When to see the doctor

Q1: When do I need to make sure my preschool/school-aged child is seen by a doctor if they are sick with a sore throat, cough, fever, aches, or other symptoms?

First of all, it is important to say if your child looks ill or distressed, please act on those concerns right away. Many clinics will have a nurse advice or triage line that you can call to help sort out your child’s symptoms. At night, sometimes there’s an on-call number to get further direction. While uncommon, some parents do need to bring their child immediately to the emergency room, but please try to call your clinic first. Another newer option is an online doctor’s visit, where you can have a brief live visit with a physician to discuss what is troubling your child. To complete an online doctor’s visit you can use a service like Online Care Anywhere (onlinecareanywahere.com). You’ll be able to log in and choose a doctor. They are available 24 hours a day/seven days a week and you can log in on your computer, tablet, or smartphone. Services like this can help you avoid an unnecessary trip to the ER, and may provide you peace of mind from not having to wait until morning if your child is sick during the night.

In general, the following symptoms will likely require children to be seen by a doctor or nurse practitioner the same day: (1) if they have a fever of 104 or higher; (2) if he or she has any breathing difficulty or is breathing more than 30 times per minute when they are otherwise resting quietly; (3) a bad headache, especially if combined with a fever and/or neck pain; (4) if they have many episodes of vomiting and/or diarrhea and are not urinating at least every 12 hours; (4) if they have joint swelling or a severe rash; (5) any new kind of severe pain, especially if they cannot walk or stand normally, and (6) if it hurts to urinate, especially if it is combined with a fever.

If your child has a sore throat and you are concerned that he or she may have strep throat, they will likely need to have a strep test done to confirm. Please check with your clinic to see how they handle strep testing.

Otherwise, if your child has relatively mild symptoms with a low grade fever (102 to 103 or lower) and are acting fairly normal, it is very likely they have a viral infection and will not need to be seen right away. Giving lots of fluids and treating with ibuprofen and/or acetaminophen to help your child be more comfortable will probably be the best way to treat your child, and will be all that they need. 

Q2: What should I consider when buying toys for infants? 

Infants are very complex right from the start of life. When thinking about appropriate toys in the first year of life, focus on their natural preferences, curiosities, and abilities during this time. As a general reference, their vision rapidly improves in the first several weeks and they will start showing preferences for bright colors and human faces. They will love to hold, turn, and manipulate objects of an appropriate size and weight. Most infants seem to prefer a variety of textures as their sense of touch becomes more refined in the first several months. Their ability to form a “pincher grasp”—the thumb and index finger working together to pick up objects—develops around seven to eight months and furthers their ability to play with more “challenging” toys.

Toys should be approved for infant use, and most new toy manufacturers will clearly indicate the appropriate age range on the packaging. Choking is a huge risk, because most things go into the mouth, a very natural behavior. If a button or small part can be bitten off, for example, it is not a safe toy. Toys with painted surfaces need to be decorated with paint that is free of lead or other heavy metals. There have been some problems in the past with toys manufactured overseas in regard to the use of lead-free paint.

Finally, you will want to avoid other contaminants such as BPA (bisphenol-A) that may be found in some plastic toys. Fortunately, today’s toy manufacturers are doing a very good job of letting you know what their toys are made of and what they do not contain.

And, do remember, one of the best gifts you can give children is a book andalso read it to them. It will give them a great start! 

This column is intended to provide general information only and not medical advice. Contact your health care provider with questions about your child. Dr. Peter Dehnel is a board-certified pediatrician and medical director with Blue Cross Blue Shield of Minnesota. Send questions to drdehnel@mnparent.com.