Do you rush off to the pediatrician every time your kid has a sniffle? Do you look at blood pouring out of your child and conclude “Eh, he’ll be fine, here’s a Bandaid?” There’s a huge range of parental discretion, and as long as you’re not committing medical neglect like these parents or these parents your child will probably be okay.
Before going further, I would like to note that I am NOT a healthcare professional or researcher, and this post merely describes my own decision-making process. If you are not sure whether to seek help or not, call your pediatrician’s office or (if relevant) Poison Control; no good doctor or nurse will ever berate you for checking out something that turns out to be a ridiculous question, and they’d all rather be “bothered” over something unnecessary than miss something life-threatening.
Now my mother-in-law tended to bring her kids to the office if they showed any symptoms of illness whatsoever. I prefer not to, because an office full of sick kids is a great way to pick up new bugs (although my pediatricians are pretty good at containing germs), and because most of the time a kid will probably get better on his own. There are several situations where I think it’s advisable always to take the kid in:
- The child is a newborn or baby under 3 months of age. Babies this small can get very sick very quickly, and sometimes the signs of serious illness are very subtle–such as grunting or cooing, the tiniest elevation of temperature, or even a slight drop in temperature. It’s hard because “normal” newborn behavior is kind of weird anyway–I was convinced my week-old daughter had a cold when it was just normal sniffles caused by the doctors clearing meconium out of her when she was born–but with a newborn or very young baby, do not mess around. Get medical help, ESPECIALLY if the child isn’t taking in proper amounts of milk or formula.
- There’s a drastic change in behavior. Is your normally active kid lying around looking like she’s been drugged? If she has a fever and you give her an antipyretic and a cool bath, is she still unable to play or eat or drink normally? Time to get her seen.
- There have been multiple vomiting and diarrhea episodes, and the kid hasn’t been able to keep Pedialyte or watered Gatorade down. Dehydration is not good for your child, and there may be something serious going on.
- Black or tarry stool (note: This doesn’t include a newborn’s meconium, which looks like it came out of Satan’s backside but is normal); coffee-ground vomit; bloody urine; something else that doesn’t Look Right. (A colorful poop is probably not a problem, since it’s quite likely to be the result of your child’s gastronomic adventures with crayons, but anything you can’t identify is worth a call.)
- Persistent genital itchiness, burning sensation while peeing, or persistent ear pain. UTIs, yeast infections, bacterial vaginosis, and ear infections generally require antibiotics. Actually, any problems with the genitals or ears should probably be looked into.
- The child has swallowed something sharp or corrosive. Pretty self-explanatory.
- The child’s gotten into broken glass, and I can’t be completely positive that there’s no glass left in the wound.
- The child’s fallen from a decent height and hit his head, or hit his head against something sharp or hard. Children have big, soft heads, and it’s important to guard against concussions or other possible brain damage.
- The child’s hurt her abdomen, and persists in complaining about it or holding it or wincing or moaning. Don’t mess with internal organs.
- The child is showing signs of a stroke or seizure. Fever-related seizures are probably nothing to worry about, but you still need to get your child checked out to rule out any serious underlying problem, and kids absolutely can get strokes.
- The child appears to be choking or having trouble breathing. CALL 911.
- The child has an underlying health condition. But then, if your kid has hemophilia or asthma or cancer or another serious condition, you probably aren’t reading this list.
- Something just seems “off,” especially if the child is too young to give me useful information. Your intuition may or may not be accurate, but if you’re worried, it’s just better to see the doctor.
Times that I “wait and see” for a kid include the following:
- The kid (not newborn) has fallen and smacked his head, but not from a great height or on anything too hard. How long does he cry? How does he act afterward? It’s time to go in if there is ANY change in behavior, eating or sleeping, or if the child complains of pain later or holds his head or even has a stomachache or other symptoms.
- The kid has smacked her nose on something. This may seem an oddly specific problem, but I am thinking of when my daughter fell off a chair and hit her nose on some hard plastic. Her nose swelled up quite a bit, so I called the pediatrician’s office, but she stopped swelling and didn’t show any other symptoms so I ended up not taking her in. Aside from looking like a child abuse victim for about a week, she was fine. However, as mentioned above, there are many important squishy things inside a child’s head, so if you have any unease or the child appears to be worsening, go in.
- The child has a fever. This page has a good discussion of when to visit a doctor for fever, but the Reader’s Digest version is that if the child isn’t very young, isn’t showing other worrisome signs, and hasn’t had the fever more than 3 days, it’s probably okay to care for him at home.
- The child has a runny nose, cough, sneezes, and maybe even a fever, but isn’t lethargic or complaining of body aches. It’s probably a cold. If the kid doesn’t get better within 7–10 days, or gets better and then appears to relapse, it’s time to go in.
- The child hurts an extremity or limb. Now, this may be a very short period of waiting and seeing; if a child has difficulty walking on an injured foot, or winces or cries when you touch the part that hurts, you may be off to the doctor. If you see massive swelling, get thee to a professional. But if your kid falls down, complains about his foot, and is merrily running off to play a few minutes later, he’s probably okay; ditto if he slams his hand in a door and doesn’t show any signs of pain or swelling after you’ve put a cold pack on for a few minutes. Kids will make an unholy fuss over nothing at all and react in an understated way to serious injuries, so their first reaction is usually not as good an indicator of the seriousness of the issue as their responses after a little waiting.
- There’s blood, but not too much, and you don’t suspect that anything’s left in the wound.
- Diarrhea or vomiting. I’ve listed exceptions above, but at some point you will be bleaching sheets and cleaning up copious bodily fluids at 2:00 AM. Most of the time, the child will be fine if you keep him hydrated and wait out the nastiness.
- The kid has a non-itchy rash after getting sick and then recovering. Quarantine the child for a few days; if the rash gets worse or the child starts getting sick again, make an appointment.
- Your child comes down with the same symptoms as other people who’ve been around him recently, and a doctor’s weighed in on the others’ problem. My church is the proverbial petri dish of illnesses from approximately September 1 through May 30, but most of them don’t need medical intervention. “Oh, my kid’s probably going to come down with hand, foot, and mouth disease? Great. Thanks for letting me know.” Sigh.
A few final thoughts: It sucks when your child is sick or injured. You feel so helpless, especially when the kid is too young for you to explain to her why she’s feeling crappy. Hang in there. Children’s bodies are generally really good at healing themselves, and you’ll get through it. Humidifiers, chicken soup, juice, rest, and snuggles will take care of a lot. Lastly, for the love of all that’s good and holy, don’t refer to yourself as a “Warrior Mama” when you successfully nurse your children through a problem. (I do not know of a male equivalent to this vile phrase.) Take care of your kids, take care of yourself, and call the doctor if you’re worried.
Appendix: Good Resources for Health Questions
Medline Plus is the National Institute of Health’s patient resource site. It can be a little difficult to navigate around the site, but there’s lots of reliable information.
The Mayo Clinic tends a bit toward woo, but they have a huge set of patient-directed pages that are very informative and better-sourced than WebMD. Their symptom-checker is just as lousy, however.
The Centers for Disease Control and Prevention (CDC) tracks influenza and other disease activity. This can be helpful during flu season.
Poison Control. If your kid has ingested or come into contact with doubtful substances, this is the resource of choice.
Drugs.com is great for checking out medications.