My 4-year-old came home from school complaining of a headache. He had no fever, no congestion or sore throat, no stomachache or diarrhea. But he kept saying his head hurt, first at the temple, then in the center of his forehead, then near his ear.
The baby, 7 months old, had had a cold for more than a week. While he was cheerful and energetic and his appetite was good, he was having trouble sleeping because he was so congested. His breathing was noisy and it seemed his nose would never stop running.
My 11-year-old’s stomach pains quickly progressed to diarrhea and then vomiting. She was feverish and lethargic, sleeping except for when she had to make yet another panicky run to the bathroom. She couldn’t seem to keep anything in her stomach, even Tylenol.
What’s similar about these three cases? Each time, I debated whether or not to call the doctor. I hate to call for each little ache or sniffle, or to drag my kids to the doctor’s office for a cold or a stomach virus — problems the doctor really can’t solve.
On the other hand, if a child is coming down with an ear infection or bronchitis, something easily treatable that will quickly become much worse if I don’t call the doctor, I never hesitate at all.
Rules can be helpful, but there are always exceptions. The three cases outlined above are good illustrations.
I once believed, for instance, that a child needed to see the doctor only if he or she had a fever. No fever, I thought, means no infection. But it turns out my 4-year-old, like some other children, is prone to fast-onset ear infections that appear suddenly, manifesting severe pain and no fever.
After a few instances of not calling the doctor when my son complained of head pain but had no other symptoms and then discovering a few days down the road that he had a serious ear infection, I began taking his headache complaints seriously and calling the doctor right away. A prompt exam and — usually — a prescription for antibiotics can head off a full-blown infection.
The baby, it seems, had an endless cold last winter. He catches everything his siblings bring home and then hangs onto it much longer than they do. I once believed that if any coldlike illness lingered longer than a week, it had become bronchitis or pneumonia and required a visit to the doctor and a course of medicine.
But though every lingering cold in a young child should be looked at by a doctor, many are mild viral infections that, however tenacious, cannot be “cured” by any medical treatment.
Even if your baby’s cold has progressed to bronchitis, it’s usually viral and will not respond to antibiotics.
With an older child, like my 11-year-old, most illnesses are less worrisome. For one thing, the child can usually describe symptoms accurately. For another, parents are fairly experienced by this time and better able to assess matters.
My daughter, for instance, tends to vomit readily, so I don’t get alarmed when this happens. In fact, when she’s struck down with a stomach virus, I can pretty much predict that she’ll be violently ill for one day and fine the next. With her, I tend to wait longer before I call the doctor and to be more certain of my decision when I do.
While there are no hard-and-fast rules about when to call the doctor, you can use the following guidelines, adopted from “Your Child’s Wellness Newsletter.” You should call the doctor when these conditions arise:
*Sore throat with fever.
*Earache with or without fever.
*Persistent cough with or without fever.
*Generalized rash with or without fever.
*Fever in an infant under 6 months.
*Persistent fever in a child of any age.
*Difficulty breathing.
*Unusual lethargy.
*Abrupt loss of appetite.
*Headache and stiff neck, with or without fever.
*Vomiting for more than 12 hours.
*Runny nose in which clear mucus turns yellow or green.
*Any other behavior or symptom that makes you uneasy.
In the end, trust your instincts and call the doctor if you have any question about what’s going on with your child’s illness, however mild it seems.
Set aside any worries about “bothering” the doctor — that’s what they’re there for — and recognize that it’s better to err on the side of caution and waste a phone call or a visit to the doctor than to put off calling and thus risk your child’s health.