When Should You Call the Pediatrician

First time parents are particularly prone to calling their baby’s doctor… a lot! Why is the baby crying like this? Is that color poo normal? Should she be able to projectile spit up like that? It’s all new and scary for parents, and even those who are on their second or third child will have moments of fear where the comfort of a second opinion would be most welcome.

It’s completely normal to be nervous about issues and concerns that you’ve never encountered before, and since baby can’t talk and tell you what’s wrong, your instinct is to defer to experts. That’s a good instinct!

What constitutes a serious enough issue to call your pediatrician is a question that many parents wrestle with: they don’t want to end up feeling silly for having called for something normal. Trust us when we say that the doctor has heard it all before! But if you’re concerned about overdoing the calls to the pediatrician, think of your baby’s well being on a scale. As you go through each level, you can make the decision as to whether the issue warrants going up to the next level or not.

Level 1 – Mom or Mother in Law/Friends with babies

Very often, a parent’s first point of referral for areas of concern are people who have been there and probably done that. They can sometimes put an issue into perspective for you and help you decide if the problem is serious enough to warrant going up a level to a more experienced, professional resource.

Level 2 – Your postpartum doula

If you’re not sure that the advice you’ve received is any good, or the people you’ve talked to haven’t experienced exactly what you’re dealing with, and you’re still concerned, it’s time to go up a level, to your postpartum doula.

The level of experience your doula will have had means that they’ve probably seen whatever it is you’re worried about and can either reassure you or encourage you to seek treatment for baby.

Level 3 – Your pediatrician

If you’re still concerned or are prompted to do so by your doula or others, call your pediatrician. As we said before, they’ve seen and heard it all. They know that first time parents, in particular, will worry about the slightest thing and, frankly, they’re probably expecting your call!

Are there times where your FIRST call should be to your pediatrician?

Yes. There are certain situations when you should go straight to the person who can best help your baby. Some of these are situations that can wait until morning and some of these occasions to use the emergency number, or even to call 911.

Call the pediatrician’s office in the morning

• A nagging cough that isn’t preventing the child from sleeping.</li>
• A low grade temperature that has persisted for several days, but the child is still relatively happy.</li>
• A higher fever in a child over 3 months of age that is responding to fever reducing medication and no other symptoms, but that is going on for several days.

Call the emergency number

• Baby refuses to eat for several feedings in a row.
• Vomiting or diarrhea that lasts more than a few hours or seems to be getting worse, or showing signs of dehydration (few wet diapers, dry lips, no tears).
• Rash with fever, low energy and pain at the site of the rash.
• Cuts that may require stitches.
• Fever of 100.4 or more for a child 3 months of age or younger.
• Fever over 101 for child 3 months or older, with other symptoms like vomiting, difficulty waking them, neck pain or stiffness or if fever persists for three days.
• Fever of over 104 at any age.
• Blood in urine, vomit or diarrhea, for older children, if they are having pain while urinating.
• Pain that is worsening (difficult to assess with a baby, so better safe than sorry!), particularly if the stomach is tender to the touch.
• Cough or cold that is not improving after a week, or is worsening, particularly with difficulty breathing (breathing fast, wheezing, with ribs showing when they breathe in) and ear pain (for babies under three months, call at the first sign of a cold as it can get worse quickly).
• Inability to move a limb.

Call 911 if any of the following apply

• Seizures
• Bleeding that won’t stop with pressure applied.
• Possible poisoning – Poison Control number is 1-800-222-1222.
• Not breathing or difficulty breathing with lips/mouth turning blue.
• Head injury with loss of consciousness, vomiting, seizure or the child seems sleepy/difficult to wake.
• Loss of consciousness.
• A serious cut or burn.
• Tenderness on the bottom right of their stomach, vomiting, fever can be signs of appendicitis.

Ultimately, you have to trust your instincts as a parent: if you feel that something warrants a call to your pediatrician, don’t hesitate because of the possibility that it might be nothing and you’ll be a little embarrassed. That’s nothing compared to the health and well being of your child, so do what you feel is best.