How to Know when to Take Your Baby or Toddler to the Doctor or Emergency Room

When I had my children, I expected to face certain parenting challenges. I knew we would deal with typical newborn sleepless nights, anxiety about meeting developmental milestones, the terrible twos, and temper tantrums. What I never expected was watching my newborn at six weeks of age nearly die in my arms from viral meningitis. I also never expected that before my son reached the age of two we would have rushed him to the emergency room not once, but twice for signs of respiratory distress due to respiratory syncytial virus (RSV) and bronchiolitis. Having spent too many hours in the emergency room and in the pediatric intensive care unit watching an infant, and later a toddler, struggle to breathe, I have learned a few things about what to watch for in a sick child. Sometimes knowing the difference between a common cold and a dangerous illness can mean the difference between getting the help you need at the emergency room or getting there too late.

How to Know When to Take your Baby or Toddler to the Doctor or Emergency Room: The Fever Dilemma

A child with a fever is not necessarily something to worry about. Fevers can accompany a common cold or an ear infection, neither of which are typically life threatening. However, a fever in a newborn should not be ignored. Even a low fever, like the one my son had when he contracted viral meningitis, can signal a serious infection. Call your doctor right away if your newborn has a fever.

A fever in a toddler is less distressing. However, if your child's fever is prolonged, or if fever reducing medicines like Children's Tylenol or Motrin do not bring the fever down, it may be time to call the doctor. Your doctor may also give you special instructions about high fevers. For example, your doctor may recommend that you call the office if your child's fever reaches 103 degrees or higher.

How to Know When to Take your Baby or Toddler to the Doctor or Emergency Room: Dehydration

Another dangerous condition in a newborn or infant is dehydration. During an illness, young babies are especially susceptible to dehydration. Toddlers can likewise become dehydrated quickly if they are vomiting or having diarrhea.

Watch your child carefully for signs of dehydration. If your baby does not have wet diapers as frequently as is typical, does not have tears, has a dry mouth and lips, or is lethargic, your child may be dehydrated. If your child has sunken eyes, is very fussy, or has a sunken soft spot (fontanel), these may be signs of serious dehydration, and you should call your doctor immediately to describe the symptoms. If your doctor's office is closed and your child is showing signs of serious dehydration, consider going to the emergency room.

How to Know When to Take your Baby or Toddler to the Doctor or Emergency Room: Respiratory Problems

Common illnesses, such as colds, influenza, or RSV, can be dangerous in infants and toddlers. Having had too many encounters with respiratory distress with my own baby, I learned some of the easier signs of respiratory distress to watch for.

Symptoms of respiratory distress include fast breathing. If your child seems to be breathing faster than normal, or more than 40 breaths per minute, call the doctor immediately or head to the emergency room.

Another symptom of respiratory distress that is easy to spot in an infant or toddler is a separation or indentation under the rib cage with each breath. Doctors call this retraction. For me, this was an easy symptom to spot and one I still check for in my little guy when he gets sick. Just lift up your baby's shirt while he is lying in the crib and watch to see if the rib cage is expanding more than usual with each breath or if there is a small indented line running along the underside of the ribcage. If you see that line, call the doctor immediately or head to the emergency room.

Finally, if your child sounds like he is struggling to breathe, if he is grunting with each breath, or if you can hear wheezing, call the doctor immediately or head to the emergency room.

The funny thing about being a parent is that sometimes we worry we are overreacting by going to the emergency room or calling the doctor. When you have an infant who is sick, you cannot overreact. It never hurts to get things checked out, and as the old adage goes, better safe than sorry.