When we answer messages and phone calls from worried caregivers, there are a few things we always need to know to understand how dangerous the situation is.
If these symptoms are present, your child may require a trip to the emergency department for further evaluation and treatment.
1. Dehydration
You may read or hear about different ways you can monitor this (sunken fontanelle, not making tears, dry or cracked lips, dry mouth, dry skin).
Unfortunately, interpreting these symptoms correctly is complicated and takes years of practice.
For this reason, we do not recommend parents use these methods.
The best and easiest way to determine hydration at home is to track how often they urinate
Regardless of how old your child is, they should pee at least every 8 hours.
If they’re sick or acting differently, make a note of the time of day they urinate
Any urine counts as a urination episode
The diaper doesn’t have to be as full as it is normally
If your child goes longer than 8 hours without making urine, and is sick or acting differently, you should let us know right away.
2. Respiratory Distress
Respiratory distress is a medical term which means “working hard to breathe.”
Another way to think about this is “labored breathing.”
The best way we’ve found to describe respiratory distress to parents is that it looks like the baby is out of breath, i.e. "huffing and puffing."
Here are some examples of respiratory distress for you to compare to:
It's impossible to evaluate the breathing with a shirt on.
For this reason, your child needs to be completely naked from the waist up
Turn on the light
Take the shirt or onesie off over their head and completely off the body
3. Inconsolability
Inconsolable is defined in the following way:
30 minutes or longer
Continuous, non-stop crying, without interruption
You've done everything you can think of to get them to stop
e.g. feed more, go for a walk, drive around the block)
If your baby has been crying continuously without stopping, for at least 30 minutes in a row, and you’ve tried everything discussed here, you should let us know right away.
Any child, regardless of age, who meets this definition needs to be evaluated immediately, day or night.
4. Altered Mental Status
Altered mental status is a clinical term that means the brain isn't working correctly
Examples of altered mental status include:
seizure
does not recognize parents or surroundings
clearly off balance compared to normal
Clinically lethargic
Luckily, when parents say their child is lethargic, they usually mean that, compared to normal, their child has less energy, or is more clingy, fussy or tired
The medical definition of lethargic is an almost coma-like state. Essentially, the child responds very little or not at all, despite the caregivers best attempt to get them to do so
True lethargy is a sign of serious illness, and usually warrants immediate evaluation in the emergency department
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