By Robin Stevenson
From the print edition, October 2012
Parents just seem to know when their child is unwell, yet we often fret that we are overreacting and debate whether the issue is serious enough to warrant a trip to the doctor. Larry Pancer, MD, a pediatrician in Markham, Ont., and a spokesperson for the Canadian Paediatric Society, says the first instinct is often the correct one. “If your Spidey senses are tingling, trust them. If a mom says her child is off, I take it very seriously.” With that said, we asked Dr. Pancer and Michael Peer, MD, a pediatrician at Toronto’s The Hospital for Sick Children, which symptoms are definite red flags.
Symptom #1: Unresponsiveness when sick
Children usually experience periods of fussiness or irritability when they are ill. That’s normal. But a child who is lethargic, limp and unresponsive when unwell is not normal, says Dr. Peer. “If he looks just completely dazed and is not making good eye contact, those can be signs that he has a serious bacterial or viral infection.”
Symptom #2: A fever of 100.4ºF (38ºC) or higher in a baby under three months of age (taken rectally)
A fever is a sign that the body is fighting an infection, which is why doctors stress that how your child looks and acts is a better indication of how she is feeling than the reading on the thermometer. However, any fever in a newborn is considered significant and requires immediate medical attention, says Dr. Pancer.
Symptom #3: Loss of consciousness after a head injury
With any concussion, there is a fast but brief impairment of neurological functions. Your child may experience headache, nausea or dizziness. However, if he suffers any loss of consciousness, experiences repeated vomiting, a persistent headache, visual symptoms (blurred or double vision); or has trouble speaking or walking after a blow to the head, he should see a doctor immediately, says Dr. Pancer.
Symptom #4: Laboured breathing
“Any child who has laboured breathing should not wait to receive medical attention,” says Dr. Peer. In fact, he adds, “If you show up at any emergency room with a child who has trouble breathing, you won’t be put in the waiting room—you should go right to the front of the line. ”Signs your child may be struggling include discolouration around the mouth, rapid or heavy breathing, or a wheezing or whistling sound when breathing. Asthma, pneumonia, whooping cough, allergic reaction or even choking may cause acute breathing issues.
Symptom #5: Decreased urination, no tears when crying, dry mouth, low energy, very sunken eyes, sunken fontanel (soft spot on an infant’s head)
A loss of body fluids is not uncommon during an illness, but moderate or severe dehydration in children, especially babies and toddlers, can be life threatening and requires medical treatment. But it can be tricky to identify, says Dr. Peer. “Children require a relatively higher fluid intake for body weight compared to adults. Anything that impedes the ability to take in fluids, like vomiting, or retain fluids, like diarrhea, puts them at risk of dehydration.”
Symptom #6: Swollen tongue, lips and eyes, garbled speech, shortness of breath
“These symptoms are signs of anaphylaxis, a life threatening allergic reaction,” says Dr. Pancer. Anaphylaxis is an emergency and parents should administer epinephrine (if available) and call 911.