When to Contact Your Pediatrician

As a new parent, it is sometimes hard to know when your child is sick enough to need medical attention and when you are simply overreacting. 

Does your concern stem from being a normal, novice parent with a lot of concern and very little experience?  Or is your child really sick? 

Of course you don’t want to make a mistake with your new baby’s health! Here are some pointers that may help you determine when to call the doctor.  As always, if you are TRULY concerned and you need reassurance, feel free to call your pediatrician for advice.  Understand that she/he is used to this cycle and that your doctor knows that if they can educate you, you will be a better parent and their investment will pay off.  If you encounter a pediatrician who is less than understanding when he gets your phone call, FIND YOURSELF A NEW DOCTOR!

When you call your doctor, her advice will depend on the following general criteria:

• The severity of your child’s symptoms
• The frequency of your child’s symptoms

The doctor may give you a temporary solution to tide you over until you can get to the office, and he may tell you to call the office to make an appointment.  OR, he may tell you to go to the emergency room if the symptoms or health problem is more severe and needs immediate attention. 

The important thing to remember is not to panic.  Be prepared to answer questions (we’ll go over this in a minute) and call your doctor’s office line.  If you are calling at night, you will get an answering service and they will either have the doctor call you back or refer you to an ‘emergency pager’ number. 

If your child displays any of the following symptoms, it is wise to call your pediatrician. 

• Fever – While it is common for children between 2 and 12 months to develop mild fevers, your doctor will decide whether your child should be examined or whether to simply monitor and treat the symptoms of the fever.
• Vomiting or Diarrhea – Babies sometimes have soft stool (especially if you are nursing), and all babies ‘spit up’.  If these symptoms are frequent or severe, you should call your doctor.  If your baby has had diarrhea or vomiting for a day or two, your doctor will be concerned about dehydration. 
• Upper Respiratory Infections, Colds – Colds and viruses can be uncomfortable for a baby, but normally they are not of concern.  However, if your child is having problems breathing, or problems eating because he cannot breathe through his nose, or if your baby is coughing or congested, you should call your doctor.
  Ear or Eye Problems – If your baby is pulling on her ear or seems not to respond to your voice as usual, she may have an ear infection or congestion.   This can be associated with fever and/or upper respiratory infection.  Likewise, if your baby’s eyes are swollen or if you see any discharge from the eyes, call your doctor. 
• Cuts, Bumps, Bruises -  As your baby begins to crawl and walk, he is likely to get a minor cut or bump on occasion.  If you do not know how to treat these minor injuries or if the cut seems to take a long time in healing, call your doctor. 
• General Changes in Habits – If your baby’s appetite, sleep patterns, mood or motor skills seem to change drastically and if these changes are persistent, call your doctor.  If your child is lethargic or irritable at times of day when he would otherwise be active or playful, and if these changes are persistent, call your doctor.  If your child develops a rash all over his body or an unexplained rash (not diaper rash), call your doctor.  Likewise, if your child’s skin tone changes (developing a yellowish color) call your doctor.  This would typically occur within the first few weeks after you bring him home and could be a sign of jaundice, which is not unusual but does require treatment.

EMERGENCIES!

If your child has any of these symptoms, you should consider this an emergency and immediately call 911 or take your child to an emergency room (DO NOT attempt to drive your child to the Emergency Room if you are alone with the child).  You will need someone in the car with you to care for your baby while you are driving. 
In the event you and your child are alone when the emergency occurs, remain calm and call 911.

Seek emergency treatment if your child:

• Has swallowed an unknown substance or a poisonous substance (like a household cleaner)
  Is having seizures or is unresponsive
• If your child has a serious wound or cut that will not stop bleeding or that may require stitches
  If your child is having real problems breathing (labored, heaving breath or severe wheezing), and/or his skin tone is bluish or gray in color (look at the nails and lips, as this is where you will first see these signs appear)
• If your child has a high fever (100.4 F rectally for 0-3 months, or 102 F or over when taken by ear or mouth in children older than 3 months)
• If your child has sustained a head injury (with or without bruising or outward signs) and appears to be listless, dizzy, is vomiting or sleepy or is unresponsive
• If your child cannot move or is having trouble moving arms or legs or controlling motor skills they have already mastered
• If your child is choking or appears not to be breathing

When you contact a medical professional or take your child in for emergency care, you will be expected to provide answers to questions that will help the doctors, nurses and EMTs better care for your child. 

Remain calm and be prepared to answer these questions:

• How old is your child
• Does your child have any known medical conditions or problems (including allergies to medications and/or foods)
• What are your child’s symptoms (how long has this been going on, how frequently (in the case of vomiting/diarrhea, etc.)
• How is your child responding (crying, listless, unresponsive)
• Who is your pediatrician (if you are going to an emergency care clinic or hospital rather than calling your doctor directly, they will need to know your doctor’s name to contact her and let her know they are treating her patient and get her advice)
• When was your child’s last doctor’s appointment?  Do you have another one scheduled any time soon?
• Has your baby been immunized?  How recently, and for what?  Has your baby had a tetanus shot?  If so, when?
• What changes have you noticed in your baby’s regular schedule lately, if any?  (eating, bowel or urination habits, sleeping, mood, etc.)
• Has anyone with a health problem or contagious illness been around your child recently?  Have you fed your child anything different recently, or given him any new medication.
• And lastly, be prepared to provide medical coverage information and the name of the pharmacy you use for your prescriptions. 

The bottom line for all parents of children ages 1-12 months is to remain calm in the event your child has a health crisis or problem.  At this young age, your child is incapable of caring for her own needs and is depending on you to make the right decisions.  Don’t panic!  Call your doctor if you feel you should, and let your intuition guide you in that respect.  And, if it is an emergency, get your child to a doctor immediately!