Your kid’s sick. How to know when to let it ride and when to call a doctor

“To become a parent is to fall into love and into fear in ways you never thought possible,” says Dr. Kenneth Haller, a SLUCare pediatrician at SSM Health Cardinal Glennon Children’s Hospital. “You will love your child for every moment of your life and be afraid for their safety at every moment of your life.” Haller understands the struggles parents go through; he’s known for his bedside manner and communication, and he teaches a course for first-year medical students that employs acting techniques to teach empathy and mindfulness in patient interaction.

Kids seem to get sick pretty often. How does a parent know when to let it ride and when to call a doctor? Breathing, hydration, and activity are things to focus on when you’re concerned that your child may be sick. Kids in the first two years of life get an average of about 12 upper respiratory viral infections per year. This means that if your child seems to get a cold about once a month, or if it seems like they always have a cold, they are pretty normal. If you make sure they are drinking plenty of fluids and you allow them to sleep as much as they want, they will likely get over it on their own. On the other hand, if your child is pulling at the ribs to breathe so much and for so long that it seems they are spending all their energy and they can’t drink because of how hard it is to breathe, then their breathing, hydration, and activity are being compromised, and you should consider taking them to see the doctor or to the ER.

What about when your child is running a fever? It’s a pretty dramatic and scary symptom, but in and of itself, it’s not a problem. Fever tells us that something is going on, but it doesn’t tell us what. So if your child has a fever, check to see what else may be going on. Do they have a sore throat? Does it hurt when they pee? Does their ear hurt? A lot of viruses and bacteria don’t survive well at temperatures higher than normal body temperature, so often a fever is our body’s way of turning up the thermostat to try to kill them. As a parent, your job is to look at your child to see what else might be going on to cause that fever.

What should you do when your child expresses pain? Often, your child’s pain complaint is straightforward: “My ear hurts.” “It hurts when I swallow.” Sometimes, though, pain complaints can be vague. In that case, try to figure out when your child is having pain and what makes it better. Keeping a diary of that pain over time—when it happens, where it happens, what brings it on, what makes it better—can be helpful if you decide to see the doctor.

What’s the most important thing for parents to remember? How do you feel about what’s happening? As a pediatrician, I may be the expert on children, but you are the expert on your child. As such, your intuition that something is just not right with your child is really important for both you and your child’s doctor to take seriously.