The Panicky Parent's Guide to Kids' Health

Stomach Scares

Scary symptom: Your child is doubled over with stomach pain.

You think: It's appendicitis!

It's probably just: A stomach bug, especially if she has diarrhea and a fever. Don't reach for over-the-counter upset-stomach remedies -- some contain an aspirin-like compound that can lead to a dangerous condition called Reye's syndrome in children. Just help your child feel more comfortable: Place a heating pad on a low setting on her belly and give her an ounce or two of clear liquid every 10 or 15 minutes to keep her hydrated.

When to worry: It may be appendicitis if she has crampy stomach pain that starts around the belly button and worsens as it moves to the lower right side of her abdomen. She may also have a fever and might vomit -- but she won't have diarrhea or any bowel movements, due to swelling in the bowel area. "One of the best ways to tell whether it's appendicitis is to ask your child to jump up and down," says Ari Brown, MD, Parents advisor and coauthor of Toddler 411. "A child with an inflamed appendix can't do it because it hurts too much." Appendicitis requires immediate attention, so go to the ER right away.

Constipation?

Scary symptom: Your toddler hasn't pooped in days, and her belly looks swollen.

You think: She has a bowel obstruction -- people die from that!

It's probably just: Plain old constipation. "When your child's bowels don't move, her intestines can fill with poop, which will make her belly look bloated," explains Dr. Brown. Constipation is a common issue for toddlers -- it often occurs when a child is switching from formula or breast milk to cow's milk and when she's potty training (lots of kids are scared of using a toilet and hold it, which could make it more painful and difficult to poop later).

Your constipated kid may also pass gas and refuse to eat. The fix? Give her more fruit (even a couple of ounces of prune or apple juice a day may do the trick), vegetables, fluids, and whole grains. If she hasn't pooped in a week or so, call your pediatrician. "Ask if using oral stool softeners or laxatives along with plenty of fiber and water will work," says Dr. Brown.

When to worry: If your child has a distended and extremely tender belly, hasn't pooped in days, or passes stool that looks black and jellylike and is also vomiting, you should head to the ER immediately. These are signs of a bowel obstruction, which occurs when the intestine becomes twisted. She may need emergency surgery.

Coughs & Headaches

Scary symptom: Your child has had a nagging cough for weeks.

You think: It has to be asthma!

It's probably just: A lingering cough due to a respiratory problem. If your child had a cold and is still stuffed up 10 or more days later, it may be a sinus infection, especially if he has a fever. Postnasal drip can irritate the throat, causing a cough. But if your child's cough started out dry and became wet, he may have bronchitis and should see a doctor. Bronchitis is often caused by a virus, so you probably won't get antibiotics; rest, fluids, and pain relievers can help him feel better, as will bronchodilators, which expand the airways.

You may be tempted to rely on over-the-counter cough syrups, but they're often not a big help and can cause dangerous side effects in kids under 2. Try using saline nose drops and placing a cool-mist humidifier in your child's bedroom to thin his mucus instead, says Ken Haller, MD, associate professor of pediatrics at the Saint Louis School of Medicine.

When to worry: Suspect asthma if your child's cough sounds dry and hacking, occurs only in certain situations (exercise and cold air are common triggers), or if he has breathing problems (wheezing when he exhales, flaring nostrils, or rapid, shallow breathing -- all signs he's in respiratory distress and needs immediate medical attention). Asthma has a strong genetic link, so be particularly suspicious if you have a family history of the disease. Left untreated, asthma can damage your child's lungs, so see your pediatrician ASAP for a diagnosis.

Headaches

Scary symptom: Your child complains of frequent headaches.

You think: What if it's a brain tumor?

It's probably just: A headache. Congestion can put pressure on nerve endings, so sinus infections and allergies are often the culprit. Look for telltale symptoms such as a runny nose; itchy, puffy eyes; and chronic postnasal drip. "School-age children can also get tension headaches, or they'll claim they have a headache to avoid school," says Dr. Brown. If your child is pain-free on weekends or it mysteriously only hurts during math class, you may have your answer. Treat the root of the headache to prevent them and use pain relievers like acetaminophen for a fast fix.

Another possibility: Your kid may have a migraine, a debilitating headache that sometimes causes nausea and vision problems. Migraines don't usually pop up until a child is 9 or 10, but kids as young as 3 or 4 aren't immune, especially if family members are also prone to them. If you suspect your child has a migraine, give her a pain reliever and let her rest in a dark room; then, see your pediatrician. It's unusual for kids under 5 or 6 to have headaches, so don't ignore them.

When to worry: Although brain tumors are rare, they do occur. One red flag: "Headaches associated with brain tumors are often severe and wake children up from sleep because lying down increases pressure on the brain," says Gary Emmett, MD, director of general pediatrics at Thomas Jefferson University, in Philadelphia. Your child may also complain of vision trouble and have balance or coordination problems. If that's the case, see your pediatrician right away.

Problems...Ummm, Down There

Scary symptom: You notice a lump in your baby boy's groin area.

You think: Could it be cancer?

It's probably just: A hydrocele -- a fluid-filled sac that surrounds the testicle. It's not a cause for alarm: In fact, 10 percent of baby boys are born with hydroceles and it usually goes away without treatment by age 1. Or your child may have a hernia, a protrusion of part of the intestine through a weak area in the wall of the abdomen and into the scrotum, which can occur during fetal development. (Girls can get a hernia in the groin area as well, though the problem is more common in boys.) A hernia feels soft, and you'll be able to push it back into the abdomen. Your child will need surgery, but there's no rush unless the area is extremely tender and red -- signs that the hernia is stuck.

The lump could also be an enlarged lymph node, especially if it's located where the leg and torso meet. "Lymph nodes are part of the immune system, so whenever your child has inflammation or an infection -- even from something seemingly minor like a cut or an insect bite -- they swell to protect the body," says Dr. Brown. When the infection clears up, the lump will also disappear.

When to worry: If the lump is rock-hard and immovable, it may be a tumor, though don't start freaking out: Cancer in a baby's groin area is rare. Leukemia also causes lymph nodes in the groin area to swell, but you'd also notice enlarged nodes in your child's neck and armpits, along with weight loss and paleness. Regardless of the cause, you should get any lump evaluated by your pediatrician.

Frequent Urination

Scary symptom: Your daughter says she constantly feels like she has to pee.

You think: She has diabetes!

It's probably just: Vaginitis, caused by overzealous or improper wiping. When the skin around the vagina is irritated, urination is painful. "Your daughter may only pee a little at a time because it hurts," explains Dr. Brown. "Her bladder is always full, so she always has to go." To soothe the skin, have your child sit in a warm bath. Coat the area around the vagina with petroleum jelly to create a protective barrier, which makes urinating more comfortable.

Urinary-tract infections can also trigger constant peeing. Check for symptoms such as a fever, painful urination, peeing in small amounts, and concentrated urine that smells foul. The common causes: bad wiping habits and holding it in. See your pediatrician, who can prescribe antibiotics to kill off the bacteria.

When to worry: If your child pees a lot -- and is losing weight, always tired, and excessively thirsty -- she may have Type 1 (also known as juvenile) diabetes. "When a child with Type 1 diabetes pees, it's not painful but there's a lot of urine, and it's almost colorless," says Dr. Haller. If your child has these symptoms, see your pediatrician for a screening.

Don't Ignore the Snores

If your kid snores, don't just shrug it off as a pesky habit. Although many kids snore occasionally (typically when they have allergies or a cold), regular, loud snoring may be a sign of obstructive sleep apnea syndrome (OSAS), when your child regularly stops breathing for 10 seconds or longer during sleep. Often, large tonsils and adenoids are to blame. Other symptoms include:

• Gasping, snorting, and sweating during sleep
• Restless sleep and sleeping in unusual positions
• Excessive daytime sleepiness
• Mouth breathing

If you suspect your child has sleep apnea, see your pediatrician ASAP. Left untreated, it may lead to learning and behavior problems.

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