Common Pediatric Problems

When to call the doctor?

A parents dilemma. Decisions, decisions. Worry in the night. Frustration because my child is so little and can’t tell me what’s wrong. Is this something simple or something serious? Taking a guess, explaining it away, hoping that if I wait, it will go away, these are natural reactions, but none of us would want to place our child at risk. Most doctors, when asked, will reply that they would rather hear from you no matter the time of day or night than have you take a chance….so pick up the phone and call the pediatrician if you think your baby is sick.

Here’s how you can help us help you:

We can be effective partners, and we can help you to handle a feverish infant, a vomiting toddler, a child in pain. Participating in the evaluation and handling of your child’s illness will give you confidence and assurance.

What’s the problem?

Here are a few sample questions your doctor will probably want to ask, so gather some of this information before you pick up the phone.

  • How long has he been ill?
  • When did symptoms first appear?
  • Does she have a fever?
  • How high?
  • Is the baby having trouble breathing? – you can check respirations by counting how many times in a minute his or her chest rises and falls.
  • Is the child coughing?
  • Does he have a runny nose or is he congested? Is it a barky or a crowing cough?
  • Has the baby refused to eat? Is her tummy hard or bloated?
  • How many times has the child vomited or had diarrhea in the past 24 hours?
  • Is this baby sleeping more than usual, or is he difficult to arouse?
  • Has there been a recent injury, or has she been recently exposed to contagious illness?
  • Does the child have a chronic medical problem we need to be reminded about, when we don’t have your chart with us after hours?
  • What medicines have you given? Allergies to medications?
  • Does the baby just not seem “right” to you?

What to do when your child has a cold?

A cold is a viral infection that causes inflammation of the linings of the upper respiratory tract, including the nose, the sinuses, and the throat. The inflammation produces swelling and increases the rate of mucus formation leading to congestion and stuffiness. At last count over l00 different viruses have been isolated and implicated as causing the common cold, or what we call and upper respiratory infection.


  • A cold is self-limiting, usually lasting about one to two weeks.
  • A cold is spread via droplet spray and by direct contact; coughing, sneezing, kissing, and touching.
  • In older children, the cold symptoms may last 5 – 7 days, preschoolers usually take a week to 10 days and infants may not clear up for up to two weeks.
  • May be accompanied by low grade temperature of 100 degrees to 102 degrees F. orally which may last for 2 – 3 days. As long as the temperature responds to treatment, the other symptoms are not as worrisome so long as there is no overall worsening of the patient’s general condition.


Acetaminophen (Tylenol) for children and infants for temperature elevation and to relieve aches and pains. When mucus drainage is copious, decongestants may be used to help dry up mucus membranes. Saline nose drops (Ocean Spray), Pediacare Infant Drops for infants, or Dimetapp and Triaminic for toddlers and older children are helpful. Rest and fluids, also humidification of room with mist may help. Do not give babies 3 months of age or younger any medication not prescribed for him by a doctor, not even an over- the-counter drug.

Call your doctor:

If your child is less than 3 months old, if cold symptoms persist more than 10 days, or any of the above symptoms intensify. Ear pain, drainage, productive cough,, behavior changes, persistent high fever, rapid, noisy, and difficult breathing, swollen glands in the neck, severe or continuous cough that keeps the child awake at night.

It’s perfectly normal for your child to pick up several colds each year. You can handle most colds at home without seeing a physician. If, however, you suspect that your youngster may be suffering from more than a simple cold, always check with your pediatrician.

How to deal with fevers?

Fever is a normal response to infection, but it is only one sign of illness and the general condition of the child is in many ways more important. A fever may cause your child to appear more ill than she is – so we try to lower the temperature in order to make the child more comfortable and define symptoms more objectively…

  • Use a thermometer to take the temperature orally or rectally.
  • Give Tylenol or Acetaminophen every 4 hours until the temperature is under 101 degrees F.
  • Place child in a lukewarm bath for 20 minutes. (Do not sponge with cold water or alcohol).
  • Give the child extra fluids: popsicles, juice, soda, Gatorade.
  • Retake the temperature after the above – this step is important to us, to be able to communicate accurately with you when you call us for fever.
  • Call us for persistent high fever or if your child is under 3 months of age. Call us if your child has other symptoms in addition to the fever which concerns you.

What to do about breathing problems?

After your child has been seen for a respiratory illness, it is important to follow the recommendations of your physician or nurse practitioner. Please notify them right away if it is not possible to do so.

Signs of worsening = Need to call the doctor

  • Rapid, shallow breathing or panting, grunting.
  • 60 breaths per minute (in + out = l breath)
  • Child is short of breath, or coughs non-stop.
  • Belly and/or chest rising and falling quickly, or skin is tugging between the ribs with every breath.
  • Treatments “don’t last” until the next one is due in four hours.
  • Peak Flow Meter level is decreasing.

Call 911 or go to the emergency room:

  • If child looks confused
  • If child looks blue
  • If child is limp.


Medical advice on the Internet is not a substitute for good medical care and advice provided by your doctor. Please call Sarasota Children’s Clinic if you think your child is in need of medical care.