MAYWOOD, Ill. -- Unfortunately, kids get sick. Fighting a virus or common cold is good for a child’s immune system and can help build antibodies that protect them from dangerous illnesses. Still, there are times when that tummy ache or cough may require medical attention.
“Parents know their child best and know when something is not right. The confusion comes from the next steps, like what do I do about it? When do I call the doctor?” said Hannah Chow-Johnson, MD, a pediatrician at Loyola University Health System and an assistant professor of pediatrics at Loyola University Chicago Stritch School of Medicine.
According to Chow, there are 10 symptoms and signs that a child may need more than fluids and rest and a parent should call the doctor.
1. Extreme changes in behavior
Not being aware of surroundings or familiar people
Changes in speaking, such as difficulty forming words or completing thoughts
A child who is truly lethargic - “I hear parents talk about their child being lethargic, but this term is often used incorrectly,” Chow said. “Lethargic is when a child sleeps a lot and barely can awaken despite plentiful sleep or has difficulty staying awake. If your child is tired but alert and aware of what is going on, this is reassuring."
2. Signs of dehydration
Unable to keep down liquids
Frequent vomiting or diarrhea
Diminishing urine output
Infrequent requests for fluids and a dry, sticky mouth
Urinating infrequently (less than every 8 hours in children younger than age 1, less than every 12 hours in children older than age 1)
3. Pains that awaken a child at night - “Headaches, stomachaches or muscle aches that awaken a child from a sound sleep should be taken seriously. Call and make an appointment to see your child’s doctor if this happens,” Chow said.
4. Abdominal pain that worsens and persists
If pain does not improve with child over-the-counter pain relievers
If a fever also is persistent
Pain with physical movement like walking
5. Blood in urine or stool
Blood in urine is very uncommon in children and could be a sign of infection or a kidney problem
Blood in stool when a child has not been constipated
Blood in stool when there is a history of travel
Painless bleeding without bowel movement
“There are several reasons why a child may have blood in his or her stool so it’s best to get it checked out to rule out anything serious,” Chow said.
6. Pain or frequency with urination
Going to the bathroom many times in an hour
Pain when trying to urinate
Eating and drinking a lot but still losing weight
If a child is not verbal, look for these clues:
Fever for 2-3 days with no known cause
7. Fevers in certain age groups
Any child younger than 2 months with a rectal temperature of 100.4 degrees or higher should be evaluated immediately
Ages 2 months-3 years with a fever for 2 to 3 days but no known cause
Fevers lasting longer than 5 to 6 days
“Viruses are the most common cause of fevers. They tend to scare parents, but most likely they will go away when the virus is gone,” Chow said.
8. Breathing problems
If your child does not have asthma and any of the following are persistent
Straining abdominal muscles
Audible wheezing, which is a noise that sounds like harsh air blowing through a straw
A tight whistling sound during inhalation. If this isn’t helped by a cool mist or humidity, seek medical attention immediately
Coughing that is so severe that your child can’t breathe
9. Difficulty drinking
Can’t drink enough to urinate every 3-4 hours
Going 8-12 hours or more without urinating
10. Parent’s gut instinct that something is wrong
“Generally speaking, if a healthy child is drinking well, urinating well and acting within normal limits, he or she is most likely doing fine,” Chow said. “Still, I tell my patients’ parents that if they can’t sleep through the night to give us a call and be reassured."
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