Minor illnesses are more frequent in children than in adults. They are rarely of any great consequence.
Examples of problems that should be reported to us include:
- Changes in behavior such as excessive or prolonged crying, listlessness, unresponsiveness or convulsions (seizures).
- Changes in normal breathing such as grunting, choking, shortness of breath, gasping, wheezing or excessive coughing. A good rule of thumb about breathing problems is to ask yourself, who is the breathing problem bothering more, the child or the parent? If your child is not having enough trouble breathing to affect his or her sleeping or eating, then it probably is not too serious. If you have questions about this, call us. Often we can help you decide over the phone whether your child needs to be seen.
- Dusky or bluish tint to the skin.
- Repeated choking spells or blue "spells" when feeding. Some infants will normally look slightly blue around the mouth only when they are feeding since their skin is so transparent.
- Persistent forceful vomiting (projectile vomiting) as opposed to just spitting up. Call us if the vomited material is bile-stained (yellow-green) or if it contains blood.
- Refusal to feed or drink for eight or more hours except at night.
- Loose, runny bowel movements (more than four in 4 hours).
- Stools containing blood. Many infants will have a few drops of blood on (as opposed to in) the stool because of a slight tear just inside the rectum or sometimes visible in the external anal area. This is called an anal fissure.
- Some breast-feeding babies will have blood in their spit-ups or stools which comes from the mothers nipples; this is normal (but frightening), and often happens when the baby is nursing very frequently at the beginning. Mothers are often unaware that there is a break in the skin of the nipple, which leads to bleeding.
- Ear drainage, which does not appear like normal earwax.
- Ear pulling which is accompanied by pain. This is hard to tell. Some babies pull on their ears after they have discovered them. Others rub their ears when they are teething, especially when the molars are coming in.
- Pustules, or a rash that does not seem to go away or which seems to be painful.
- A generalized rash (over the whole body or a large part of it), whether or not it is itchy.
- A thick white coating on the tongue or insides of the cheeks (thrush or oral monilia) which does not come off with a cotton-tipped applicator or a wash cloth. Many breast-fed babies will get a coating of milk on their tongues from the cream of the breast milk. This is normal. The little white pearls on the roof of the mouth of a newborn infant are normal. This is not thrush.
- A definite deep yellow color of the baby's skin and whites of the eyes which was not present when the baby left the hospital. Many newborns leave the hospital soon after 24 hours and the jaundice that often appears may be the normal, or physiologic, jaundice that will disappear within a week. Time is often the best treatment for this. If your baby is feeding poorly or is becoming more and more lethargic, call us for advice.
- Thick pus-like drainage from the baby's eyes.
- In a newborn, fever of 100.4° (taken rectally) alone, or with any of the above problems. After two months, fever of over 102.0° is a sign of a problem.
CALL US IF YOU HAVE QUESTIONS!
We would rather have you call, or bring your child in, rather than having you neglect a potentially serious problem.