Times Herald-Record: When should you call your baby’s doctor?

When should you call your baby’s doctor?

By Beth Kalet
For the Times Herald-Record

Posted Mar. 16, 2015 at 11:17 AM

When it comes to babies, sometimes a cry is a call for cuddling, and sometimes it’s much more serious. It isn’t always easy to know what those more urgent cries mean. Wouldn’t it be nice if babies could simply describe their symptoms to parents and pediatricians? It would make diagnosis a whole lot easier.

Because babies and children don’t have the vocabulary to detail their symptoms, pediatricians need to help parents recognize when it’s imperative to visit the doctor.

“There are some things that are red flags that I want parents to call me about,” says Dr. Jeff Horowitz, a pediatrician in Warwick for 30 years. He’s part of the Herbert Kania Pediatric Group, which is part of Children’s and Women’s Physicians of Westchester, with offices in West Milford, N.J., too.

Horowitz listed four major situations where “I absolutely want to be called.”

1. Fever. If a baby under 2 months old has a rectal temperature above 100.3, this is cause for concern. “That is something I want to be called about right away,” Horowitz says. “Babies don’t localize infections very well, and they don’t tell us what’s wrong, so when they have fever it could be something trivial like the start of a cold or it could be something serious like sepsis.”

2. Vomiting. Of course all babies spit up, Horowitz acknowledges. But vomiting is a more serious situation. If a baby vomits a full feeding twice in a row, “doctors need to be notified.”

3. Respiratory difficulty. “Clearly any child with respiratory difficulty, who is breathing fast, breathing hard, where you can see their rib muscles going in and out” is in distress. Don’t wait and to see if it will pass. Contact the pediatrician.

4. Irritability. “This is different from fussiness,” explains Horowitz. “There are fussy baby cries and whines and complaints and then you pick them up and they stop. A baby who’s irritable no matter what and doesn’t stop” falls into a different category. Bring the baby in for a consultation. While the cause may not be directly evident, it’s the physician’s job to try to find out the reason behind the symptom.

“The thing with kids,” Horowitz says, “is all of the these symptoms are non-specific and can be the sign of serious illness.” By heeding these guidelines, parents can help pediatricians to discover what’s behind the complaints — “to help us differentiate a kid who’s not feeling well from a kid who’s really got something bad.”

“We worry about congenital anomalies, for example babies with obstructions; we worry about infectious diseases, about babies with metabolic conditions, where they don’t digest food properly,” Horowitz explained. “Those are the biggies.”

Keeping kids safe and healthy

Above and beyond being on the lookout for these symptoms, Horowitz says there’s an overriding everyday parental mandate: “It’s not so much recognizing when they (children) are sick, but keeping them healthy and keeping them safe.”

“The biggest cause of mortality with kids,” stressed Horowitz, “is accidents: household accidents and car accidents.”

Ensuring a child’s safety and health are the most important jobs for parents and caregivers. Here are Horowitz’s top tips for keeping baby safe and strong.

Car seats. Make sure car seats are properly installed and being used correctly.

Sudden Infant Death Syndrome. For newborns, preventing SIDS (Sudden Infant Death Syndrome) is a parent’s first priority. Current research dictates that babies should sleep on their backs. “The newborn environment, the crib, should be a very stark environment with just a mattress and a sheet. No bumpers, no blankets, no stuffed animals. Nothing soft that babies’ noses could get into.” The suspected process that leads to SIDS, Horowitz says, “is rebreathing your own air.”

Vaccines. “Make sure you give your kids the vaccines. For vaccine-hesitant people, we try to allay their fears with data. They really are safe.”

Baby proof your home. Keep medicines and poisons locked. Install gates by stairs. Set hot water temperature below 120 degrees F.

Pool safety. Keep swimming pools fenced and locked.

Encourage a healthy lifestyle. Horowitz urges parents to follow the “5-2-1-0 plan.” “Five fruits and vegetables per day. Not more than two hours of screen time during the day. At least one hour of exercise every day and zero soda.” That’s a lifestyle choice that benefits children throughout their lives, he adds.