It is a fact of life that children get sick. Most of the illnesses that are seen in pediatric offices are caused by viruses. Many of these viral illnesses, including the common cold, will go away by themselves without a visit to the pediatrician. However, it can be challenging for parents to determine whether they should continue to treat their child at home or if they should make an appointment with their pediatric provider. This is one of the most common questions that pediatric providers hear from parents. Here are some of key symptoms that parents can watch out for to help them determine if they should call the doctor.
Fever
The fever itself does not tell us much about the severity of the sickness in a child. Many children with uncomplicated viral illnesses will have a fever of 103 or 104 degrees. Rather the child’s behavior is a better predictor of if an appointment is needed. If a child is still interested in playing, eating/drinking, alert, smiling, or looks well when the fever comes down then he/she likely has an uncomplicated viral illness than can be monitored at home. If a child with a fever is unusually drowsy, very fussy, and continues to act very ill once the fever goes down, the parent should make an appointment. A baby younger than 3 months of age with a fever of 100.4 degrees or above should always be seen by a provider. Additionally, a child should be seen if his/her fever lasts longer than three days.
Cough/Breathing Concerns
Most coughs can be monitored at home using saline in the nose, a humidifier, or over-the-counter decongestants for children ages 6 years of age and older. A cough is worrisome if it is accompanied by rapid breathing, labored or tight breathing, chest pain, or a whistling or wheezing sound with breathing. Many parents worry about a “rattling” sound heard in their child’s chest. This is usually due to upper airway congestion and will often go away when a child coughs. A cough is helpful in this case and can be monitored at home. However, if the rattling is persistent despite a child’s coughing, the child should be seen by their primary care provider. “Barky” or seal-like coughs also warrant a call to the pediatrician as well as a cough lasting more than 10-14 days and seemingly getting worse.
Persistent Pain
Sometimes a child will acquire a bacterial infection during or after a viral illness. These types of infections are called secondary infections. Ear infections, pneumonia, and sinusitis are examples of secondary infections. If a child is consistently complaining of ear pain, sore throat, chest pain, or severe headaches, he/she should be seen by a provider to rule out a secondary bacterial infection. In addition, a child should be seen if a new fever is noted after several fever free days of a viral illness. Bacterial infections almost always need to be treated with an antibiotic.
Dehydration
Some viral illnesses cause severe vomiting and/or diarrhea. If a child is vomiting everything they eat or drink for longer than 24 hours, they should be evaluated for dehydration. If the vomiting becomes less often throughout the day and he/she can drink small amounts of fluid, parents should to monitor the illness at home. Signs of dehydration are decreased urine output, dry mouth and tongue, no fevers, or a sunken soft spot in babies. If a child is alert, happy, and playful, then he or she is not dehydrated.
Rashes
Rashes are a common symptom that worry parents. Most rashes, especially in children, are harmless and clear up on their own. It is common for a child to experience a rash during a viral illness. A rash that is painful to touch, goes deep in the skin, or is very itchy should be seen by a provider. A purple bruise-like rash should also be seen by a provider. Additionally, any rash that is not improving with home care after a few days warrants a call to the pediatrician.
These key symptoms can serve as mere guidelines for parents to care for their sick children. However, if a parent is concerned about their child and uncertain if they should treat the illness at home, they should always call the pediatrician. Many parents are afraid that the provider will view the visit as a waste of time if no further treatment is needed. If a parent is concerned enough to call the doctor, then we want to see the child. Sometimes, reassurance and peace of mind is worth a trip to the pediatrician.
These symptoms were written by the pediatricians and staff located at the SSM Health Medical Group Pediatrics in O'Fallon, Illinois. You can schedule an appointment for this location online or by calling 618-222-9244. You can also search for a pediatrician near you for expert care.
