When to call the Doctor

Infants and young children in particular are not just small adults. The problems listed are either more common in children under 3 years, or they can be more serious than in an older child.

Infants under age 3 months

There will probably be times when you have questions or concerns. Below are specific examples of circumstances when you should call right away:

your baby has a fever (rectal temperature of 100.4°F or higher);
s/he has fed poorly (say, less then half of usual) two or more consecutive feedings;
there is a marked change in your baby’s behavior lasting more than a few hours;
your baby has a new cough that lasts more than a day or two and his/her sleep or feeding isn’t normal;
your baby has held his/her breath for more than 10 seconds, not associated with a spit up or vomit;
there is blood in the diaper (except if the baby recently had a hard stool you can wait till the daytime to call, and a little blood from the vagina of a girl in the first week or so of life is normal);
there is a lump in the groin, about where the crease is at the top of the leg, and it seems tender (if it’s not tender, please call non-urgently, during the day);
one side of the scrotum is both swollen and tender or discolored compared to normal.

Babies from 3 months to 1 year

After your baby turns 3 months old, we are more confident with his or her ability to fight infections, especially if s/he has received the usual vaccinations on time. So, illness doesn’t require urgent evaluation as often as in younger infants.

Please call if your baby:

has had a fever (temperature of 100.4°F or more) for 2 days or longer, without cold symptoms or diarrhea;
has a cough that interferes with eating or sleeping (call during the day unless very concerned);
develops difficulty sleeping, especially a lot of crying overnight, after a few days of cold symptoms (call in the morning unless you can't settle him/her with pain medicine);
has had repeated vomiting or diarrhea, or both, and you have questions or concerns about fluids, diet or dehydration;
has poor feeding so that the baby is not urinating at least every 4–6 hours (a tissue in the diaper can help prove small urinations);
has had twitching and seemed to be unconscious (not able to see you or respond), esp. if s/he has a fever;
has held his/her breath for more than 10 seconds, not associated with a spit up or vomit;
there is blood in the diaper (except if the baby recently had a hard stool you can wait till the daytime to call);
there is a lump in the groin, about where the crease is at the top of the leg, and it seems tender (if it’s not tender, please call non-urgently, during the day);
one side of the scrotum is both swollen and tender or discolored compared to normal;

Children from 1 to 3 years

After one year, if your child has received the usual vaccinations, a serious infection is uncommon. Accidents become more common. The following list provides examples, and is not complete.

Please call if your child:

is acting unwell and has had a fever (temperature of 100.4°F or more) for 2 days or longer, without cold symptoms or diarrhea;
develops difficulty sleeping, especially a lot of crying overnight, after a few days of cold symptoms (call in the morning unless you can’t settle him/her with pain medicine);
has a cough that interferes with eating or sleeping (call during the day unless very concerned, or you suspect asthma, or severe croup);
has had repeated vomiting or diarrhea, or both, and you have questions or concerns about fluids, diet or dehydration;
is drinking so poorly that s/he is not urinating at least every 6–8 hours (a tissue in the diaper can help prove small urinations);
has had twitching and seemed to be unconscious (not able to see you or respond), esp. if s/he has a fever;
has had a head injury and after the first few minutes or so has vomited, or is acting lethargic and confused despite ibuprofen;
has a cut that seems deep or long and may need stitches;
you suspect your child has taken a medicine overdose, alcohol or a poison;
won’t walk or use an arm or hand and you suspect a broken bone or dislocation;
there is a lump in the groin, about where the crease is at the top of the leg, and it seems tender.