When to Call a Physician – Babies and Toddlers

One of the biggest questions new parents have is when should they call the doctor. We have compiled some guidelines for you, but remember that pediatricians are a resource for you, and if you feel things are not right, be sure to call your pediatrician or an ask a nurse hotline so that you get answers. As a parent, you know your child better than anyone else, and you should follow your instincts when it comes to the medical care of your little one.

I recommend that you start a medical notebook for your child and start recording information after their birth. What tests were done in the hospital, when were shots administered, what are your child’s habits and actions when healthy (eating, attention, sleep and voiding). When you call the doctor, be prepared with information. What are your baby’s symptoms and what are your concerns? What is your baby’s medical history? What changes have you observed in your child’s eating, drinking, wetting and bowel movements? Does the baby have a temperature? What treatments have you tried? Has your child been around anyone who is ill? Keep your notebook handy to write down any advice the doctor may give you. Be prepared with your pharmacy information and any allergies also.

Here are some guidelines on when to seek medical assistance.

FEVER

Call a doctor if:

• In a baby under 2 months old, a rectal temperature of 100.4 F or higher is an emergency. Take the baby to the emergency room or an urgent care immediately if your doctor is not available to see them.
• You have an infant under 3 months old and they run any fever.
• You have an infant ages 3-6 months and they have a rectal temperature over 101 degrees F or higher.
• You have a child over 6 months old and they have a rectal temperature over 103 degrees F or higher.
• If the fever lasts more than 3 days, regardless of the age of the child.

COLD SYMPTOMS:

Call the doctor if:

• The child develops an earache.
• The child develops a fever over 102 degrees F.
• The child becomes exceptionally sleepy, cranky or fussy.
• A skin rash develops.
• Breathing becomes rapid or labored. Your child’s nostrils flare or ribs sink in with a breath.  If there is a wheeze or other noise when they try to breathe.
• The cough becomes persistent or severe.

Call 911 right away if a bluish color appears around your child’s lips or nails. They are not getting enough oxygen and this is an emergency.

VOMITING AND DIAHREA:

• Call a doctor if these symptoms appear:
• Crying but no tears
• Less pee than usual — fewer than 6 wet diapers per day in infants
• Dark urine
• Dry, cracked lips and mouth
• Sunken eyes
• Crankiness
• Sunken soft spot on top of the head (in babies younger than 18 months)
• If vomiting or diarrhea last more than 24 hours

If there is a a red or black color in the poop or vomit, or flecks that look like coffee grounds, these could be blood. Seek medical attention immediately.

RASH

• If the rash lasts more than three days
• If it is a rash with a fever
• A rash that oozes or weeps
• A blistery or bubbly rash
• A rash that looks like a bull’s-eye or target
• Swollen bumps on the skin, along with trouble breathing or swelling of the face
• A rash on a child who looks sick or isn’t acting like themselves

OTHER SYMPTOMS THAT NEED IMMEDIATE ACTION

• Trouble waking your child
• Sharp or constant belly pain
• Burning when your child pees or blood in their urine
• A constant need to pee
• Seizures
• Changes in appetite over a period of time (several feedings in a row)
• If your child is floppy, crying more than usual or very hard to console.
• Tender navel or penis, especially with redness, oozing or bleeding.
• If your child has fewer bowel movements for a few days and seems uncomfortable.
• If one or both eyes are leaking mucus or are unusually red and swollen.

WHEN TO SEEK EMERGENCY CARE

• Bleeding that can’t be stopped
• Poisoning
• Seizures
• Increasing difficulty breathing
• Any change in consciousness, confusion, a bad headache or vomiting several times after a head injury
• Unconsciousness, acting strangely or becoming more withdrawn and less alert
• Large or deep cuts or burns or smoke inhalation
• Skin or lips that look blue, purple or gray
• Increasing or severe persistent pain
• Major mouth or facial injuries
• Near drowning