Your two-year-old is flushed and blazing hot. She's been sniffly for two days and feverish since this morning when the underarm thermometer showed 38°C (100.4°F). You gave her Children's Tylenol twice through the day, but her temperature stayed the same. Now it's suppertime and you get out the thermometer again " it's risen to 38.5°C (101°F)! Time to call the doctor?
Not necessarily, says Cathryn Tobin, a paediatrician in Markham, Ont., and author of The Parent's Problem Solver. "What's important with a fever is not so much the number or whether it comes down with acetaminophen. It's how the child appears, how long the fever has lasted, and whether she has any specific complaints." Is she smiling, alert, eating? Is she interested in her toys? If the answer is yes, she probably doesn't need a doctor right away. On the other hand, a child who is lethargic and unresponsive, crying inconsolably, or showing symptoms such as a strange rash or headache, may be much sicker even with a temperature that's just a notch above normal.
Fever scares parents and accounts for a great many calls to the doctor's office and late-night trips to emergency. However, doctors emphasize that fever is not an illness in itself but rather a sign that your child's body is battling an infection. The underlying condition is what determines how sick your child is and whether he needs immediate treatment; signals like behaviour and appearance are much more telling than temperature. (The exception is fever in infants: If your baby is younger than three or four months, get medical attention right away. )
We asked physicians about other symptoms that appear frightening but that, on their own, seldom indicate a major problem. And we asked for the flip side too: symptoms that tend not to worry parents, but that should be checked out, if only to rule out serious illness.
All our sources emphasized that you know your child best and it's never wrong to call her doctor (or your local or provincial health line) if something is nagging at you. Armed with a little extra information, however, you may find the reassurance you need to ride out a rough patch, or seek help when it's really needed.
Scary, but probably fine
Infrequent bowel movements in a nursing infant
When a baby is breastfed, she can produce anywhere from 10 bowel movements a day to just one a week. It's all within the normal range, says Cheryl Mutch, a paediatrician at BC's Burnaby Hospital and a member of the community paediatrics committee of the Canadian Paediatric Society. That can be hard to believe for parents who get more fretful with each day that goes by without a poopy diaper. But if the baby is feeding well and gaining weight, there's probably nothing to worry about. (The exceptions: In the first week or two, regular BMs help show that nursing is getting established; and in a formula-fed baby, scarce BMs could indicate constipation, which should be treated.)
Breath-holding spells
A toddler who holds her breath until she faints? It can be frightening to watch, says Toronto paediatrician Janet Saunderson, but your child is in no danger of depriving herself of oxygen. Nor is she doing it to manipulate you. Breath holding is fairly common among toddlers frustrated by restrictions they don't understand. It can also be a shock reaction to a sudden trauma such as a finger pinched in a drawer.
