When to Pay Close Attention

Amanda ChanIt's inevitable: Children will get sick. All that time spent playing with friends on the jungle gym means they’re exposed to germs, and that’s normal. But what are the symptoms that should give parents real pause?

Dr. Amanda Chan, a pediatrician at Blue Fish Pediatrics, in association with Children’s Memorial Hermann, has advice for parents.


When a rash develops, it’s helpful to look back on the day’s events, since it can result from a new exposure. Look for additional signs as well: Does your child notice the rash, or is it painful? Is the rash covering a large surface area of the body? Does your child have a fever or worsening cold symptoms? Is he/she suffering from diarrhea or vomiting? If the answer is yes to one or more of these questions, you need to visit a doctor. Otherwise, try applying moisturizer to the affected area. For itchiness, parents may give children Benadryl; however, certain associated symptoms—facial or lip swelling, trouble breathing, and prolonged vomiting—are serious enough to see a doctor immediately.

A Stomach Virus

If your school-age child is vomiting, you need to assess whether he or she is able to keep down enough fluid to stay hydrated and comfortable. If the answer is no, you need to visit a doctor. Prescription medication can help with nausea and vomiting, but if dehydration is a serious concern, the child may need IV fluids. If severe abdominal pain is present, a physician is needed to further investigate the cause. If your child has diarrhea, that means he/she has a virus, which should resolve on its own with rest and fluids. To speed up the process, start giving your child probiotics, such as Culturelle or Florastor, twice a day, to bulk up their stool. If the amount or color of diarrhea is concerning, don’t hesitate to see your pediatrician.

Did you know? Children in the US miss 22 million days of school each year due to colds, flu and other infections.

A Fever Over 100 Degrees

The severity of fever in children depends on their age. When newborns have a fever of 100.4 or higher, parents must take the situation very seriously. Parents should immediately take infants to the ER to be evaluated for more serious infections including meningitis, urinary tract infections, or blood infections, which can rapidly progress and become life-threatening. If your child is older, watch for other symptoms like a sore throat, persistent runny nose, prolonged vomiting and diarrhea. Fever reducers—Tylenol or Motrin—which are dosed by how much your child weighs, can provide some relief as a first step before seeing your doctor.

A Stiff Neck

The underlying cause of a stiff neck is very important and a key indicator of its severity. If your child was fine the day before and woke up with only neck pain, it may only be a muscle spasm; but if he/she has cold-like symptoms including a fever and now can’t bend his/her neck, the condition could be more serious. One possibility is the brain infection called meningitis, which requires evaluation at the ER. Another scenario mostly occurs among children who play contact sports; their neck pain may be due to physical contact and need a doctor’s evaluation.

A Bad Headache

Headaches can have many different causes, from not eating or drinking, to not sleeping enough, to migraines, to even infections or tumors. Many questions can be answered by visiting your doctor to fully assess the problem and its cause. In school-age children, Tylenol or Motrin can be used. But if headaches persist or are frequent, a trip to the doctor is warranted.

Difficulty Breathing

Trouble breathing can be caused by multiple things: The child could have swallowed something, for example, or could be suffering from asthma. Whatever the cause, seek medical attention. Children, especially young infants, can only breathe hard and fast for so long before they tire out. When signs of distress occur, it’s important to see a physician, whether it’s your pediatrician, an urgent care doctor, or an emergency medicine doctor.

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General Health and Safety Guide