Babies - When Should I Call the Doctor?

Babies are delicate but tough. They can tolerate other children and even dogs, but they are subject to problems that may seem trivial to the casual eye, but in reality are really serious and should result in a call to the doctor. How are parents to know the difference?

Abnormal Sleep
If your baby wakes early, is uninterested in sleeping, seems tired or doesn't wake for feedings, there might be something wrong. According to Dr. Alan Greene, of the Stanford University School of Medicine:

"The average amount of sleep at three months is 15 hours out of 24, give or take an hour or two. This may come in almost any combination of naps or nighttime. But when kids sleep less than about 12 hours out of 24, it is important to determine why.
"It could be related to nutrition, but it could also be a variety of other things: an ear infection that hurts when he lies down, a food intolerance, a cow's milk allergy (up to 20% of those intolerant to milk are also intolerant to soy), even a hernia. Sometimes, too much thyroid hormone can keep kids awake. Either way, this is a good reason for a visit with your pediatrician."

Trouble Breathing
One problem that causes baby to wake over and over is constricted breathing. Babies may even have sleep apnea, a condition that blocks air intake at the nostrils and mouth lasting at least 10 seconds. This is serious and dangerous. "Apnea of Infancy" is reserved for babies nine months old and older, while "Apnea of Prematurity" applies to younger infants. Watch your baby sleep. Is his breathing noisy? Does he hold his breath, then catch it with a start that wakes or partially wakes him? Does this happen several times during his rest, and does he change color or go limp? If so, call the doctor.

Infection
The baby may have an infection. Check him all over for any wounds in the skin, especially if red or inflamed - in a newborn, check the umbilical cord stump carefully. This is a likely site for infection. Take the baby's temperature, using a rectal thermometer, or one of the new "high-tech" thermometers with a probe. If using a rectal thermometer, take the baby's diaper off and let him cool down a bit. Put a little petroleum jelly on the end of the thermometer and with baby on his back, pull his legs up, lifting his bottom. Insert the thermometer one-half to one inch. If using a probe thermometer, place the probe in his armpit and wait 2-3 minutes. If the baby's temperature is more than 100.4o, call the doctor.

According to the University of Utah Health Sciences Center, babies who have an infection in another part of the body may exhibit the following symptoms:

- Listlessness, does not interact
- Trouble breathing
- May exhibit cold symptoms
- Temperature up or up and down
- Seizures (may indicate meningitis - very serious)
- No appetite

If your baby shows these symptoms, call the doctor.

Falls, Cuts and Abrasions
If your child falls or bumps his head hard enough to knock him out, even for just a few minutes or even seconds, call the doctor immediately. The baby may have concussion, which is always dangerous. If your baby seems confused or drowsy after a fall, call the doctor immediately. If your baby has a cut that doesn't easily close, if it gapes or is ragged-edged, stitches may be required, especially with babies who are inclined to rip bandages off. Wounds on face, arms or hands should also be stitched, to reduce or prevent scarring. Don't let more than 8 hours elapse before calling the doctor.

Dehydration
Babies can easily become dehydrated. If your baby throws up despite your best efforts or has persistent diarrhea, call your doctor immediately. If you are uneasy with the advice he gives you, take your baby to the emergency room. Do NOT allow this to continue past one day!

Constant Crying
"My baby cries all the time!" Babies naturally cry; it is their only means of communication (besides body language). But if it seems excessive to you, check to make sure:

The baby is hungry: If you are feeding on a schedule or if the formula is not strong enough, the baby may become hungry "between" feedings. The cry will be fierce and angry. Check with your doctor - it may be time to start your baby on a little solid food.

The baby is tired: Don't forget that young babies need a lot of sleep. If you are dragging your baby around while you do errands, he may not be sleeping as much as you think. Sometimes, of course, it may be unavoidable, but try to find a trusted relative willing to care for him. This kind of crying more resembles
fussing, and baby may scrub his eyes with his fists. If the baby is relatively new and has been passed around for hours among relatives, he may not only be tired, but sore, from all that handling. A soothing bath and straight to bed should do the trick. Of course if he won't sleep and continues to cry and fuss, make sure he's dry, fed and has no other complaints. Then call your doctor.

The baby has stomach-ache: The baby may simply need to be burped, or he may have genuine stomach pain. Hold the baby upright and pat his back gently - he should burp fairly quickly, and may need more than one. Don't rush. If the burps don't help; if the baby continues in what is obviously severe pain, call the
doctor.

The baby cries for no reason: If you have done all you can think of for your baby and he continues to cry, don't panic. Babies often cry for no discernable reason, especially in the evening, when there is apt to be a lot of hustle and bustle around the house. Babies can't tolerate a lot of commotion, and crying seems to lessen their tension. If the house is quiet and the crying persists, call the doctor.

An Ounce of Prevention
What can parents do to keep their baby healthy?

Consider breastfeeding. Not all mothers are attracted to breastfeeding. The mother may think that breastfeeding will tie her down, but in actuality, it can actually simplify her life. No mixing formula in the middle of the night, no bottle washing, no need to carry bottles of milk or formula around with her all day - more than one mother has fed her baby soured milk!

Immunizations: Make sure your baby has all his shots, and that they are given at the proper time. Your doctor can advise you on this. Keep a record, as you will need this information later.

Keep baby clean: Check with your doctor on this, but use your common sense, too. Some doctors advise bathing the baby every day, others say once a week is enough. Here's a rule of thumb: if your baby doesn't smell fresh and clean, it's definitely time for a bath. Hold the baby securely - they can be slippery creatures!- and NEVER, EVER leave him alone in the bath, not even for 10 seconds. If the phone rings, ignore it. Someone's at the door? Ignore it until baby is secured. A drowned baby is not something you want to deal with.

Avoid the sun: Babies younger than six months should not be given sunscreen and will quickly burn if exposed to the sun for an extended period. Even if your baby is older, watch his sun exposure and do use sunscreen whenever he goes outside.

Smoking: Don't let anyone who smokes around your baby. Even if they don't smoke in his presence, smoke lingers in the air, on their clothes and their furniture. It is dangerous for babies, as their tissues are delicate and their airways small. Smoking around the baby may result in coughing, wheezing, and general discomfort, for which he is sure to blame you when he grows up. Bronchitis and pneumonia are much more common in babies who are exposed to smoke, and asthma twice as common. The more smoke the baby is exposed to, the more likely he will suffer from it, now and/or in the future.

Keeping track: Make sure you know everything that goes into your baby's mouth. Babies use taste ahead of almost anything else except perhaps vision to explore their world. The dominant question of the baby's day seems to be: "Is this edible?" If it is a small object, baby might choke on it. Keep such things out of his grasp. Don't let others feed your baby unless you have approved the food.

The information within this article is not meant to be taken as medical advice. If you have questions about your child's health, or suspect there may be a reason to take your baby to the hospital, contact a doctor immediately.

For more information, visit:
"Caring for a Newborn Baby" on www.medem.com.
"How to Know When to Call the Doctor if Yor Baby or Child is Sick on www.ehow.com.
"Taking Your Child to the GP" on www.bbc.co.uk.