial to watch for this in Cayman due to the hot weather. Our paediatricians, Dr Jasmina Marinova, Dr Sara Watkin & Dr Sarah Newton, will see children with vomiting and diarrhea at a very short notice and advise on treatment and how to keep them well hydrated.

Chronic vomiting and diarrhea are not as common, however are usually a sign of more complex conditions, which all three of our paediatricians are experienced in diagnosing and treating. If you are concerned about this, please do make an appointment to see one of us. 

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Children commonly get constipated from holding in their stool to avoid or delay having a bowel movement. When stool stays too long in the colon, the colon absorbs too much fluid from the stool. Then the stool becomes hard, dry, and difficult to pass. Occasionally, bowel difficulties can be a sign of other illness in children. There are a range of options to help with constipation and bowel problems and all three of our paediatricians are experienced in diagnosing the more complex problems from the simple ones, including problems common in Cayman and due to our Cayman Islands dietary habits, especially in children. We can rapidly rule out any more sinister bowel problems and advise you on how to reduce or prevent constipation going forward. You can discover more at the very helpful Johns Hopkins page on Constipation in Children https://www.hopkinsmedicine.org/health/conditions-and-diseases/constipation-in-children

Abdominal pain, or referred in children as stomach, belly, or tummy pain, is fairly common in children. It could be very nonspecific, but equally can be a sign of a serious illness that requires emergency treatment. The pain can originate from any organ within the abdomen or can be referred from other areas, like chest or throat. Our paediatricians will assess acute abdominal pain in children at a short notice, due to the importance of early intervention for the more serious problems, and will arrange the appropriate investigations (like abdominal ultrasound, which we can have conducted in our practice) and any onwards referrals in Cayman, including for surgery where required. In the cases of chronic abdominal pain our paediatricians will perform a comprehensive assessment and arrange relevant investigations and treatment.

Guide to thermometers and temperature »

Headache is defined as pain or discomfort in the head. The exact cause of the headaches is not completely understood, and it is believed to be mostly a result of tight muscles and dilated blood vessels in the head. Headaches can be single or recurrent in nature and are classified as migraines, tension headaches, cluster headaches or secondary headaches (due to organic problem in the brain). If your child presents with headache, our paediatricians will perform a comprehensive physical and neurological examination and, if appropriate, will arrange the relevant scans in the best MRI facilities in Cayman. They will advise on lifestyle changes and treatment if required. All of our paediatricians – Dr Jasmina Marinova, Dr Sara Watkin and Dr Sarah Newton – are experienced in diagnosing and treatment of other neurological conditions in children too.

More information about headaches in children »

Ear infections in infants and children are extremely common. It is due to their immature immune system and the fact that their Eustachian tubes (connection between the ear and the back of the nose and throat) are smaller and more horizontal, which makes it more difficult for fluid to drain out of the ear.  The most common type of ear infection is Otitis Media (Middle Ear Infection) which results when fluid builds up behind the eardrum and parts of the middle ear become infected and swollen. Children living in Cayman Islands often suffer from Otitis Externa (Swimmer’s ear), which is inflammation, irritation, or infection of the external ear canal. Swimmer’s ear is caused when water that remains trapped in the ear canal (when swimming, for example) may provide a source for the growth of bacteria and fungi. Our paediatricians are up to date with the latest guidelines in management of Otitis Media and Otitis Externa in children and will prescribe the recommended treatment and advise on prevention.

Conjunctivitis or Pink Eye is an irritation and/or inflammation of the conjunctiva of the eye. The conjunctiva is the membrane that lines the inside of the eyelids and covers the eye. Conjunctivitis is most caused by bacteria, viruses, allergies, and chemicals used for eye medicines. Conjunctivitis in children rarely has long-term complications, however it needs prompt examination and treatment. Pink Eye is quite common in the Cayman Islands and our pediatricians are experienced in assessing it and will advise you what eye drops to use for your child (as treatment is based on the actual cause). We’ll also guide you on how to prevent spreading the infection to other family members, which is common.

Rhinitis is when a reaction occurs that causes nasal congestion, runny nose, sneezing, and itching. Rhinitis is caused by an inflammation or allergy and is often associated with symptoms in the eyes, ears, or throat. Acute Rhinitis or runny nose is a common presentation of viral illness in children and most of the time is a self-limiting condition that does not require specific treatment. Infants with nasal congestion may struggle to breath and feed, and our paediatricians will help with assessment and advise, including how to help your child breathe more easily if they are suffering from this.

Allergic rhinitis can happen on a seasonal basis or year-round. Year-round allergic rhinitis happens more often in younger children. There is usually a family history of allergic rhinitis. Our paediatricians will perform a detailed allergy assessment, will order appropriate tests, and advise on treatment or referral to ENT specialist in Cayman Islands.

Nose bleeds can be associated with acute or recurrent rhinitis or can happen separately. They may also be a sign of blood disorder, which obviously requires more complex investigation. Discuss with our paediatricians if your child is suffering from nose bleeds, especially outside of acute rhinitis or more obvious causes.

Urinary Tract Infections (UTIs) are caused by bacteria and can affect any part of the urinary tract – the kidneys, the ureters (the tubes that carry urine from the kidneys to the bladder), the bladder or the urethra (the tube that carries the urine from the bladder out of the body). Normally the urine is free from germs and infection happens when germs enter the urinary system. Most infections are caused by bacteria from the digestive tract, the most common being E Coli. UTI is more common in girls (as urethra is short) and in children born with congenital problems to urinary tract. UTI in infants and children ought to prompt diagnosis and treatment as potentially can leave the child with life-long complications. Our paediatricians will assess your child, will order investigations, and commence treatment. Occasionally investigations are required that are not available in the Cayman Islands. We’ll advise specifically and arrange these for to ensure your child gets the right tests in the best possible place.

Sore throat refers to Pharyngitis, which is redness, pain, and swelling of the throat (pharynx) or/and Tonsillitis, which is inflammation of the tonsils. Both can be viral or bacterial and are very common in children at any age, but mainly those attending day-care. Our paediatricians will examine your child thoroughly and suggest appropriate treatment to treat the infection and to provide symptomatic relief. If needed we will do Rapid Strep Test here in our clinic (this is not available in all healthcare providers in Cayman Islands) to identify Strep Throat in less than five minutes, as the condition requires urgent attention.

Children often have difficulties in breathing. Those can have acute onset and are usually caused by infections or can be of a more chronic nature. There are many causes.

Bronchiolitis is an inflammation of the bronchioles (small passages in the lungs) usually caused by a viral infection, most common being RSV (Respiratory Syncytial Virus). The disease affects infants under the age of 2, with a peak age of 3 to 6 months, and although common, sometimes can be a severe illness requiring hospital admission.

Asthma is a long-term (chronic) lung disease that causes your child’s airways to become sensitive to certain triggers, mostly respiratory viruses. When exposed to triggers the airways become narrow due to the following changes: swelling of the inner lining, tightening of the muscle and production of thick mucus. This makes it difficult for air to go in and out of your child’s lungs and causes the symptoms of asthma. Severe asthma can be life-threatening and very scary for parents. It is important to have an active management plan in place and we will always help ensure you have one appropriate to your child.

All of our paediatricians are highly experienced in treating all types of respiratory illnesses in children, both in office and in the hospital, especially as we all have a hospital training and background, where the more severe cases are managed.  We are up to date with current management of childhood asthma and aware of the specifics of the condition in Cayman, including common triggers. We will not only advise on appropriate management, but will educate the whole family on how to prevent exacerbations.

Chest infection refers to Pneumonia, which is an infection of one or both lungs caused by bacteria or viruses or Bronchitis, which is an inflammation of the breathing tubes (bronchi)

Children at any age are at risk of developing chest infections and can be quite sick with it. Our pediatricians will examine your child and check their respiratory rate and oxygen saturations. Most of the community acquired chest infections in Cayman are treated successfully with oral medications, however if required our paediatriucians will organize chest XR, blood work and hospital admission on the Children’s ward under their care. Dr Jasmina Marinova, Dr Sara Watkin and Dr Sarah Newton all have admitting rights to the paediatric wards at George Town Hospital, which is the right place for hospital care of this nature.

Rashes are very common presentation in children. They can be associated with fever and be a symptom of an acute viral childhood illness, called viral exanthema, or are of more chronic nature like childhood eczema. Skin Infections are caused by viruses, bacteria, or fungi. Skin gets infected easily if it is already affected by a different problem such as eczema, insect bites, cuts and scrapes. Childhood rashes can be due to certain allergies or be a symptom of a congenital or acquired complex medical conditions.

Rashes in children can be challenging to diagnose due to their various causes and natural courses. Our healthcare facility is unique in Cayman as we have a multidisciplinary team of paediatricians and dermatologists, that enables a timely diagnosis, highly specialized management, and appropriate medical follow up.

Our doctors and nurses provide education on prevention of skin infections, flares of chronic rashes.

Insect repellents and sun protection for infants and children.

Dr Jasmina Marinova has a special interest in paediatric skin conditions and works closely with Dr Alison Duncan, one of our dermatologists who has a specific interest in children. We are privileged to have very comprehensive dermatology services for children with one paediatrician with an interest in skin combined with one dermatologist with an interest in paediatrics.