As a parent, you can always tell when your child isn’t feeling their best. But how do you know when it is safe to treat your child’s illness at home and when should you contact the doctor? Most importantly, when is it necessary to get to the emergency room? If you have a newborn, infant, or very young child, the additional worry is that your little one can’t use words to describe their symptoms.
Some of the most common symptoms of illness in a child include fever, vomiting, diarrhea, sore throat, cough, headache, stomach pains, skin rashes, fussiness, and fatigue. Having a good understanding of these symptoms and associated illnesses helps us know when to double down on home care and when to pick up the phone and call a pediatrician.
This article outlines the typical symptoms of the most common illnesses in children, and what to watch for when making the decision to see a doctor.
Some pediatricians, such as Metro Pediatrics, offer virtual appointments by video so that the child and parent can review symptoms and possible treatments from the comfort of home. These video visits are only available for certain illnesses and not appropriate in all cases.
At Metro Pediatrics, we’re your partners in caring for your child and want to help you through any illness. Always feel free to contact us with any concerns at 833-PDX-KIDS. We also have a 24/7 nurse advice line where parents can talk through their child’s symptoms and discuss next steps.
Typical Signs and Symptoms of Common Childhood Illness
1. High Fever in a Child
Fever can accompany many childhood illnesses. In a sense, it’s a positive sign that your child’s immune system is working to fight off infection. Some fevers can be managed at home and others require a physician’s attention. The American Academy of Pediatrics recently updated guidelines on infant and childhood fevers. If your child has a rectal temperature that’s higher than 100.4 degrees, this is considered a fever.
When your child has a fever, you should call the doctor under the following circumstances:
- For newborns and infants younger than 3 months (12 weeks), you should contact your doctor with a reading of any elevated temperature. A rectal temperature in a newborn at or above 100.4 degrees Fahrenheit is considered an emergency.
- For children 4 months to 2 years old – fever persists for more than 24 hours.
- For any child over the age of 2 years old – the child’s fever lasts more than 3 days.
- For children of any age – fever rises above 104 degrees Fahrenheit repeatedly.
- For children of any age – if they have immune system problems from disease, cancer, or are taking steroids, or other medications that suppress the immune system.
Call Your Doctor if Your Child Has a Fever and Any of These Symptoms
Parents and caregivers should seek help from a doctor, nurse, or urgent care center if a child exhibits any of the following:
- Difficulty breathing (if severe, call 911 immediately).
- Unusually fussy and cannot be soothed.
- Lethargic and overly sleepy
- No wet diaper for over 8 hours.
- Dark urine or dry mouth.
- No tears when crying.
- Stiff neck
- Severe headache
- Severe sore throat
- Severe earache
- Unexplained rash
- Repeated vomiting
Typical Behaviors in Children with a Fever
Toddlers and older children might also exhibit these behaviors with a fever.
- Irritability or fussiness
- Decreased activity or talkativeness
- Loss of appetite
- Excessive thirst
Home Care for a Child’s Fever
When your child is clearly uncomfortable with a fever and the symptoms can be managed at home, there are several ways to make them feel a little better.
Dress an infant in a light sleep sack so as not to trap the body’s heat. Try nursing your infant to help sooth them and make them more comfortable. An older child can dress in lighter clothing with a light sheet or blanket for cuddling or sleeping.
Offer plenty of fluids – breastmilk or formula for infants and Pedialyte for children.
Provide popsicles or diluted juice. If you use sports drinks for older children, be sure to dilute them as too much sugar is not healthy with a fever.
Try soft foods if they are hungry – cereal, rice, applesauce, bananas, toast, crackers.
Over the Counter Medications
Two over the counter (OTC) medications are available without a prescription: Acetaminophen and Ibuprofen are both approved by the American Academy of Pediatrics for use in children with a fever. Do not give aspirin to a child. Studies have shown that aspirin in children with illness can cause a dangerous condition called Reye’s Syndrome.
One of the biggest concerns with any OTC medication is giving the wrong amount, or dose. It’s very important to give the child the correct amount based on their age and weight. These links below include detailed dosing tables that help parents figure out the right amount. Be sure to check with your doctor regularly regarding the correct dose for your child.
Medication Dosing Tables
2. Vomiting and Diarrhea in Children
Vomiting and diarrhea can frequently occur together, making for a particularly unhappy child as well as an overwhelmed parent. It’s possible that the culprit could be a stomach virus such as gastroenteritis. Diarrhea and vomiting may also be warning signs of more serious illness.
It’s important to pay close attention to the symptoms that determine when the doctor should be involved. It’s a good sign if your child only vomits a few times, can keep small amounts of fluids down, and doesn’t have significant stomach pain.
When it comes to babies, dehydration is especially a concern as their bodies are less efficient at conserving water, and it takes less loss of fluid to become dehydrated. Monitor closely any child when they are vomiting or have diarrhea to help them recover and report symptoms to a physician if necessary.
Call Your Doctor Right Away if Your Child with Any of These Symptoms
- Significant stomach pain is also present with vomiting and diarrhea
- Vomiting that is green, bloody, or dark brown
- Projectile vomiting
- Cannot keep small amounts of fluids down
- Excessive sleepiness or fussiness
- Blood in the stool
- Signs of dehydration, such as urinating less frequently, fewer than 3 wet diapers daily in infants, reduction of tears, dry tongue, sunken eyes, wrinkled skin, sunken soft spot on the head of babies, weakness in older children when trying to stand
Home Care for Vomiting and Diarrhea in Children
Rehydration is the most important thing for a child with vomiting or diarrhea. For the first 24 hours or so, offer small amounts of fluids or frozen popsicles every 20-30 minutes over a few hours. Liquids provide hydration, and are also less likely than solid food to trigger further vomiting.
For young babies, offer breastmilk or formula. If that is not tolerated, try a small amount of Pedialyte. Children older than one can tolerate a commercial hydration formula like Pedialyte or other options such as popsicles, diluted apple juice, or commercial sports drink (half water/half drink). Don’t overdo the sports drink as sugar can make things worse.
When the vomiting or diarrhea have subsided for more than 12 hours, introduce soft and bland foods – oatmeal, bananas, peaches, pears, applesauce, cooked eggs, pancakes, toast.
3. Severe Sore Throat or Cough in Children
Sore throat (also called pharyngitis) is common in children with a variety of illnesses. Your child may feel pain or scratchiness in the throat, have a hoarse or muffled voice, or have minor difficulty swallowing. Children may also have swollen glands in the neck or reddened tonsils. Sometimes a cough will also accompany your child’s sore throat.
Most sore throats are caused by a virus and will go away on their own. Sore throats, like Group A Strep, may require medications to recover and prevent more serious complications.
A sore throat or cough can be the result of many types of conditions:
- Viral infection – cold or flu
- Bacterial infection – strep throat (Group A Streptococcus)
- Post-nasal drip
- Excessive mouth breathing
Call Your Doctor Right Away if Your Child Has Any of These Symptoms
- Severe sore throat not improving with Acetominophen/Ibuprofen
- Your child’s cough seems to be getting worse (deeper in their chest or labored)
- Your child’s cough has a barking or wheezing sound with labored or gasping breathing
- Your child’s face, hands, or fingers have a grayish tone
- Cough is accompanied by significant fever
- Cough is accompanied by rapid breathing
- Difficulty swallowing fluids
- Persistent drooling or the need to keep their mouth open for breathing
- Difficulty talking or crying
If your child shows signs of extreme difficulty breathing and/or skin tone is bluish, this indicates a medical emergency and it’s very important that you get to the emergency room or call 911.
Home Care for a Sore Throat or Cough
- Comfort Care. Keep your child home and comfortable when they have a sore throat or cough to watch for worsening signs, and to prevent the spread of serious illness. Encourage plenty of rest and fluids.
- OTC Medications. Your pediatrician may recommend over the counter medications, such as acetaminophen or ibuprofen. Thoroughly read the instructions and refer to the dosage table to ensure you give your child the correct amount for their age and weight.
- Herbal Tea. Older children may enjoy warm herbal tea with honey that can be very soothing on a sore throat. Peppermint or chamomile with honey tastes great and has anti-inflammatory properties. Do not give honey to any child under one year of age.
- OTC Lozenge. Children middle school and older might enjoy a flavored medicinal throat lozenge.
- Chicken Soup. Chicken broth or chicken soup is grandma’s favorite recommendation for a sore throat for a reason. Medical research studies have shown that chicken soup has amino acids and spices that help loosen up trapped mucus, and potassium helps with dehydration. Other vegetable ingredients offer antioxidants, reducing inflammatory response. It’s the ultimate comfort and medicinal food.
4. Severe Headaches in Children
It would be wonderful if our little ones were free of any nagging headache pains that plague us adults, but unfortunately, headaches are fairly common in children. Fortunately, most headaches go away within a few hours. However, if left untreated, severe headaches might lead to behavioral problems and academic issues, and they can be signs of more serious problems.
Headaches in kids aren’t uncommon, but usually aren’t serious. Children can experience different types of headaches, including tension (stress-related) and even migraines. Some kids are extra sensitive to perfumes, light, or sound. There are also more challenging headaches such as chronic daily headaches, persistent headaches after head trauma, or persistent migraines.
Most minor and infrequent headaches can be treated with over-the-counter pain medication and healthy lifestyle habits – regular sleep, nutrition, and hydration.
When headaches won’t go away and there are unusual symptoms, it’s time to inform your pediatrician.
Call Your Doctor Right Away if Your Child Has a Headache with any of These Symptoms
- Frequent occurrences
- The child is awakened by head pain
- Following an injury
- Pain in the eye area or behind the ears
- Sensitivity to light
- Sudden and acute headache happening for the first time.
- Headache with nausea or vomiting.
Call 911 or get to the nearest emergency room in the following cases:
- Headaches are accompanied by double vision, confusion, or lethargy.
- If your child has a painful or stiff neck.
5. Abdominal Pain in Children
It’s a challenging feeling as a parent to try and determine if your child’s stomach pain is due to too much candy at a school party or something more serious. Much of the time, a painful tummy will go away within the day. The best preventive measure for less tummy problems is for kids to have a healthy diet with plenty of fiber and fluids to prevent gastrointestinal concerns. Exercise and regular activity helps to ensure healthy bowel movements. Constipation can be a common reason for abdominal pain in children. Call you doctor if these preventative measures are not helping.
As we’ve already learned, sometimes pain could be the result of a stomach virus that also causes vomiting and diarrhea. Several underlying illnesses can also result in abdominal pain, such as urinary tract infection, intestinal gas, or lactose intolerance.
Sometimes kids experience stomach pain due to anxiety or stress. Behavioral Health Clinicians who specialize in pediatric mental wellness can help a family better understand how to help support a child who is feeling stressed.
Call Your Doctor Right Away if Your Child Has a Stomach Ache with any of These Symptoms
- Stomach pain comes and goes for over a week
- Troubling pain causing the child to cry consistently or for over 8 hours
- Your child’s belly appears swollen
- Vomiting that is green, bloody, or dark brown
- Vomiting and reason to suspect food poisoning
- Pain when urinating or more frequently urinating (indicating urinary tract infection).
- You think your child might have appendicitis. Typically, pain begins in the navel and then spreads to the right side, progressing to sharp, acute pain. Children may also vomit and lose their appetite.
- Stomach pain associated with bloody diarrhea.
Call Poison Control at 800-222-1222 if you suspect your child has ingested a poisonous substance, and follow their instructions, including potentially going to the nearest emergency room.
6. Skin Rashes in Kids
Any number of illnesses, allergies, or environmental exposures may cause various types of skin rashes. Although some conditions are extremely common and innocuous, if rashes persist, we recommend that you put in a call to your healthcare provider for advice, recommendations, and possibly prescription medications. Here are a few common childhood skin rashes:
- Contact dermatitis – the delicate skin of young children is often subject to irritation and rash from many natural and human-made materials, such as soaps, detergents, foods, and certain plants (such as poison ivy).
- Ringworm – Caused by skin-to-skin contact or sharing towels and sports gear. Your child’s doctor can treat ringworm with an anti-fungal cream.
- Heat rash (prickly heat) – Usually seen on small babies. This happens when well-meaning parents dress the children too warmly.
- Chronic eczema – atopic dermatitis is an inflammatory disease of the skin that can be uncomfortable and itchy, with frequent or infrequent outbreaks.
It’s hard to resist the temptation to scratch itchy skin. But it’s also easy for that scratchy relief to turn into a nasty infection. There are over-the-counter creams designed to reduce the itchiness of a rash or skin lesion. You may also need to cover the area in younger children to prevent scratching. Some pediatricians may recommend an antihistamine or steroid. Call your pediatrician for their consultation before giving your child over-the-counter medications for a rash.
Call Your Doctor Right Away if Your Child Has a Rash with any of These Symptoms
- Fever with rash
- Rash all over the body (sometimes you’ll see raised bumps called hives)
- Rash is preventing the child from participating in activities
- Rash is becoming infected with an angry, red border or oozing lesion
- Chronic skin conditions are frequent and uncomfortable
Sick and Injury Care at Metro Pediatrics of Oregon
As a parent, it’s sometimes overwhelming to determine the best course of action when your child is sick or injured. If there’s any doubt in your child’s condition and the best course of action, it’s perfectly OK and always preferred that you contact your child’s doctor.
Our team is ready to help you. We have same-day appointments available for those unexpected illnesses. With 6 locations in the Portland metro area, we’re close by. Our 24/7 nurse advice team is happy to listen to your concerns and provide guidance.
From primary care to illness and chronic care management, we’ve got the most comprehensive pediatric care services for kids of all ages. New patients are always welcome. Call today or book your visit online.