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How to Know When to Call the Doctor If Your Baby or Child Is Sick.
When dealing with a baby or child with signs of possible illness or injury, it can be difficult to separate reason from emotion.
Should you call the doctor just to be sure, or will you be bothering the office and worrying yourself (and the child) over nothing?
By informing yourself beforehand with common injury and illness symptoms that demand a call to the pediatrician (and those that don’t), you can feel much more confident in your decision.
Remember, however, to trust your own judgment in the end, and to err on the side of caution if unsure.
Assessing Fevers and Illnesses
Call the doctor when in doubt.
No one wants to be the parent who calls the pediatrician over every little sniffle or minuscule fever, only to be told not to worry unless symptoms worsen.
If the choice is between risking embarrassment and risking your child’s health, however, it should be a simple one.
Most pediatricians and nurses are very understanding about worried parents calling over what turn out to be minor issues.
Indeed, if you ever sense anything but understanding when you call with a reasonable concern, you may want to consider your medical care options.
Arm yourself with medically-sound information, and use that and your best judgment to decide when to call.
Invest in a book recommended by your pediatrician, and also consult your pediatrician’s website, as they usually have good information.
The American Academy of Pediatrics also has a lot of good information for parents about sick children.
Follow but don’t fear fevers.
Except in the case of newborns under three months, most doctors now agree that a non-extreme fever alone — without additional symptoms — is not normally a cause for major concern.
Fever is, after all, a natural process of the body in fighting off illness and infection.
Newborns under three months are a special case.
If a newborn has a fever at or above 100.4℉ (38℃), call the doctor or seek medical attention immediately.
For children between three months and three years of age, call the doctor if there is a sustained (more than two days) fever over 102.2℉ (39℃).
For children over three years, call if the fever is above 104℉ (40℃) or if it is accompanied with changes in behavior or activity level, or, if the fever has been present for more than 3 days of any height.
Observe common signs of illness.
Parents of young children quickly learn that diarrhea, vomiting, and projectile-sneezing and coughing are among the many common causes for kid clean-ups.
Any of these can be signs of illnesses serious enough to warrant a call to the doctor, but more often a “wait and see” approach is appropriate.
Use the following list of common illness symptoms as a quick guide.
Dehydration: Urination frequency is one of the best ways to determine possible dehydration.
Babies and small children should be urinating at least every six hours, and older children should urinate at least three times per 24 hours.
Call the doctor if urination frequency is low and you observe dry lips, skin, or mouth;
dark yellow urine; weight loss; no tear production; or a sunken look to the skin on the face or soft spot.
Vomiting: Vomiting a few times over the course of a day or two is not on its own a reason for major concern.
However, call if vomiting increases or worsens over time, it is accompanied by abdominal pain, there is blood in the vomit or it is green in color, or if there are signs of dehydration.
Diarrhea: Diarrhea can last for several days without being a major cause for concern.
Call, however, if there are signs of dehydration, there is blood in the stool, it occurs more than six to eight times per day, if the diarrhea lasts more than seven days, or depending upon the existence of other illness symptoms.
Colds: The common cold can last for 10 to 14 days in children.
Call if cold symptoms last for longer than this time frame, are accompanied by earache or breathing trouble, difficulty feeding, or worsen after three to five days.
Congestion: Call if it causes noticeable breathing trouble — for instance, you can see the skin sucking in between the ribs during breaths or if the child is having difficulty feeding due to the congestion.
Also call if any accompanying coughing is not only frequent, but nearly nonstop.
Ear infections: These can be quite common in children, and your doctor may recommend that your child simply wait out more mild occurrences.
Call if the pain is substantial or there is discharge, or as per your doctor’s recommendations.
In babies, use tugging at the ears, in combination with congestion, fussiness, and fever, as signs of an ear infection.
Use a “worry scale” for signs of illness.
This checklist, provided by Riley Hospital for Children in the state of Indiana, rates common signs of illness by severity and the degree of concern they indicate.
“Reassuring” signs indicate a wait-and-see approach, “Worrisome” signs warrant a call to the doctor, and “Serious” signs require immediate medical attention.
Appearance: bright-eyed and alert (Reassuring); sleepy, dull-eyed, expressionless (Worrisome); glassy-eyed, blank stare (Serious).
Crying: normal-sounding (R); whiny, whimpering (W); weak, moaning (S).
Activity level: normal (R); fussy, more sleeping (W); hard to awaken, no interest in play (S).
Appetite: normal (R); takes food but eats/drinks little (W); refuses food/drink (S).
Urination: normal (R); less frequent and/or dark yellow (W); little output, child looks “dry” in face, eyes, etc. (S).
Assessing Injuries and Wounds
Play it safe. As mentioned before, when in doubt, call the doctor.
Use the information available here and elsewhere to empower you to feel more confident about when you need to act, but always trust your judgment as well.
For some wounds and injuries, it will be immediately obvious that a call to the doctor (or more) is necessary.
For others, such as with some head injuries, symptoms may not be immediately present.
Keep an eye out for emerging or worsening symptoms after any injury, and be ready to call or act as needed.
Care for cuts and bleeding.
Every child gets his of scrapes and cuts, and most of these can be treated at home with soap, water, and a clean bandage.
In between these minor bleeding events and major wounds that require immediate medical attention, there are some episodes that do warrant a call to the doctor.
For cuts, call the doctor if the wound is too large to be bandaged, if the wound is deep or penetrating, if the bleeding will not stop after fifteen minutes of applying pressure, or if the edges of the wound are ragged and spread apart.
Also call for cuts to the face that seem large or deep.
If an existing cut shows signs of infection, such as swelling, discharge, or odor, call immediately.
For nosebleeds, call only if they recur frequently, such as several times per day, or if the bleeding will not stop after applying pressure for at least fifteen minutes (with the head faced down).
Be alert to burns and rashes.
While they have different sources, burns and rashes on the skin should be observed similarly for symptoms.
For burns and rashes, call the doctor if they cover more than a small area of the body, if they blister, ooze, or open up, or if they affect the face or genitals.
Both of these conditions can take time to fully present themselves on the skin, so check frequently for changes, and especially any signs of infection.
Follow up on falls and other injuries.
Many “boo-boos” are immediately apparent and the decision whether medical attention is needed can be made on the spot.
Head injuries in particular, however, often require continued observation for symptoms
Call the doctor for an injury that makes moving any extremity (hands, arms, feet, legs) difficult or painful, if more than a small bump or bruise appears, or if there is a lot of swelling of the area.
With a baby, call for any falls, even if no symptoms of injury appear.
For children, call after a fall if there is a sign of injury, or if you know the child fell but cannot determine how far or what part of the body hit the ground.
After any type of fall or bump to the head, watch for signs of headache, confusion, tiredness, nausea or vomiting, blurred vision, and other possible symptoms of a concussion.
If unsure, always err on the side of calling.
If your child has lost consciousness after a head injury, she should be seen right away.
If your child vomits more than once or twice, or a headache is getting worse, she should also be seen.
Preparing Yourself and Others
Keep important phone numbers handy.
When you have an injured or sick child who is crying, you don’t want to be stuck searching around for the doctor’s phone number.
Also, whether you leave your child with a professional babysitter or your Aunt Rose, it is always wise to make important contact information readily available.
Prominently display the phone number for your child’s pediatrician, the emergency phone number (such as 911), the poison control center number, and your own number.
Ideally, caregivers for your children will be trained in child CPR and first aid care.
Regardless, it is a good idea to keep a small guidebook handy for them.
Keep a “must-call” checklist of symptoms.
For the benefit of yourself and others, you may want to post a list of “must-call” symptoms in your child.
When any of them are present, call immediately. Consider the following list:
- Changes in color (paleness or bluish color around the lips, face, or nails; yellowish skin or eyes)
- Body becomes unusually floppy or stiff
- One or both eyes are red, swollen, or leaking sticky fluid
- Navel is red or tender
- Fever with a rash
- A bite by a dog, cat, or other animal that draws blood
- Difficulty breathing, swallowing, nursing, eating, or speaking
- Blood in the stools or vomit
- Crying for a long time, child can’t be comforted
- Refusal to eat
- Unusually cranky or tired
- Chills that make the body shake or any seizures
- Loses consciousness for a period (child faints, has a seizure, etc.)
- Severe headache
- Nasal fluid is strange color, smells bad, or is bloody
- Hearing loss
- Blood or fluid coming out of the mouth or ears
- Changes in vision, eyes are hurt by light
- Stiffness or pain in the neck
- Severe sore throat, uncontrolled drooling
- Rapid breathing or wheezing not responsive to asthma medications
- Severe cough, cough that brings up blood, cough that lasts a long time
- Very bad stomach pain
- Swollen stomach
- Pain in the back, pain with urination, frequent urination
- Urine that is a strange color, smells bad, or is very dark
- Pain, redness, or swelling around a joint, not caused by injury
- Cut or scrape that appears infected (red, oozes pus, tender, swollen, hot)