Being a new parent is one of the most stressful roles one experiences in their lifetime. In the midst of not sleeping, learning a whole new skillset (diaper changes, putting clothes on a helpless blob, etc), and physically/mentally recovering from the craziness that is childbirth (for mom especially, of course, but dad too), you also have to simply worry about the health of your little one. While babies are resilient creatures, parents often have very few clues as to what’s actually going on. In older, verbal children, crying is an obvious indicator, and they can often just tell you when something really hurts or doesn’t feel right. The non-verbal, constantly crying baby, however, is not nearly as helpful.
In the absence of clear feedback, it can be hard to know if your baby is suffering an ailment, and whether or not it’s severe enough to warrant a trip to the doctor. You wonder if it’s worth perhaps interfering with your baby’s sleep, and possibly exposing them to more germs at the doctor’s office, while also weighing, let’s admit it, the hassle such a visit will incur to you as well. Do their symptoms need to be looked at by a professional, or is it fine to hold off and just keep an eye on things?
To help assuage some of your worries, and aid you in deciding what to do, let’s take a look at a few handy tips and guidelines for how to know when your baby should be brought in to see the doctor versus waiting things out at home.
Preliminary Note #1: Utilize New Email/Phone Services
As a preliminary note, be sure to do some homework right away and ask your doctor if you can email them, video chat, or call with questions. Nowadays, many providers would much rather you call or even email them first (through a specialized patient portal — not their personal gmail address) and potentially save the time and hassle, on both sides, of a 45-minute appointment that inevitably runs late and includes commutes to and from. Some offices and doctors are even providing the ability to video chat after-hours if you have urgent questions. So rather than taking your kid into an ER or scheduling an urgent appointment, first check with the pediatrician’s office about how to ask questions without/before coming in.
Preliminary Note #2: The Value of Peace of Mind
It can sometimes be hard to gauge whether or not your child is manifesting the symptoms listed below. Is your baby having a hard time breathing, or just doing the kind of snoring and wheezing that isn’t uncommon in infants? Even if you know you’re being slightly irrational in your worry, it’s certainly sometimes worth it to give the doctor a call simply for the sake of your own peace of mind. Parenting is hard, especially when it’s your first; don’t have any qualms about doing that. You may intuitively know your kid is okay, but it’s helpful for a medical professional to confirm your hunch. You’ll learn to better trust your judgement over time, and doctors are fine with offering positive affirmation in the meantime.
Which is to say, when stressed and in doubt, call or visit your doctor!
Below is what you’ll see doctors advise for various symptoms; I put in my own parental experiences in a few places. Those opinions are, of course, anecdotal and completely non-medically informed.
- If baby has refused multiple feedings in a row, and/or isn’t wetting a diaper at least every 6 hours or so, call the doc.
- If baby has a bad, consistent cough that doesn’t go away for 72 hours, call the doc. Also do so if the coughing is so bad it makes your child throw up. (Personal experience here: if the baby coughs and makes himself throw up as a singular incident, and if there aren’t any other symptoms — they’re sleeping, breathing, and eating okay — it’s probably fine and doesn’t warrant a trip to the doc.)
- A cough that sounds more like a bark might be croup. You might be tempted to call the doc, and that’s okay, but it can generally be helped with some home remedies: turn on a hot shower and sit together in the steamy bathroom; take him outside if it’s chilly out to clear things up; stand in front of your fridge/freezer for a few minutes. (Use common sense with these, of course.)
- If baby is under 3 months, call the doc once the fever hits 100.4 or higher. If it’s less than that, but still elevated and accompanied by other symptoms like vomiting and extreme sleepiness, call the doc.
- Between 3-6 months, call at 102 or higher, or if the fever is prolonged, lasting more than 3 days (72 hours). (Personal experience: Try children’s Tylenol first (only if baby is 2+ months old), and if the fever goes down from that you’re probably okay and just have to wait it out. Fevers spike and dip throughout the course of an illness; it’s when it goes way up, and stays up, that you need to be concerned.)
- Between 6-24 months, call if a high fever has lasted longer than 24 hours with no other symptoms (there’s no real set number here, but that usually means 102-104). If a lower fever is accompanied by other symptoms, call when needed based on the severity of those symptoms.
The exception for all of these is if your baby recently got shots or is teething. It’s common for them to run a little bit of a fever in the 36 hours following vaccinations, and also while getting new teeth. This type of fever, though, shouldn’t exceed about 101 degrees.
- If vomiting is a singular incident, or even just a few times, there’s no need to worry or call the doc right away. It could be a quick bug. If it’s repeated, though, your baby appears dehydrated (cries with fewer tears, sluggish, appears to have dry mouth, and/or the soft spot appears sunken), and can’t keep anything down for more than 8 hours, then it’s time to call.
- If your baby vomits blood, or a green/yellow projectile, call the doc.
- Rashes generally aren’t something to be concerned with, unless they aren’t going away after 1-2 days, appear to be painful, and/or are accompanied by a fever. If those other factors aren’t present, try an over-the-counter topical after a day or so, and then feel free to call the doc. (Personal experience: Our son had rashes on and off as a baby, but we only brought him to the doc once, when it didn’t go away and in fact only got bigger after about a day and a half. Other rashes, stemming from something we never figured out, sort of shrank and grew over the course of a couple days, clearly weren’t painful, and ultimately went away on their own.)
- You can also press on the rash a little bit, and if the color goes away and quickly comes back, you’re most likely in the clear. If the rash is small, flat red dots in which the color does not go away, call the doctor, as it could be a dangerous meningitis infection.
- Ear pain. Hard to gauge, of course, but if consistent crying is paired with a baby tugging at their ear and not feeding, they might have an ear infection. Call the doc.
- Trouble breathing. If your baby appears to be wheezing, or generally having trouble breathing, call the doc right away.
- Looks blue. If baby looks blue, especially around extremities and lips, call the doc. (Personal experience: This one is really hard to gauge; lips can turn a little blue when baby is cold, or just feeling a little off. Try a warm bath first, and a feeding, and if that doesn’t work, call the doc.)
- Bump on the head. These are always scary, but generally appear worse than they really are. If baby vomits after bumping their head, or appears disoriented at all (I know, that’s a hard thing to tell in a baby!), call the doc.
- Pink eye. With goopy or crusty eyes, there’s no need to make a call to the doc for at least 1-2 days. (Personal experience: Our son one time had pink eye for about 4 days. We never took him to the doc and it went away on its own. There are two kinds of pink eye — viral and bacterial — and there’s no way to know which your child has, even for a doctor. So if you go in, and are given an antibacterial, it may not do anything and you’ll just worry more. My own, real parent recommendation is to give it almost a week before calling.)
When Calling or Going to the Doc, Be Prepared
It’s really easy to be frazzled when you have a fussy baby who clearly isn’t feeling well. Know, though, that the doctor or nurse is going to ask a bunch of questions at the outset to try to get a feel for what’s going on. You want to be able to give clear answers, so expect some form of the following questions:
- Symptoms. Why did you call/come in? What, specifically, is worrying you?
- Medical history. Known allergies? Current medications? Home remedies? Is your baby current on his/her shots? Especially if baby is under 3 months, be able to detail the health of the pregnancy and birth as well.
- Feeding and diapers. Any changes to baby’s feeding patterns? Are wet/poopy diapers consistent?
- Temp. If you go to the doc’s office, they’ll take baby’s temp (often rectally at 3 months or less), but will ask about what the temp has been like in the last 24 hours or so. If you’re just on the phone, they’ll ask about baby’s current temp, as well as history.
- Exposures. Has baby been exposed to illness? At home, daycare, airplane, etc.? If it’s a rash, they’ll ask about new foods or cleaning agents they may have been exposed to.