Dr. Solomon Laktineh

Article

When to call the pediatrician, an honest guide

When to call now, when to wait until morning, and when to go straight to the emergency room. Forty-five years of pediatric judgment, in plain language.

Most parents wait too long to call about real problems and call too quickly about non-problems. After forty-five years in pediatrics, I can give you a clearer map. The point is not to avoid calling. The point is to learn the few patterns that actually matter so you can act with confidence.

Always emergency, head to the ER or call 911

  1. Trouble breathing

    Working hard to breathe, chest pulling in, blue lips, gasping, or unable to speak in full sentences.

  2. Severe lethargy

    Difficult to wake. Not making eye contact. Not responding to you in the usual way.

  3. Severe injury

    Loss of consciousness, repeated vomiting after a head hit, broken bones with deformity, deep cuts that will not stop bleeding.

  4. Severe allergic reaction

    Swelling of the lips, face, or tongue. Hives spreading rapidly. Difficulty breathing.

  5. Any fever in a baby under 3 months

    Always a reason for immediate evaluation, not waiting.

Call within hours, do not wait a day

Fever above 102 in a child older than three months that is not coming down with appropriate medication. Persistent vomiting that prevents fluids from staying down. Earache with high fever. Rash with fever. New limping. A child who simply does not look right and you cannot explain why.

Call when convenient, often in 24 to 48 hours

Lingering cough or congestion that is improving slowly. Mild rashes without fever. Behavioral changes that are not severe. Sleep problems. Picky eating. Most parenting questions. These are exactly the kind of question online consultations are built for.

The most important rule

You know your child better than anyone. If your gut says something is wrong, call. After forty-five years, I have learned that parental intuition is right far more often than not. Better to call and be reassured than to wait and worry.

Frequently asked

What temperature counts as a fever?
100.4 F or 38 C and above is a fever. The exact number matters less than how your child looks and acts. A fever in a baby under three months is always a reason to call.
Should I worry about a single vomit?
Usually no. Pay attention to whether your child can keep small sips of fluid down within an hour. Persistent vomiting, especially with belly pain or lethargy, is a reason to call.
When is a cough an emergency?
Difficulty breathing, blue lips, or working hard to breathe with the chest pulling in are emergencies. A cough alone is rarely an emergency.
What about head injuries?
Seek urgent care for loss of consciousness, repeated vomiting, severe headache, unequal pupils, or any unusual sleepiness. Most minor bumps without those signs can be watched at home.
Can I just call instead of bringing my child in?
Yes, often. A 30-minute online consultation is a great first step for non-urgent concerns and saves you a trip when none is needed.

Related reading: newborn care basics and childhood anxiety. For non-urgent questions, book a consultation.

Have a non-urgent question about your child?

A private 30-minute call. Faster than a clinic visit. Costs less than urgent care.