Sick baby? When to call the doctor

It's sometimes hard to know when to take your baby to the doctor. These guidelines will help you decide.

Your baby can't tell you when something hurts. Sometimes normal fussiness and mild illnesses are tough to distinguish from more serious problems. Here's when to call the doctor — and when to seek emergency care.
Making the call

Occasional illnesses are usually nothing to worry about. But if you're concerned about your baby's crying or your baby isn't eating, sleeping or behaving like usual, a call to the doctor may be in order. Be on the lookout for specific signs and symptoms:

* Changes in appetite. If your baby refuses several feedings or eats poorly, contact your baby's doctor.
* Changes in mood. If your baby is lethargic or unusually difficult to rouse, tell the doctor right away. Also let the doctor know if your baby is persistently irritable or has inconsolable crying jags.
* Changes in skin color. If your baby's skin becomes yellowish or you notice a bluish color around your baby's lips or nails, contact the doctor right away.
* Tender navel or penis. Contact the doctor if your baby's umbilical area or penis suddenly becomes red or starts to ooze or bleed.
* Fever. Mild fevers are common and usually harmless, but it's important to keep an eye on the thermometer. Contact the doctor if your baby is younger than age 2 months and has a rectal temperature of 100.4 F or higher or if your older infant has an oral or ear temperature of 102 F or higher.
* Diarrhea. Breast-fed babies typically have soft stools. Contact the doctor if your baby's stools are especially loose or watery for six to eight diaper changes.
* Vomiting. Occasional spitting up is normal. Contact the doctor if your baby begins to spit up a large portion of every feeding or vomit forcefully after feedings.
* Dehydration. Contact the doctor if your baby doesn't wet a diaper for six hours or longer or if the soft spot on top of your baby's head seems to sink. Crying without tears also warrants a prompt call to the doctor.
* Constipation. If your baby suddenly cries during a bowel movement, passes bloody or jelly-like stools, or has fewer bowel movements than usual for a few days, contact the doctor.
* Upper respiratory infections. Contact the doctor if your baby has a cold that interferes with breathing or feeding, or if the cold is accompanied by severe coughing or discolored phlegm.
* Ear pain. Contact the doctor if your baby pulls at one or both ears, fails to respond to loud sounds, or has drainage from one or both ears.
* Rash. Contact the doctor if a diaper rash or patch of eczema becomes red and raw, or if your baby suddenly develops an unexplained rash — especially if the rash is accompanied by a fever.
* Eye discharge. If one or both eyes are pink, red, swollen or leaking sticky fluid, contact the doctor.
* Minor injuries. As your baby gains mobility, he or she will become more accident-prone. If you're unsure how to treat a minor cut, bruise or burn, call the doctor for advice.

Above all, trust your instincts. If you think you should call the doctor, go ahead.
In case of emergency

Sometimes there isn't time to call your baby's doctor. Seek emergency care for:

* Bleeding that can't be stopped
* Poisoning
* Seizures
* Trouble breathing
* High fever
* Head injuries
* Sudden lethargy or inability to move
* Choking
* Unresponsiveness

Be prepared to answer questions

Whether you contact your baby's doctor or seek emergency care, be prepared to help the medical staff understand what's happening with your baby. Expect questions about:

* Your baby's symptoms. Why did you decide to seek medical attention now?
* Your baby's medical history. Does your baby have any known allergies? Are your baby's immunizations current? Does your baby have any chronic conditions? Has your baby been exposed to illness at home or elsewhere? Has your baby been injured?
* Changes in your baby's feeding and bowel movements. Have you noticed changes in your baby's eating or drinking patterns, in the number of wet diapers, or in the number and consistency of bowel movements?
* Changes in your baby's temperament. Has your baby ever acted like this before? What concerns do you have about your baby's behavior?
* Changes in your baby's temperature. Does your baby have a fever? What is your baby's temperature? How did you take your baby's temperature?
* Home remedies and medications. Have you tried any home remedies or given your baby any over-the-counter or prescription medications? If so, what, how much and when?

Knowing the answers to these important questions will save you and your baby's doctor time — and stress — during an office visit or emergency situation.