"Should I call the doctor?" It's a question many parents, grandparents and caretakers wrestle with when children get sick. On the one hand, you don't want to overreact and lug a sick child to the doctor's office where they can be exposed to germs lingering in the waiting room. But on the other hand, you don't want to miss something and have your child's fever, cough or dehydration turn into a bigger problem.

Pharmacists field a lot of questions from parents who are worried about calling their pediatrician too frequently, or concerned about making unnecessary doctor appointments where they could expose their children to even more viruses and bacteria in waiting rooms. Parents should always feel comfortable calling their child's pediatrician, but paying attention to key symptoms and knowing some basic guidelines can really empower their decisions on when to contact their physician.

Consider these tips for managing common childhood ailments and deciding when you should "make the call" to the doctor.

Fever
Many parents have fever phobia and race their children to the doctor anytime temperatures spike above normal, but not all fevers require treatment. Keep in mind that fever is the body's way of fighting infection.¹ While it can be scary when your child has a fever, most viral infections that cause fever, such as cold and flu, typically go away in a few days. If your child's fever persists beyond 2-3 days, it could indicate a more serious issue and you should bring them in to see the doctor.

When dealing with a fever at home, apply cool compresses to your child's forehead. Never put them in a cold bath because that can actually cause your child to shiver, which can lead to an increase in body temperature. Instead, give your child a lukewarm bath. And be sure to give plenty of fluids to avoid dehydration - water, fruit or vegetable juice, and broths are all good options to help keep your little one hydrated.

Never give aspirin to children as it may increase the risk of Reye's syndrome, a rare disorder that can cause brain and liver damage.² If your child is uncomfortable and it's necessary for comfort, you can consider giving acetaminophen or ibuprofen. Be sure to check with your doctor or pharmacist about the right dose for your child's age and weight.

While a fever is not cause for immediate concern, you should call your doctor right away if your child's temperature rises above 103 degrees, and any child under the age of three months with a temperature of 100.4 degrees or higher should see a doctor.³ You should also monitor the duration of a fever and keep track of other symptoms your child is experiencing. If your child's fever lasts longer than 2-3 days or is accompanied by neck or ear pain, vomiting, diarrhea, seizures, or if your child is unusually drowsy, it's time to see the doctor.

Vomiting and diarrhea
Much like fever, diarrhea and vomiting are often signs that your child's body is fighting a bug.⁴ During a bout of vomiting or diarrhea, the child's body is trying to flush out and eliminate the foreign invader. While it can be unpleasant for both the child and the parents, in most cases, symptoms of diarrhea and vomiting will resolve with some simple, at-home treatments.

With both vomiting and diarrhea, preventing dehydration is key.⁵ Avoid sugary drinks like juice and soft drinks. For children who are vomiting, encourage them to drink fluids once the vomiting has stopped and eat a bland diet: crackers, toast, white rice, and bananas.

Diarrhea, especially, can be frustrating for parents. There aren't many diarrhea relief products that are safe for young children, but there is a nutritional, solution-oriented option that is effective called DiaResQ, which is safe for children as young as one. It is not a drug or antibiotic, but a Food for Special Dietary Use that contains naturally derived ingredients, bovine colostrum and egg solids, providing a high-quality source of important nutrients and immune factors that work with the body to help rapidly restore normal intestinal function and relieve diarrhea. Clinical trials have shown DiaResQ resolves most cases of diarrhea in children on the first day of use.

Call your doctor if your child's symptoms are severe, if there is blood in the vomit or stool, if they are experiencing a high fever or if the symptoms persist longer than 24 hours.⁶

Coughs, Colds and Respiratory Problems:
Children typically experience multiple cold episodes each year and one of the most annoying symptoms that accompanies a cold is a cough. Again, coughing is the body's natural way of dealing with a bug - the body is trying to expel the unwanted invader.

For children with minor cough and cold symptoms, there are some remedies in the pharmacy that can provide relief. Echinacea and elderberry can help lessen symptoms and speed healing. Honey is helpful in providing relief for cough and sore throat but should not be given to children less than one year of age.⁷ You can also run a vaporizer in your child's room and offer saline nasal drops to help with congestion. Encourage your child to drink plenty of fluids: warm broth and herbal teas are good options.

Call your doctor if your child has ear or neck pain, trouble breathing, or symptoms that last longer than 7-10 days. If your child is three months or younger seek medical attention right away for cold symptoms, since colds can quickly turn into something more serious, like bronchiolitis, croup or pneumonia. When visiting the doctor and discussing potential treatments, keep in mind that antibiotics cannot help a virus. When antibiotics are used unnecessarily this can contribute to bacterial resistance, which can cause the antibiotics not to work when your child actually needs them.⁸

Over-the-counter cold and cough medications can also cause serious side effects in children. Talk with your child's doctor before giving any medications.

Rash
Children tend to experience frequent rashes as they are constantly exploring. A rash can arise from contact with a new food, detergent, soap, or any other irritant in their environment.

Most rashes are harmless and clear up on their own. Wash the rash with mild soap, but don't scrub it, then rinse with warm water. Do not cover the rash, but you can put a wet cloth on it to ease the pain and itching. Use a cream that contains zinc, vitamin E, almond or coconut oil, which work to soothe, protect and recondition the child's skin. Avoid products that contain phthalates, parabens, and sodium laurel sulfate.

Call the doctor if your child is younger than six months with a rash, has a fever along with the rash, or has a rash that oozes or appears red, swollen, or wet, which could be signs of an infection.⁹

While having a sick child can be stressful, these tips can help your little one feel better faster and help you determine whether you should head to the doctor or handle it at home.

References:

1. "How a fever helps the immune system to battle infection". Nature Immunology. January 2019.
2. Schor, K. Aspirin and Reye syndrome: a review of the evidence. Pediatric Drugs. 2007;9(3):195-204.
3. "Fever: When to call the doctor". Cleveland Clinic. January 2019.
4. Vomiting and diarrhea in children. Am Fam Physician. 2001 Feb 15;63(4):775-776.
5. DeWitt, TG. Acute diarrhea in children. Pediatric Review. 1989 Jul;11(1):6-13.
6. "Diarrhea - When to see a doctor". Mayo Clinic. April 2019.
7. "Honey: An effective Cough Strategy?" Mayo Clinic. May 2018.
8. "Be Antibiotics Aware: Smart Use, Best Care". CDC. November 2018.
9. "How to spot and take care of your baby's rash". Healthline. January 2019.