Most parents have stood by a sick child’s bed in the middle of the night, wondering whether or not to call the doctor.
While the list of illnesses that can afflict a child is lengthy, reasons for seeking medical attention in the middle of the night are few. They also make good sense.
Fever fits or seizures
A small percentage of sick children with fever will suffer from seizures. Febrile seizures are not the result of, especially high fever. Doctors say febrile seizures are harmless in themselves, but they scare parents witless.
Get the child on the floor so she will not fall off the bed. Roll her on her side so she will not choke. Clear the immediate area of anything that might injure her, and call the pediatrician. Try not to leave her alone. Times like this are when cordless phones are worth their weight in gold.
Don’t give a child with seizures any medicine unless the pediatrician tells you too. The doctor will want to see the child right away, mostly to check for injuries and see what’s causing the fever. Be prepared for tests to rule out serious ailments such as spinal meningitis.
Children from birth to 48 months typically need to see their doctor for any temperature, but not necessarily at midnight.
Call your doctor any time of night if a baby up to 6 months is quite feverish, weak, vomiting a lot, suffers frequent diarrhea, is listless or hard to wake, suffers pain (especially in the abdomen), or shows blood in their vomit or stool.
Older children’s normal temperatures and “normal” fevers vary. Call the doctor if you feel the sick child’s fever is very high and it will not respond to medication. Allow 45 minutes after giving medicine to determine if the fever is responding. Your doctor will want to know how long the child has been feverish, what the temperatures were, and are, what you have given the child, and if the fever responded.
You should have already worked out with your pediatrician what and how much medicine to give your child, depending on the child’s age, weight, and medical history. Most doctors strongly oppose giving children aspirin, since it can cause Reyes syndrome, a serious and potentially lethal turn of events.
Even a moderate fever can produce dangerous conditions in a child, notably dehydration. Signs of dehydration include few or no tears when the child cries, prolonged absence of urination, dry mouth, lips and skin, and lethargy. Lethargy under any circumstances warrants a call right away.
Give a feverish child lots of fluids.
Most children will at one time or another wake from a sound sleep and throw up on the bed. They may throw up frequently over the next few hours. Help the sick child rinse her mouth, but don’t give liquids or foods until the vomiting has stopped – say, after an hour without vomiting.
Vomiting that lasts four hours needs attention. So, if your child throws up after supper and continues to throw up until 10 p.m., call your doctor.
Don’t wait if the child is lethargic, appears dehydrated, or is in pain.
Call immediately if the vomit shows blood or bile. Blood can be red, meaning it is fresh, or black, meaning it is old. Black or green material in the vomit can be bile, which means the child may have a serious obstruction. Green can also be candy or salad, but call anyway.
When a child does quit vomiting, give some water. If she keeps it down, continue to give fluids, eventually adding some easy-to-digest foods such as soda crackers or dry toast. Avoid over-the-counter stomach remedies unless directed by a doctor.
Frequent diarrhea demands lots of fluids since the first serious effect can be dehydration. It’s best not to offer boiled milk or other so-called remedies. Don’t give any diarrhea medicines unless your doctor tells you to.
If frequent diarrhea persists, check for signs of dehydration, no matter how much fluid the sick child is drinking. Strong, persistent thirst can be a sign of dehydration.
Call the doctor if frequent diarrhea persists. Call right away if the diarrhea is bloody, or if the child has pain.
A chest cold lasts a week or 10 days. If a cold produces a strange cough that some liken to a seal barking, it could be croup. Croup is not dangerous in and of itself, but warrants a call to the doctor, especially if you have never witnessed such a thing.
Difficult breathing and croupy coughs can be alleviated somewhat by moist air from a humidifier or in a steamy bathroom. Don’t leave the child alone in the bathroom. The doctor may also suggest fresh night air in season.
If a child with breathing difficulty grows pale, or if the lips lose color and the child feels cold, call right away. Again, be aware of listlessness and lethargy. A chest cold can trigger asthma in some children.
Anyone young or old who cannot seem to get enough breath needs medical attention right away.
Pain, injury, bleeding
Any serious injury needs to be attended to right away. Any strong bleeding or serious pain also warrants an immediate call.
A blow to the head needs careful watching. Danger signals might not appear for a few minutes, or an hour. Look for bad color. In lighter complexions, look for a yellowing, or distinct paleness. In darker complexions, you may notice graying. Look for persistent sleepiness, listlessness, lethargy. Babies who have been crying nonstop may stop crying and grow quite dopey. Call the doctor instantly, if you haven’t already.
Pain is tricky. A child may respond energetically to pain that an adult would suffer through. On the other hand, a sick child might not mention pain, thinking it part-and-parcel of just being sick. Always ask about pain.
If your child is definitely in pain, don’t be afraid to call the doctor or go to the emergency room. It may turn out to be nothing, but you do not want to take a chance.
The bottom line is this: If you are quite worried or frightened, call your pediatrician right away. If the pediatrician scolds you or later treats you badly for your call, seek a new doctor.The bottom line is this