A Pediatrician Says: When To See Your Doctor With A Sick Child

Did you ever wonder why children get sick so often, and adults don’t? Simple answer: Children are born with little or no immunity against disease. Immunity is the ability of the body to defend itself against disease-causing germs like bacteria and viruses.

Immunity develops as a child is exposed to germs that surround us in people who are sick or coming down with an illness. Each illness produces immunity against only the particular germ or germ family that caused the illness. So, immunity builds, one illness at a time throughout childhood. It takes a whole childhood to develop immunity against most of the common illnesses in a community. But, by the time adult life is reached, protection against most disease is in place, and adults don’t get sick as often as children do.

What we have to understand, as parents, is that illnesses in children are unavoidable, and, though worrisome, are actually useful in providing immunity to the child. In many instances, illnesses are less serious in a child than in an adult. So, my philosophy is that illnesses are to be accepted with some equanimity.

When is it worth seeing your pediatrician for an illness?

Doctors differ to some degree on this. Follow your own doctor’s advice. The rules I have followed with my own patients are listed below:

Fever with no obvious symptoms — probably safest to have your child examined by your doctor, rather than waiting.

Fever with one of the following danger signs — see your doctor for sure:

• Sore throat — your pediatrician will want to examine your child and do a test for strep germs. Strep can cause rheumatic fever — a heart and joint disease — if not diagnosed and treated.
• Rash — could indicate a more serious illness, especially if your child has a fever and is droopy.
• Stiff neck when neck is bent forward — could indicate meningitis (a serious infection of the spinal fluid).
• Lethargy (droopiness) that seems at all worrisome or of unexpected duration.

With or without fever, I suggest a visit to your pediatrician for any of the following:

• Croup –a husky, hoarse, raspy, bark-like cough that indicates laryngitis in a child. Croup usually increases at night, so call your doctor early, if possible.
• Difficulty breathing, especially if the problem is accompanied by drawing in under or between the ribs, noisy throat or chest breathing, or blueness (cyanosis) of the lips or skin.
• Illnesses in children under age 3 months can progress faster and show fewer signs than in an older child. Therefore, any illness in an infant under three months, including a cold without a fever, should be brought to the attention of your pediatrician without delay.
• Ear pain — should never be ignored. An untreated ear infection can lead to permanent hearing loss.
• Pus in eyes — often indicates an underlying treatable illness which could spread to ears or to other parts of the body.
• Stomach pain can be caused by problems that are not too serious — an intestinal virus or even constipation — but abdominal pain can also mean more serious disease, like intestinal obstruction or appendicitis. So consult with your pediatrician on this one.

Doctor Feinberg’s writings and views are his own and do not necessarily represent the opinions of other physicians or of the facilities with which he is or has been associated. Parents should always consult with their own physician for medical advice and treatment. Copyright Sheldon N. Feinberg MD FAAP.