Guidelines for the first three years of your child's life


If you're ever really worried about your child's health, do not hesitate to call your pediatrician at any time of day or night. It's always important to be attentive to changes in your child's appearance and behavior, but be assured that if he seems generally healthy and normal, there is probably no cause for alarm. Depending on your child's age and the severity of the signs, symptoms, and behaviors, you can probably wait until regular hours to call your doctor about the following, but do call if you notice:

  1. Changes in behavior. In a nonverbal child, a glassy-eyed, sick look; a lack of responsiveness; excessive sleepiness or wakefulness; continuous or high-pitched crying all indicate that something is wrong.
  2. Pain. A verbal child can tell you when something hurts. If your baby is in pain, he will likely be irritable and difficult to console, and will have a hard time feeding. Babies with ear infections are uncomfortable lying down and may start shrieking when placed in a horizontal position.
  3. Rapid, uncomfortable breathing. If you see your child's ribs, stomach or neck muscles working; hear him wheezing; or if he has a persistent cough that's disrupting his sleep, bring him in to see the doctor.
  4. Limpness. If your baby seems limp or isn't using his arms or legs, or your toddler's gait seems funny, let your doctor know.
  5. Changes in coloration. A blue tinge to your baby's face, fingernails, or toenails, or a pale, ashen appearance may indicate a breathing or circulatory problem. A yellow tinge to the skin or the white of the eyes may suggest jaundice or another liver condition.
  6. Prolonged fever. Your child's fever is a clue that his body is fighting an infection, a healthy response. And he may be running a temperature for a day or so and be otherwise healthy and happy. However, if he doesn't respond to fever-reducing medication such as ibuprofen or acetaminophen within several doses, or if he seems uncomfortable and sick, you should check in with your doctor.
  7. Excessive vomiting or diarrhea. Although spitting up can be forceful and therefore confused with vomiting, a child who spits up seems and is perfectly fine. When he vomits, he is and feels sick so you should call the doctor.
  8. Changes in urine output. Report any significant increase or decrease.
  9. Changes in bowel movements. Report a substantial change in the frequency, color, or consistency of the stool.
  10. Blood in urine or in the stool.
  11. Unusual skin rashes. Spots, blisters, canker sores, hives, or any red, weepy, yellow, crusted spots on your child's skin should be examined.
  12. Spreading skin infection. Any warm, red, tender, irritated area that appears to be spreading should be seen by a doctor.
  13. Minor injuries that don't heal. If your child hurts his finger and it's hurting (or worse) two days later, call the doctor. Also check in if he has a wound that looks red, yellow, or pussy.
  14. A nosebleed that's hard to stop. Call the doctor if it takes longer than ten minutes to stop the bleeding by gently pinching the nose, applying ice, and holding the head back.
  15. Any minor symptoms that get worse or don't resolve. A cold should go away in two weeks. If, during the course of the cold your child develops a high fever or severe cough, alert your doctor.
  16. Swollen eyes, hands, or feet.
  17. Eye pain or discharge.
  18. Progressive abdominal pain. If your child has a simple tummy ache, he will writhe or wriggle and typically feel better if you rub it. However, if he does not want to be touched or moved and cannot stand (he would rather lie perfectly still), he may have appendicitis or another internal problem.
  19. A distended belly. Alert the doctor if your child has a bloated or tender abdomen.
  20. A bulge in the crotch or by the belly button. This may indicate a hernia.
  21. Multiple bruises on the upper body. A doctor should examine any unexplained bruising in odd places.
  22. Scrotal swelling or pain (in boys). This may indicate a hernia or undescended testicles.

From The Parents Book of Lists: From Birth to Age Three, by the editors of Parents magazine with Marge Kennedy. Copyright © by Roundtable Press and G+J USA Publishing.

All content here, including advice from doctors and other health professionals, should be considered as opinion only. Always seek the direct advice of your own doctor in connection with any questions or issues you may have regarding your own health or the health of others.

Parents Magazine