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As parents, we're tuned in to every skinned knee, sneeze and cough. In the vast majority of cases, such symptoms don't warrant a trip to the emergency room or even a call to your pediatrician. But how do you know when they do? Here are the top kids' symptoms you should never ignore in your kids:
1. High Fever
It's just a fact of parenthood: Your child is going to have a fever at some point. The good news is that fevers are completely normal and usually nothing to worry about. "Fevers are a response to infections -- it means the body is doing what it need to do to fight them off," says Scott Goldstein, M.D., a pediatrician at The Northwestern Children's Practice in Chicago and a clinical instructor at Northwestern University School of Medicine. The one exception: In infants under 2 months, see your doctor immediately whenever the rectal temperature is over 100.4 degrees. "Because they are more vulnerable to infection, fevers in children this age are always potentially serious," says Andrew Adesman, M.D., chief of developmental and behavioral pediatrics at the Steven & Alexandra Children's Medical Center of New York.
For older babies and children, parents shouldn't get too worried, even if the fever spikes very high. "We treat fever with medicine such as acetaminophen to make kids more comfortable, not because it's dangerous -- even if it's 105 degrees," says Dr. Goldstein. "As the temperature goes up, the head and face often get flushed and sweaty, the heart beats faster and the breathing rate is faster, but as long as these symptoms go away as the temperature comes down with medicine, we don't worry any more about a temperature of 105 than we do about a temp of 102." All experts agree that parents should be more concerned with how their child looks than with the number of the temperature. If your older child is having trouble breathing, looking pale and acting out-of-the ordinary after you've given him medicine to reduce his fever, then notify your doctor immediately.
Most children will complain of a headache occasionally, and there are plenty of causes for one: allergies, poor sleep, vision problems or just staring at the TV for too long. And in the vast majority of cases, headaches can simply be treated with pain medication, like acetaminophen or ibuprofen. However, there are some red flags to watch out for: "It is unusual for children under age four to complain of a headache, for kids to wake up in the middle of the night with headaches (especially with vomiting), or for headaches to be accompanied by loss of balance, blurred vision, weakness, or loss of coordination," says Dr. Goldstein. "Any of the above needs to be evaluated by a doctor quickly, although usually you can wait until regular office hours. Severe headaches, ones that do not improve with pain medication, ones accompanied by neck stiffness or pain with bright light should be evaluated in the emergency room right away." Also, notify your doctor if your child's headaches are recurrent, particularly painful, or if they don't go away easily. Again, rest assured that most headaches are completely benign -- it's just important that you notice out-of-the ordinary symptoms to rule out more serious conditions like bacterial meningitis, head trauma and, in very rare cases, brain tumors.
3. Cuts and Scrapes
Skinned knees and boo-boos are just part of the territory when it comes to little kids. There's no need to panic every time yours gets one -- most will heal in no time. "Your first priority is always to control the bleeding and keep the cut clean," explains Anita Chandra-Puri, M.D., a pediatrician in Chicago and a spokesperson for the American Academy of Pediatrics. "If you can't control the bleeding after 30 minutes or if the cut is gaping, see your physician right away." Not only might your child need stitches, but it's also important that the physician clean the wound thoroughly to prevent an infection. Also, notify your doctor quickly if, at any point, you notice redness or swelling around the wound, inflammation or discharge, or if your child is in excessive pain, lethargic or feverish. Not only do you want to make sure there isn't an infection, but it's crucial to rule out sepsis, which is a very serious medical condition in which bacteria gets into the blood stream and the body attacks its own organs and tissues as an immune response. "A cut shouldn't affect the general well-being of a child," adds Dr. Adesman. "Sepsis will make a child look very sick, so if your child has a cut and is suddenly feverish or has a change in his level or alertness, alert your doctor and/or seek emergency care immediately." A quick diagnosis of sepsis -- which can be treated with antibiotics and intensive care -- can be life-saving.
Sorry, but if you're the mom of a young child you’re going to deal with throw-up at some point. It's gross, but it's part of the territory of being a parent. In most cases, vomiting is caused by gastroenteritis (known as stomach flu) which is benign and simply has to run its course. What's most important in these cases is to watch your child; when a child can't hold down even small quantities of fluids, dehydration is a serious risk. Signs of dehydration include decreased urine output, sunken eyes, extreme sleepiness, parched lips, or if your baby is crying but not producing tears. If you think your child might be dehydrated, or if your child is throwing up repeatedly and is six months or younger, call your doctor right away. Extreme dehydration can be very serious, but it's fixable -- you might have to take a trip to the hospital so your little one can receive fluids through an IV. If your child is throwing up blood, call your doctor immediately to rule out serious illnesses. And if his vomit contains bile -- a bright greenish yellow substance -- or has blood that looks like coffee grounds, get to the emergency room right away to make sure he doesn't have a life-threating condition like a blocked intestine.
As with vomiting, diarrhea is usually the (gross) result of a stomach bug. It will usually subside on its own once the virus has passed through your child's system. Again, it's most important to watch out for dehydration and get to the emergency room if the diarrhea is accompanied by severe stomach pain, or if your child is having trouble staying awake, says Dr. Goldstein. Notify your doctor right away if there's blood in the stool -- though, in many cases, blood can just be a result of excess straining -- or if the stool is atypical in any way. One other possible cause to consider: If your child has persistent diarrhea, abdominal cramps, rectal bleeding, reduced appetite or weight loss, talk to your doctor about checking for ulcerative colitis and Chron's disease, two chronic conditions which can be treated once diagnosed.
Rashes are very common during childhood, and the vast majority are nothing to worry about. That being said, there are times when you should notify your doctor. "Purple rashes, painful rashes or rashes associated with other significant illness symptoms such as a fever or vomiting should prompt an urgent visit to your physician," says Dr. Chandra-Puri. "If your child has a rash but is otherwise acting well, then you may want to see your doctor if it doesn't go away on its own in a few days," says Dr. Goldstein. Of course, parents should always be on the lookout for allergic reactions. If your child suddenly develops an itchy rash, give him a dose of Benadryl and watch him closely to see if the reaction subsides. However, anything more than a mild reaction requires immediate medical attention. "If you notice any difficulty breathing, wheezing, trouble swallowing, if your child's lips and face are swollen, or if he's saying he has abdominal pain or a weird feeling in his throat, it could be a sign of anaphylactic reaction." Use an EpiPen if you have one, and call 911 immediately.
7. Pain While Urinating
If your little girl is complaining of pain when she pees, chances are it's vulvitis, an inflammation of the vulva most likely caused by bubble baths or harsh soaps. Another possible cause: a urinary tract infection (UTI). In fact, according to the U.S. Department of Health and Human Services, UTIs account for more than a million visits to pediatricians' offices each year. The key is knowing how to detect one: For younger babies, they might seem irritable, feverish or they might vomit or have trouble feeding. Older children might complain of discomfort while peeing, an increased urge to urinate, foul-smelling urine, and wetting their pants even after they've been potty trained. They also might have a fever. If you notice any of these symptoms, notify your doctor, who can prescribe an antibiotic to treat the infection if that's the cause. Also, try to prevent UTIs in the first place: Avoid giving your daughter bubble baths, don’t let her use strong soaps, make sure she always wipes front to back, and check that her underwear isn't too tight. If your little boy is complaining of pain while urinating -- a symptom much more common in girls -- call the doctor.
8. Excessive Sleepiness
If your child is taking extra naps or seems to hit the hay earlier than usual, chances are he's just not getting enough sleep. Keep in mind that kids need a lot of shut-eye: According to the National Sleep Foundation, infants need 14-15 hours, toddlers need 12 to 14 hours, preschoolers require 11-13 hours and school-aged children up to age 10 need 10 or 11 hours. So, how to know if excessive sleepiness is a sign of something serious? "Sick toddlers and children will often sleep more than they usually would since rest helps the body heal, but you should be able to wake your child up if you try, and she should answer your questions or, if she's too young to do so, at least focus on you," says Dr. Goldstein. "If that's not the case, or if you have an infant who is not waking up to feed, you should call your doctor immediately to help determine what the cause might be."
9. Lack of Interest in School
Most kids wake up once in a while saying, "Mommy, I don't want to go to school today." Maybe they're just tired or looking for a little extra one-on-one time with you. And that's normal. However, if this is occurring on a regular basis, it's worth notifying your child's doctor. "For the most part, kids like going to school, seeing their friends, learning interesting things, and having fun on the playground," says Joan Bregstein, M.D., associate clinical professor of pediatrics at Columbia University Medical Center. "So if a child doesn't want to go to school, especially if he's also not eating or sleeping well, that could indicate a problem. For instance, a child can have attention deficit hyperactivity disorder (ADHD) and feel lost or out of place in class because they're having trouble focusing." Also, a child might be battling depression or they might be having trouble with bullies in school. Bottom line: If your child doesn't seem to like school, work with his teachers and doctor to figure out why so you can get him the help he needs.
Don't rush to the doctor every time you notice your child has a bruise -- children, especially toddlers just learning to walk, and school-aged kids often have bruises from falling and playing on the playground. Yet, there are exceptions. "If you notice your child has bruises in areas you don't expect her to have, like the back or abdomen, or if she bruises quickly, that could indicate a hematologic problem ranging from the benign to the very serious, like leukemia," says Dr. Bregstein. However, remember that in most cases, bruises on a child means he's just getting a lot of exercise during recess.
11. Difficulty Reading
If you child is having trouble following along in class or with reading, don't just assume his problems are academic. It could be that he is having trouble seeing. "If you have a child who seems to have deteriorating academic function, one of the possible explanations is that he's having difficulty with blackboard work and distance vision," explains Dr. Adesman. Make an appointment for an evaluation by an eye doctor to see if your child needs glasses. Ask your pediatrician for a referral. Also, the American Academy of Ophthalmology and the American Optometric Association can both help you locate an eye doctor in your area.
12. Swelling in Joints
Just like adults, many children will experience aches in their arms and legs, especially once they get involved with sports. However, it's important to watch out for swelling. "It is common for children to complain of occasional arm or leg pain, but visible swelling of the joints is uncommon and should be evaluated at your doctors office, or in the emergency room if it is severe enough that it prevents movement or if it occurs after a fall," says Dr. Goldstein. Adds Dr. Chandra-Puri: "Persistent, asymmetric, or painful swelling of the joints should prompt medical attention." And, of course, if your child spikes a fever and has swollen, red, painful joints, seek medical care immediately to rule out sepsis, rheumatoid arthritis and other serious conditions.
13. Excessive Thirst
Yes, kids need plenty of fluids to keep up with their constant activity. However, if you suddenly notice your child drinking a lot more than usual, particularly for several days in a row, or if he's waking in the night to drink, notify your doctor, as it might be a sign of diabetes (especially if accompanied by excessive urination.) The reason: With diabetes, excess sugar builds up in the blood and the body tries to flush it out through drinking and urination. A person with diabetes might also experience weight loss, fatigue and an increased appetite. It's important to diagnose diabetes as soon as possible, so your child can start getting insulin injections before symptoms get out of hand.
14. Stiff Neck
We've all woken up with a crick in the neck from time to time, and kids are no exception. They might complain of a sore neck as a result of not sleeping properly, muscle strain, or even a sore throat. And in those cases, a mild anti-inflammatory like Advil or Motrin, along with warm towels or a heating pad to control the muscle spasms should help the pain subside. However, experts warn that if your child has a stiff neck along with a fever, you should seek medical care immediately -- though very rare, it's crucial to rule out meningitis, an inflammation of the covering around the brain and spinal cord. Other symptoms in young children can include flu-like symptoms, crankiness, sensitivity to light and a refusal to eat. Bottom line: "A fever associated with a stiff neck is meningitis until proven otherwise," says Dr. Bregstein. "A stick neck without a fever but with weakness or tingling in the arms could indicate a slipped disk or something involving the spine." Either way, call your doctor right away.