When to Call a Pediatrician

It’s 2 a.m. Your baby is crying and you can’t soothe her. She has a fever and a stuffed nose. Do you call the pediatrician, or do you wait until morning?

New parenthood is full of uncertainty. When you’re a first-time parent, it’s easy to second-guess every decision you make.

“It can be hard sometimes to know when or when not to call,” says Katie Lockwood, MD, a pediatrician at Children’s Hospital of Philadelphia. “I reassure parents to follow their instincts. If something doesn’t feel right or if they’re not sure if something is normal or not, pediatrician offices would rather you err on the side of calling us.”

A few key symptoms can be your guide as you decide whether to grab your phone and call your pediatrician.
Fever
How to handle a fever depends on your child’s age. In a baby under 2 months old, a rectal temperature of 100.4 F or higher is an emergency.

“Go straight to the ER,” advises Lockwood. “Sometimes babies can have a serious infection, and the only sign is a fever.” The hospital will do a full workup that includes blood and urine tests, and sometimes a spinal tap.

In older children, the number on the thermometer is less telling than other clues. “Most important is how the child is acting with the fever and how long they’ve had it,” Lockwood says. “If a child has a 101 [degree] fever but they’re really irritable, they won’t eat, they’re not acting like themselves, or they won’t stop crying, that’s concerning to me.” This rule applies for vaccinated children; in unvaccinated infants, most fevers should be seen by a doctor right away.
Three days is usually the magic number for viral fevers to last, she says. Any fever that lasts longer deserves a call to your doctor. It may have turned into a bacterial infection like pneumonia.

Vomiting and Diarrhea
These symptoms usually signal a viral infection. On their own, they’re nothing to worry about. But when they’re too intense, they can be a problem.
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