Kid Decisions: Call the Docto... Health Article

Knowing when to call the doctor and when to home-treat a sick child is a common parental concern. Though you can home-treat many childhood illnesses, such as colds and simple stomachaches, having guidelines to tell you when symptoms are serious enough to warrant medical attention is important.

"You know your child better than anyone does, so you're the best judge of determining when something is wrong," says Elaine St. James, author of a series of books, including "Simplify Your Life With Kids." "Basically, you should call the doctor whenever you have a question about your child's health -- your concern is sufficient reason to phone."

Childhood symptoms

Call the doctor if your child has the following serious symptoms or conditions:

• Earache. A child who can talk will tell you if his or her ears hurt. "Babies, who can't tell you what hurts, may pull at their ears or be irritable if they have an ear infection," Ms. St. James says. "The child may also have trouble sleeping because when children are lying down, the fluid in their ears doesn't drain as easily and the resulting pressure can cause extreme pain."

• Strep throat. If your child has any indications of strep -- a very sore throat, high fever, pus (white spots) on tonsils or tender lymph nodes (lymph nodes in the neck ) -- take the child to the doctor for a throat culture. Untreated strep can lead to rheumatic fever, acute glomerulonephritis or rarely, meningitis.

• Eye problems. Any child with eye pain or a sudden change in vision should see a doctor. Children who contract conjunctivitis (pink eye) -- a condition that causes the whites of the eyes to become bloodshot and pus to form in tear ducts -- also should see a doctor.

• Abdominal pain. A child who has severe pain in the abdomen, a rigid abdomen, an abdomen that is tender when the parent pushes on it, walks bent over, lies on the bed with his hips and knees flexed to relieve pain or who complains of abdominal pain and looks really sick should be seen by a doctor. Simple upset stomachs can be home-treated by feeding the child liquids and a bland, low-fat diet until the discomfort goes away.

• Severe vomiting and diarrhea. There's a danger of dehydration if a child has been repeatedly vomiting or has very loose and frequent bowel movements, especially with infants and young children. Your child needs medical attention if you notice any of these signs of dehydration: decreased urination, an absence of tears, sunken eyes or a very dry mouth and skin.

• Serious physical distress. Take your child to the doctor or emergency room if he or she has difficulty breathing or any acute pain that doesn't go away.

• High fever. Take your child to the doctor if he or she is less than 3 months old and has a rectal temperature of 100.2 degrees or higher, is between 3 and 6 months and has a rectal or armpit temperature of 101 degrees or higher; or is older than 6 months and has a rectal, armpit or oral temperature of 103 degrees or higher. Any child with a fever, regardless of how high, who looks really sick (toxic) should be seen by a physician as quickly as possible. You can home-treat low-grade fevers with children's acetaminophen or ibuprofen.

• Severe headache. Severe headaches, especially if accompanied by stiffness in the neck or a sensitivity to light, may be symptoms of meningitis and require immediate medical attention.

• Skin rashes. You can home-treat heat rashes or mild rashes caused by contact with an irritating substance (such as poison ivy).

• Any unusual symptoms that last for more than four days. "Any child who has a headache, stomachache, mild fever or other symptom that doesn't respond to home-care after four days should be taken to a doctor," Ms. St. James says.