Whether dispensing bandaids for boo-boos or aspirin for aches, parents take pride in helping kids through the scrapes and illnesses of childhood. When they’ve got a runny nose, we don’t rush to the ER; we clean them up and hope we don’t catch it. But when they’re feeling truly sick, children’s symptoms can be all over the place, making it hard to tell what the problem is.
We all want to give our little ones the best care possible, but how sick is too sick to stay home? When should you get your child medical help? Never fear. We asked two pediatricians for children’s symptoms parents shouldn’t ignore.
A Blue Face
We’ve all heard the story about the parent who rushed their toddler to the ER with blue lips, only to find out the kid had eaten a lollipop. But this is a symptom where it’s better to be safe than sorry. According to pediatric ER physician Christina Johns, while there are many reasons for poor circulation, turning blue can signify a serious underlying problem and a cause for urgent evaluation. “Changes in color to the lips or face to purple or blue can indicate that they are not getting enough oxygen,” she says.
“Any difficulty breathing may indicate a need for medication or respiratory support,” advises pediatrician Leah M. Alexander, M.D. FAAP. Typical signs in infants and toddlers are deep belly movements or rib ‘pulling’ with each breath. Parents may hear a hoarse sound (stridor) with each inspiration or a high-pitched sound (wheezing) with each expiration. Older children may also develop these breathing sounds, and these symptoms require intervention from a medical professional.
Green or Yellow Vomit
Throwing up doesn’t always rate a trip to the ER. We love our kids more than life, but as any parent knows, they can be pint-sized puke machines. When should we worry? “Sometimes, there’s an underlying problem that might require surgery. In that case, the vomiting is often bile colored–or green/yellow,” Johns says. If your infant is vomiting forcefully, seek emergency help. Call your doctor if your infant has been vomiting for more than 12 hours or if your toddler has been vomiting for more than 24 hours.
If a child is going through a bout of diarrhea or vomiting, they may lose more fluids than they can replenish and become dehydrated. Dr Johns advises parents to look for signs of dehydration, which “include decreased urination or dark urine, a dry or sticky mouth, no tears when crying, and sunken eyes.” Infants under six months should always see a doctor if you suspect dehydration, but your pediatrician may advise you to begin treatment at home for older children.
An Abnormal Pulse Rate
“Pay attention to whether their pulse rate is significantly outside the norm for their age,” Johns says. A sick kid with an elevated heart rate isn’t necessarily a cause for concern. However, call your doctor if your child’s pulse is outside the norm for their age or accompanied by dizziness, chest pains, or fainting.
Some kiddos are more prone to rashes than others. While some (such as heat rash or diaper rash) can be cared for at home, others require medical intervention. “Rashes that are rapidly evolving or spreading should be evaluated. Swelling that is painful, rapidly growing, or at a joint and accompanied by fever should be evaluated urgently,” Johns says.
High Fever in Infants
“A true fever is 100.5 degrees Fahrenheit (38 degrees Celsius) or higher,” Alexander says. “This is particularly important for infants under three months, when a fever may indicate meningitis, sepsis, or a urinary tract infection. Parents should always call a doctor the moment a fever is detected.”
The focus changes once children get a little older. “It is more important that the fever responds to measures taken to reduce it for older infants and children,” Alexander explains. “Lukewarm baths, cool fluids, and administering acetaminophen or ibuprofen (six months older) should lower the body temperature within 30 to 60 minutes. If not, parents should call a doctor. Keep in mind that sometimes kids develop fevers as high as 103 to 105 degrees Fahrenheit, and the child’s temperature may only drop by three to four degrees. Any fever that persists longer than three to five days should be evaluated.”
A couple of cough-filled days isn’t necessarily an emergency. However, according to Dr. Alexander, if the cough worsens, you should make an appointment to find out why. Any cough that lasts more than a week should also be checked. “Of course, if there is a suspected exposure to a communicable illness such as CoVID, strep throat, influenza, or bacterial pneumonia, testing, and a physical exam are important to prevent community spread of these infections,” she says.
Babies cry… a lot. But an inconsolable child can’t be soothed. They won’t be distracted by food, cannot sleep for any length of time, and will not play. “If your child is inconsolable (crying nonstop) along with other symptoms of illness, this might be time to contact a medical professional,” Johns says.
Mental Status Changes
For those of us who like solid symptoms, taking a child in because they’re ‘off’ can feel uncomfortably squishy. In reality, you may be reacting to more subtle symptoms. “Keep a close eye on how the child’s mind and behavior are doing. Are they responding to you, or are they difficult to arouse and not acting like themselves? There’s a difference between not feeling good and being ‘out of it.’ If they seem less responsive or unaware of their surroundings, it’s important to figure out why,” Johns says.
In the end, you know your child best. Listen to your gut if it’s telling you to take them to the doctor. Your medical professionals can help diagnose your children’s symptoms and help get them back to what matters most–growing into the wonderful person they’re meant to be.