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posted: 6/18/2012 6:00 AM

Trust your instincts when it comes to calling pediatrician

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Q. How can I tell if my kids' illnesses are serious enough to call the pediatrician?

A. Certain situations should be "red flags" to contact the pediatrician: inability to move part of his or her body, worsening or persistent pain, severe bleeding, or second- or third-degree burns.

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There are plenty of gray areas, of course. You can try to treat these conditions at home. But if the situation worsens, seems unusual, or you're not sure what to do, you can always pick up the phone.

Behavior change: If a child's behavior changes suddenly and dramatically, and the child does not seem to "be himself," that could indicate an underlying brain problem. This requires a lot of parental common sense. I'm not talking about a normally happy kid who gets angry or sad after some event that could reasonably have changed her mood. I'm talking about a normally energetic kid who suddenly seems apathetic, or a normally placid kid who flies off the handle for no good reason.

Burns: If a burn involves the face, hands, feet or genitals, call the pediatrician. If it's a burn elsewhere on the body and involves more than a few inches of skin, or if it produces blisters on the skin, call the pediatrician.

Vomiting: If your child vomits once or twice without other symptoms, you can manage this at home. If vomiting persists, is accompanied by abdominal pain that doesn't improve after vomiting, or if your child is dehydrated or has fever, diarrhea or headache, call the doctor. If the vomit is green or red or looks like coffee grounds, call immediately.

Diarrhea: Brief cases of diarrhea can be handled at home. Call the doctor if your child has frequent diarrhea for more than a day or two, shows signs of dehydration, or if the diarrhea contains blood or is accompanied by severe abdominal pain or high fever.

Dehydration: Try to replenish fluids if your child has vomiting, diarrhea or fever. Call your doctor immediately if you see signs of dehydration. These include dry mouth or lips, no tears, dry diapers or no urination for six hours, decreased activity or energy, and a sunken soft spot in the head (in an infant).

Fever: Call your doctor for a rectal temperature greater than 100 degrees F with an infant younger than 3 months, or greater than 101 degrees F with an older infant. Also call about a child who has any fever and appears ill, has a stiff neck, new rash, or is not eating or playing.

Colds: Treat colds at home with rest and fluids. Call your doctor if a cold makes it difficult for your baby to breathe or eat. In older children, call if an earache develops, congestion lasts more than two weeks, or symptoms worsen after three to five days.

You know your child better than anyone. If your gut tells you something is wrong, make the call.

Dr. Komaroff is a physician and professor at Harvard Medical School. Go to his website to send questions and get additional information: AskDoctorK.com.

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