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FAQ: how do I know if my child is really sick?

Posted by Dr. Claire McCarthy  December 6, 2013 08:03 AM

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It's a question all parents ask themselves at some point as they hold a sick child: is my child really sick? Not just kind of sick, but dangerously sick?

Kids get sick all the time. In an average winter, for example, an average kid might get six or more colds--and at least a couple of them could be bad ones. Illnesses are especially common among young children in daycare or school--as much as we try to wipe noses and clean shared toys, germs have a way of spreading. If one kid starts coughing or vomiting, chances are more will too in a few days.

Luckily, with some rest, fluids and TLC most kids weather illnesses just fine. It's rare that they get very sick--but it's important that parents be able to recognize it when it happens. Here are seven signs that parents should watch for:
  • Any trouble breathing. By this I don't mean a really stuffy nose, or a cough that comes and goes. I mean a really frequent cough, or fast breathing, or sucking in around the ribs, or difficulty talking (or crying, in an infant), or looking pale.  
  • Lethargy. We docs get worried if a child is excessively sleepy or weak--not just taking long naps, but hard to wake, hard to get to move or do anything. We also worry if they seem confused, or have trouble doing normal stuff like walking or using their arms and hands.
  • Bad pain that doesn't get better. Babies and toddlers might show this by being inconsolable. If cuddling and some acetaminophen or ibuprofen don't make a difference, that worries us docs.
  • Vomiting everything. If kids can't keep anything down (especially if there is diarrhea as well), it can lead to...
  • Dehydration. You can tell a child is dehydrated if they are urinating much less, have a dry mouth or no tears when they cry. 
  • A high fever (102 or more) that won't go down with medication. For any baby less than three months old, we worry about any fever 100.4 or higher, whether or not it goes down, and some children with medical problems might need to see a doctor for a lower temperature than 102 (check with your doctor). But in general, it's the persistent high fevers, the ones that either stay high or keep coming back that worry us. 
  • Any rash that looks like a bruise. If the spots are dark red or purple, no matter what the size, that warrants a call to the doctor. 
These are all signs of a serious illness--or serious complications of a minor illness. Call your doctor if they happen; if you can't reach someone quickly, go to an emergency room. 

If something your child does--or doesn't do--really worries you, even if it's not on this list, call. Over the years, I've really come to respect a parent's instincts. We doctors are always here to help, but parents know their children best.

Is there something you'd like me to write about? Leave me a message on my Facebook page--and "like" the page for links to all my MD Mama blogs as well as my blogs on Thriving and Huffington Post. 

This blog is not written or edited by or the Boston Globe.
The author is solely responsible for the content.

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About MD Mama

Claire McCarthy, M.D., is a pediatrician and Medical Communications Editor at Boston Children's Hospital . An assistant professor of pediatrics at Harvard Medical School and a senior editor for Harvard More »

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