宝宝健康晴雨表（下）：Babies' Warning Signs

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●Babies' Warning Signs
●Signs that your newborn is sick
●8 Signs Your Infant Is Ill
●When to call your baby's doctor
●Sick baby? When to seek medical attention
●Warning Signs: When Do I Take My Child To The Doctor?
●What to Do When Your Premature Baby is Sick
●Recognize Symptoms of a Sick Baby or Toddler
●When Your Newborn Gets Sick
●Alternative remedy tips for parents with sick kids

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Babies' Warning Signs

It's been said that babies do not come with instructions, but most parents certainly wish they did, especially when a young child is sick. As they grow, babies are exposed to infectious agents that may cause colds and other illnesses. These are a normal part of a baby's development and, thankfully, most outgrow the frequent-illness stage. Because babies cannot verbalize their feelings, however, adults must always stay alert for warning signs of illness.

1. Crying

Babies cry for many reasons, including hunger or thirst, but if they are inconsolable or their cries are sudden or sound particularly unusual, it may be a sign of illness. Colic in infants up to 3 months old also causes periods of intense crying and general irritability, usually around the same time every day.

2. Fever

Respiratory illnesses such as colds, croup or pneumonia, ear infections, stomach bugs, urine infections, and many other bacterial and viral illnesses may all cause fever. To check for fever, take a baby's temperature rectally with a digital or glass rectal thermometer. It is the easiest and most accurate way. (In an attempt to remove mercury from the environment, mercury thermometers should no longer be used. ) A rectal reading of 100 degrees F or less is considered normal. If a child is 3 months or younger with a rectal temperature of 100.4 degrees F or higher, call the child's health care provider immediately. Call the provider if a child between 3 months and 6 months has a fever of 101 degrees F or higher. For young children over a year old, call the provider if a fever persists for more than 24 to 48 hours (or if fever is accompanied by any other worrisome symptoms).

Fever in children between 6 months and 5 years can trigger febrile seizures (convulsions), which may last for a few minutes or may be over in seconds. They are usually harmless, but inform the child's health care provider. Call for emergency help if seizures are severe, cause difficulty breathing, or last over a few minutes. If your child has had an uncomplicated seizure, he or she should be seen by a physician during regular office hours or in an emergency room, if you are unable to get an appointment.

3. Abnormal Sleep

Newborns spend most of their time sleeping, but if a baby is rarely alert or does not wake up as expected for feedings, consult the child's health care provider.

4. Poor Appetite

If a baby refuses to eat and misses several feedings, it may be a sign of illness.

5. Umbilical Cord Infection

If there is pus or red skin around the stump of a newborn's umbilical cord or an unpleasant smell, it may be infected. Discuss it with your doctor.

6. Diarrhea and/or Vomiting

These could signal a viral or bacterial infection of the intestine an obstruction or other problem. In some cases, the child's health care provider may exam the baby's stool for bacteria, which requires treatment. Viral causes require no treatment and will resolve on their own in a week or so. Persistent diarrhea may lead to dehydration.

7. Irregular Stools

If a breast-fed or bottle-fed baby has very hard or very dry stools, it may be a sign that the child needs more fluids, or may be losing too much fluid because of fever, illness or heat. After babies start eating solid foods, hard stools may be caused by too many constipating foods, such as cereal or cow's milk, before their system can handle them.

8. Urination

Babies should wet at least four diapers a day. If a baby shows any signs of distress while urinating, it could be a sign of infection or some other problem in the urinary tract. A salmon-colored or pinkish stain on a diaper is typically a sign of highly concentrated urine and usually no cause for concern, but if staining persists, talk to a health care provider. If there is blood in the urine or a bloody spot on a diaper, call a health care provider at once. If bleeding is accompanied by abdominal pain or fever, seek medical attention immediately.

9. Intussusception

This rare intestinal blockage is a medical emergency that must be treated immediately. If a baby has a sudden onset of severe pain similar to severe colic with hard distressed crying, this could be a sign of intussusception. Early on, the infant may seem fine between bouts of pain, but soon becomes fatigued and lethargic. The baby may vomit and may pass bloody stool (sometimes described as "currant jelly" stool). Fever (often not present initially) may appear. Shock may follow.

★ What to Do

To keep your baby as healthy as possible, breast-feed your child if possible, which will provide him or her with antibodies and enzymes that help protect against illness or use a commercial infant formula such as Similac or Enfamil. Don't allow smoking around a baby. Adhere to a baby's vaccine schedule and regular checkups. In general, call your child's health care provider if the baby seems especially sluggish, is refusing food or drink, is vomiting (not just spitting-up) or has diarrhea, or has a fever. Remember, if you’re worried there probably is a good reason even if you don’t recognize it. This is a time to talk to the baby’s doctor or other available healthcare worker.

★ Self-care Steps for Baby/Warning Signs

● If the baby seems distressed, hold the infant and console him or her as much as possible.

● Keep your infant away from children who are sick, especially those with infectious diseases such as respiratory syncytial virus (RSV), stomach “flu,” influenza and other respiratory infections, cold sores (HSV1) and other obvious infectious diseases.

● Prevent family members who are sick from sharing food or drink with the baby, and from handling the baby and his or her toys.

★ Decision Guide for Baby's Warning Signs

Symptoms/Signs Action
Fever 100.4 degrees F in infants under 3 months See provider
Fever of 101 degrees F in infants age 3 to 6 months See provider
Fever of 103 degrees F in a baby 6 months or older See provider
Fever that lasts longer than 24 to 48 hours See provider
Refuses to eat See provider
Unusually cranky, irritable, inconsolable See provider
Unusually sleepy See provider
Nose blockage hinders breathing while feeding See provider
Nasal fluid that is discolored, smelly or bloody See provider
Unresponsive to sounds See provider
Fluid discharge from the ear See provider
Red, swollen and watery eyes See provider
Whites of the eyes turn yellow See provider
Serve or persistent cough See provider
Swollen abdomen See provider
Diarrhea in newborns See provider
Diarrhea streaked with blood or mucus See provider
Painful urination See provider
Discolored, bloody, cloudy or unusual smelling urine See provider
Penis discharge See provider
Vaginal discharge See provider
Joint redness or swelling See provider
Sudden rash, blotches or blisters See provider
Vomiting for 12 hours or more See provider
Sudden weakness or paralysis, "floppy" See provider
Chills that make baby shake Seek help now
Neck stiffness Seek help now
Vomiting solid blood Seek help now
Seizures Seek help now
Loss of consciousness Seek help now
Difficulty breathing Call 911

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Signs that your newborn is sick

Newborns don’t come with an operator’s manual and if you’re a first-time parent it can be difficult to work out if your baby is sick – especially since most newborns seem to cry most of the time!

It’s likely your family, friends with babies, midwife and health visitor will try to reassure you by telling you that you’ll ‘just know’ if something isn’t right but often this is no help. After all, everything about your baby and being a mum is unfamiliar to you in those first days and weeks, so it might be hard to feel confident in your ability to recognize the often minor changes that can tell if your newborn is ill.

As you become more experienced you will develop a keen instinct for the ties when your baby is unwell, but until then here are gurgle’s guidelines for monitoring your newborn’s health and wellness…

★ Is she behaving differently?
All young babies cry but if your baby is sick she may do so more or less than usual (if she’s crying less than usual she may also seem listless and might not be interested in feeding).

Her cry also may sound different: it may be more frenzied and high-pitched, or take on a whining note. You’ll probably also have noticed that your baby tends to cry more at certain times of the day – the notorious ‘arsenic hour’ for example, from 6pm onwards, which is linked to colic. If this is the case with your baby then hearing her cry continuously at a different time of the day could signal that she isn’t feeling well. She may also seem more fussy and fretful even when she isn’t crying.

★ Is she refusing feeds?
Is your baby feeding less frequently and/or not taking in as much milk when she feeds? Has she vomited and if so was it projectile (forceful) vomiting?

★ Have her toilet habits changed?
You can tell so much from a nappy! Is your baby showing signs of constipation (the poo will be hard and pellet-like if she’s bottlefed, or more solid than usual in a breastfed baby). Does she have diarrhoea, with frequent explosive watery pooping? Is she urinating less frequently than usual? Giveaway signs are her nappies feeling much lighter when you change her, and any urine she has passed may be much darker than usual or smell stronger.

★ Is she breathing normally?
Does the baby seem to be having trouble breathing, either panting and seeming breathless, or making a wheezing sound as she breathes? Does she have a cough? If so is it a barking cough, which could indicate croup? Is she congested (a red flag for this is difficulty breastfeeding since a blocked-up nose means she’ll have to keep latching off so she can breathe). Does she have a runny nose?

★ How does she look?
Is her skin pale or more flushed than usual? Does she have a rash anywhere and if so, what does it look like? A purplish blotchy or pinprick rash that doesn’t fade when pressed with a glass is a symptom of meningitis – this is a medical emergency so if your baby develops this type of rash take her to your local A&E department immediately. Do your baby’s eyes look dull or staring, or does she have any discharge from them?

★ Does she have a fever?
Check your baby’s temperature – if it’s over 37.7°C in the morning or over 38.2°C in the evening then she is running a fever. Call your doctor for advice on giving fever-relieving medication such as infant paracetamol or ibuprofen, as these are not usually recommended for newborns.

Tips to help you keep your newborn healthy:
● Wash your hands before you handle her, even if it’s a nappy change.
● Ensure that sick family members and friends keep away from your baby so that she isn’t exposed to their germs. This is particularly important with colds and flu as these are easily spread.
● Keep your baby’s toys clean by regularly washing them with soap and hot water.
● Take a toy to the doctor’s office so your baby doesn’t handle any toys that other sick children may have played with.
● If you bottlefeed, ensure that all your baby’s feeding equipment is properly sterilised.
● If you breastfeed and express breast milk, sterilise your breast pump between uses.
● If your baby uses a dummy, stock up on them so she can have a clean, sterilised one if the one she’s using falls on the floor. Never give your baby back a dummy that has fallen on the ground and never put it in your own mouth to ‘clean’ it if she does drop it.
● Keep your baby’s immunizations up-to-date.

The information in this feature is intended for educational purposes only. If you have any concerns about your health, the health of your child or the health of someone you know, please consult with a doctor or other healthcare professional.

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8 Signs Your Infant Is Ill
* Posted on Mar 14, 2010 8:25 AM by Margaret Lewin, MD, FACP

As new parents, you’ve spent nine months emotionally as well as logistically preparing to welcome that magical newborn into your household. Nevertheless, you may not be prepared to evaluate your infant when he’s ill and to know when you can handle the illness yourself and when to get help. Here are eight signs of illness for infants under the age of six months, and general guidelines for when you should call the doctor.

★ Sick Baby

1. Fever

Fever itself is not an illness, but rather the baby’s response to an illness – most commonly an infection. Call the doctor if your infant is less than three months old and has a rectal temperature above 100.3 F, or if your baby is between three and six months and has a temperature above 101 F. Even if the temperature is lower than these general guidelines, call the doctor if your infant appears ill with such signs as a rash, irritability, poor feeding, trouble breathing, a stiff neck, persistent vomiting or diarrhea, signs of dehydration or is lethargic or difficult to arouse.

2. Dehydration

Dehydration can happen if the baby is feeding poorly, has a fever, is in too warm an environment, or has persistent vomiting or diarrhea. You can recognize dehydration if your baby has a dry mouth and gums, wets the diaper less frequently, sheds no tears when crying or the fontanel (the soft spot on the top of the head) appears to sink slightly. If you think your baby is dehydrated, call the doctor.

3. Diarrhea

Diarrhea is common in infants, but call the doctor if there is blood in the stool (which can appear bright red or, more serious, black), the baby has more than six watery stools a day, is not taking fluids or shows signs of dehydration.

4. Vomiting

Infants commonly “spit up” but frequent vomiting is reason for concern. Vomiting may not be serious if it happens only once or twice. However, if it happens more frequently, contains blood or is green in color, or if the baby looks dehydrated, call your doctor.

5. Difficulty breathing

If your baby is having trouble breathing, you need to call the doctor and 911 immediately.

Signs of difficulty breathing include:

* your baby is breathing much more rapidly than usual.
* the tissue between the ribs, above the collar bones, or in the upper abdomen is sucked in when your infant inhales.
* your baby grunts while exhaling.
* your infant’s head is bobbing.
* your baby’s lips or skin develop a bluish tinge.

6. Redness, oozing or bleeding

If your baby’s navel (or umbilical remnant) or penis turns red, is oozing or bleeding, call the doctor immediately. These are signs of an infection.

7. Rashes

Rashes are common in babies, but call the doctor if the rash covers a large area, especially the face, or is accompanied by a fever, oozing, bleeding or swelling, or if the rash looks infected.

8. Colds

Upper respiratory infections (URIs) are caused by a virus and are very common in infants. They usually last one or two weeks with an associated runny nose, fever and poor appetite for a few days, and a cough which can last as long as two to three weeks. More serious symptoms require doctor’s care.

★ Call your doctor if:

* your baby’s temperature is higher than 100.3 F for infants under three months or higher than 101 F for infants between three and six months.
* your baby has a rash or difficulty breathing as described above.
* your infant is unusually fussy and cries a lot.
* your baby’s cough is severe and almost nonstop or brings up any blood.
* your infant is vomiting.
* your baby’s symptoms last more than two weeks.

Finally, under all circumstances, if you’re very worried that your baby looks really ill, trust your instincts and call the doctor!

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When to call your baby's doctor

Unfortunately, babies don't come with instruction manuals, and they can't tell you when something is wrong. It can be hard for parents to understand their newborn and tell the difference between a baby's regular fussiness and a more serious problem. Knowing when to call a health provider can be a challenging and nerve-racking experience for parents.

When in doubt, trust your instincts! If you think your baby needs medical attention, call his health provider. Some problems need immediate attention. Others can wait until regular office hours. Here are some signs to help you know when to call.

★ Urgent

Call the health provider immediately if your baby:

* Has blood in her vomit or stool.
* Has trouble breathing, very fast breathing (more than 60 breaths in a minute), or blue lips or finger nails.
* Has a seizure. (When a person has a seizure, any part, or all, of the body moves repetitively. Sometimes the person stops breathing.)
* Has eaten or drunk nonfoods that can cause harm such as vomiting, diarrhea, trouble breathing, etc. Examples of nonfoods are detergents, soaps, bleach and rodent control products.
* Is hard to waken or unusually tired.
* Has a rectal temperature above 100.4 degrees F. or below 97.8 degrees F.
* Has yellowish skin or eyes.
* Is injured and won't stop bleeding.
* Has hurt his head or another part of the body

★ Less urgent

Call the health provider's office if your baby:

* Is eating less or shows other changes in appetite.
* Is regularly crying, irritable or unable to be comforted.
* Has frequent diarrhea. This can be harder to notice in breastfed babies as they usually have soft stools. Contact the health provider's office if your baby's stools are especially soft or watery for 6-8 diaper changes.
* Vomits (more than just spit up) more than 2-3 times a day.
* Has a cold that doesn't improve or gets worse after a few days.
* Has a rash.
* Is constipated and doesn't have any stools.
* Has fewer than six wet diapers in 24 hours. This can be a sign of dehydration. Other signs include sunken eyes, sunken soft spot (fontanel) on the baby's head, or lack of tears when crying.
* Has fluid draining from her ears.
* Has a tender navel or penis. Look for any redness, bleeding or pus in these areas.

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Sick baby? When to seek medical attention

When a healthy baby gets sick, there's no reason to panic. Understand when to call the doctor and when to seek emergency care for your baby.
By Mayo Clinic staff

Every parent wants a healthy baby, but occasional infections and fevers are inevitable. Even parents who have plenty of experience with sick babies can have a tough time distinguishing normal fussiness and mild illnesses from more serious problems. Here's when to call the doctor — and when to seek emergency care — for a sick baby.

★ When to contact your baby's doctor

An occasional illness is usually nothing to worry about in an otherwise healthy baby — but sometimes it's best to contact the doctor. Look for these signs and symptoms:

* Changes in appetite. If your baby refuses several feedings in a row or eats poorly, contact the doctor.
* Changes in mood. If your baby is lethargic or unusually difficult to rouse, tell the doctor right away. Also let the doctor know if your baby is persistently irritable or has inconsolable crying jags.
* Tender navel or penis. Contact the doctor if your baby's umbilical area or penis suddenly becomes red or starts to ooze or bleed.
* Fever. Mild fevers are common and usually harmless, but keep an eye on the thermometer. If your baby is younger than age 3 months, contact the doctor for any fever. If your baby is age 3 months or older and has an oral temperature lower than 102 F (38.9 C), encourage rest and offer plenty of fluids. Call the doctor if your baby seems unusually irritable, lethargic or uncomfortable. If your baby has an oral temperature of 102 F (38.9 C) or higher, give your baby acetaminophen (Tylenol, others). Call the doctor if the fever doesn't respond to the medication or lasts longer than one day.
* Diarrhea. Contact the doctor if your baby's stools are especially loose or watery.
* Vomiting. Occasional spitting up is normal. Contact the doctor if your baby spits up large portions of multiple feedings or vomits forcefully after feedings.
* Dehydration. Contact the doctor if your baby doesn't wet a diaper for six hours or longer or if the soft spot on top of your baby's head seems to sink. Crying without tears or a dry mouth without saliva also warrants a prompt call to the doctor.
* Constipation. If your baby has fewer bowel movements than usual for a few days, contact the doctor.
* Colds. Contact the doctor if your baby has a cold that interferes with his or her breathing, produces thick nasal discharge that's yellow, green or gray, or is accompanied by severe coughing.
* Ear trouble. Contact the doctor if your baby doesn't respond normally to sounds or has fluid draining from his or her ears.
* Rash. Contact the doctor if a rash covers a large area, appears infected or if your baby suddenly develops an unexplained rash — especially if the rash is accompanied by a fever.
* Eye discharge. If one or both eyes are pink, red or leaking mucus, contact the doctor.

Trust your instincts. If you think you should call the doctor, go ahead. After hours, you may be able to call a 24-hour nurse line offered through the doctor's office, clinic or your health insurance company.

★ When to seek emergency care

Seek emergency care for:

* Bleeding that can't be stopped
* Poisoning
* Seizures
* Trouble breathing
* Head injuries
* A sudden lack of energy or inability to move
* Unresponsiveness
* Large cuts or burns
* Blood in the urine, bloody diarrhea or persistent diarrhea
* Increasing or severe persistent pain
* Skin or lips that look blue, purple or gray

Prepare for emergencies by asking your baby's doctor during a scheduled checkup what to do and where to go if your baby needs emergency care. Learn basic first aid, including CPR, and keep emergency phone numbers handy.
Be ready to answer questions

Whether you contact your baby's doctor or seek emergency care, be prepared to help the medical staff understand what's happening with your baby. Expect questions about:

* Your baby's symptoms. What prompted you to seek medical attention for your baby? What are your specific concerns?
* Your baby's medical history. Does your baby have any known allergies? Are your baby's immunizations current? Does your baby have any chronic conditions? Be prepared to share details about your pregnancy and the baby's birth.
* Changes in your baby's feeding and bowel movements. Have you noticed changes in your baby's eating or drinking patterns, in the number of wet diapers, or in the number and consistency of bowel movements?
* Changes in your baby's temperature. Does your baby have a fever? What is your baby's temperature? How did you take your baby's temperature?
* Home remedies and medications. Have you tried any home remedies or given your baby any over-the-counter or prescription medications? If so, what, how much and when?

Knowing the answers to these questions will save you and your baby's doctor time — and stress — during an office visit or emergency situation.

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Warning Signs: When Do I Take My Child To The Doctor?

By Dr. Mike Pappas

How do you know if your baby's illness is minor, or if you need to take her to the doctor? Dr. Mike helps fill in the grey areas about which symptoms set off red flags when your child is sick.

How do you know if your baby's illness is minor, or if you need to take her to the doctor? Dr. Mike helps fill in the grey areas about which symptoms set off red flags when your child is sick.

When we asked Dr. Mike, a pediatric intensive care doctor belonging to the American Academy of Pediatrics, if he could give us some guidelines as to when to give your child Robitussin and when to haul her into the emergency room, this was his professional advice:

Hi! I'm Dr. Mike.

For the past 10 years, I have worked in a pediatric intensive care unit. I have seen the "worst of the worst", making me extremely cautious when it comes to the health of children.

I hope that this information will help you become more aware of the signs and symptoms that can be early signals of a more serious impending illness.

When you as a parent are dealing with a sick child, one of the most important questions you will be confronted with is when to take your sick child to see the doctor. Since different signs and symptoms vary with age, I have separated these warning signs by age group.

The most fragile age group, which is the newborn to 1 month-of-age baby, can get sick hard and fast. Within minutes to hours, these little ones can become overwhelmed and die. If you see any of the following, take it as a sure sign to see your doctor:

★ Newborn to One Month

* Fever of more than 100.4 degrees Fahrenheit (taken rectally)
* Your baby stops eating normally
* Uncontrollable crying, and you cannot console your baby
* Vomiting that continues for more than 8-12 hours
* Bowel movements than happen more than 8 times a day
* The belly button is red
* "Pink eye"
* White patches on the tongue and inside the mouth

Now, let's move on to the older baby, age 1 month to 1 year. Watch out for the following warning signs. If present, it's best to seek medical attention for your little one immediately.

★ One Month to One Year

* Fever greater than 100.4 degrees F (rectally) in babies less than 3 months of age
* Fever greater than 101 degrees F (rectally) in babies aged 3 � 6 months
* Fever greater than 104 degrees F (rectally) in babies older than 6 months
* Refusal to eat at multiple feedings
* Extreme irritability
* Extreme drowsiness

For the child who is from 1 year of age to 18 years, there are a lot, but I've included the most important. If you see any one of these, take your treasure in to see your doctor.

★ One to Eighteen Years

* Loss of consciousness
* Seizures
* Earache
* Terrible headache
* Any discharge from the ear or eye
* Extreme sleepiness
* A loss of control of the arm, leg, or other part of the body
* Stiff neck
* Yellow hue to skin or eyes
* Any trouble breathing
* Throwing up for more than 12 hours
* Blurred vision
* Inability to walk normally
* Throwing up blood
* Severe stomach pain
* Blood or mucous in the stool
* Painful urination
* Pus from a cut or scrape
* Fast and developing rash over most of the body

Great! Now I've scared you to death. That's really not what I'm trying to do. It's just that by recognizing some of these signs early, and acting on them, you can prevent something more serious from happening.

As for the "common" sicknesses that happen at home, most can be treated with the "common sense" approach:

★ Minor Accidents and Illnesses That Can Be Treated At Home:

* Minor rashes, scrapes, and cuts can be treated with an over-the-counter antiseptic and a band-aid
* If your child has the cold or flu, keep him/her hydrated
* If your child has a low-grade temperature (outside of the parameters I set above) administer some children's Tylenol or Motrin
* If your child acts tired, let him rest

Despite this laundry list that I have provided for you, I strongly believe that most of the time, you will have to go with your gut feeling. If you are just not feeling right about your child, get on the phone and call your doc. As a pediatrician and intensive care doctor, I know that I would rather see your sick child early, instead of late.

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What to Do When Your Premature Baby is Sick
By Cheryl Morrissette, About.com Guide
Updated May 28, 2010

Deciding when to call the doctor when you think your baby is sick is always a challenge, especially when the sick baby is a premature baby you’ve recently brought home from the hospital. After all, in the NICU the doctors and nurses were only footsteps away, watching vigilantly over your baby. At home, you may feel suddenly cut off from the NICU's constant medical supervision. Even a sneeze may seem scary.

Although doctors make every effort to discharge only healthy babies from the hospital, preemies do have a greater risk of illness. If your baby seems sick, trust your instincts and visit your pediatrician. Many babies show clear signs of being sick, and knowing those signs can help you communicate more clearly when the doctor asks “What exactly is wrong with your baby?”

★ General Signs of Illness
Many signs of illness in babies are the same no matter what type of illness your baby has. These symptoms may be vague and hard to recognize. If they are persistent or a change from your baby's usual routine, a phone call to the pediatrician is in order. You should never hesitate to call your doctor if you are worried, especially when you are just getting used to having a preemie at home. Trust your instincts.

* Extreme sleepiness: Newborn babies, especially preemies, sleep a lot. If your baby seems sleepier than usual, especially if he is hard to wake up for feeding times, call your pediatrician.

* Loose stools: Breastfed babies typically have several yellow, seedy stools per day. Formula fed babies usually have 1 or more soft, tan-colored stools daily. Take your baby to the pediatrician if his stools are loose or mainly composed of liquid, as diarrhea can cause dehydration.

* Fewer wet diapers: If your baby has fewer than 6 wet diapers in a 24-hour period, he may be dehydrated. Make sure that he is breast or bottle feeding as often as usual, and call the pediatrician. The doctor may want to check your baby for other signs of dehydration.

* Vomiting: Many babies spit up frequently, but spitting up shouldn’t be forceful or painful. If your baby vomits more than 2 or 3 times in a day, let your doctor know.

★ Signs of Serious Illness
Although the signs of mild illness can be vague, the signs of more serious illness are usually easy to recognize. If your baby shows any of these symptoms, call the doctor immediately or take your baby to the emergency room.

* Difficulty breathing: If your baby seems to be working very hard to breathe, is flaring his nostrils or sucking so hard that you can see his ribs when taking a breath, has a bluish tint to his lips or mouth, or is breathing faster than 60 breaths per minute, seek immediate medical attention. Call 911 or take your baby to the closest emergency room.

* Fever: Fevers that would be routine in older children are considered serious in infants under about 3 months of age. An infant’s temperature should be between 97.8 F and 100.4 F. A temperature higher than that could be a sign of infection, and you should call your doctor immediately.

* Feeding difficulties: If your baby won’t wake up to eat, does not want to eat, or has a reduction in the amount of breast milk or formula he normally eats, call your doctor right away.

* Redness, streaking, inflammation: Inflammation around any opening into the body is a serious medical condition that warrants immediate treatment. Umbilical cord stumps, circumcision sites, gastrostomy tube insertion sites, tracheostomies, and any other opening into the body may become infected. If the area is warm, red, puffy, or streaky, call your doctor.

Sources:

Kaiser Permanente. “Feeding Your Premature Baby: After Your Child’s Visit.” Accessed February 12, 2009. http://members.kaiserpermanente.org/kpweb/healthency.do?hwid=uh5099

Kids Health. “Medical Care and Your Newborn.” Accessed February 12, 2009. http://kidshealth.org/parent/pregnancy_newborn/medical_care/mednewborn.html

March of Dimes. “When to Call Your Baby’s Doctor.” Accessed February 12, 2009. http://www.marchofdimes.com/pnhec/298_1449.asp

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Recognize Symptoms of a Sick Baby or Toddler

How do you know if you have a sick baby?

This page will help you recognize symptoms of serious illness in your baby or toddler, so you will know if you have a sick baby or toddler.

There are 2 sections

* Symptoms of a Seriously Ill Baby
* Symptoms of a Seriously Ill Toddler (over 18 months of age)

★ Symptoms of a Seriously Ill Baby

- see your doctor if your baby:

* has poor feeding - feeding less than half normal
* is very lethargic and uninterested in her surroundings
* has difficulty breathing - her ribs are very prominent with each breath and she is struggling to breath
* is cold to touch - press your thumb over her breast-bone for 5 seconds until the skin goes white. Take your thumb off and count in seconds until the color returns to the skin. (1000-1, 1000-2, 1000-3 etc is equivalent to 1 second, 2 seconds, 3 seconds etc). If the color has not returned within 3 seconds (1000-1, 1000-2, 1000-3), she needs urgent medical attention
* is very irritable and difficult to settle
* is blue in color around the lips or mouth
* is grey or mottled in color
* has bile-stained vomiting
* has a red rash that does not blanch (go away) when pressed
* has high fever and misery for more than 5 days

If you think you have a sick baby, see your doctor urgently

To use BabyCheck, click here - this is a scoring system designed by an English doctor to help parents of infants decide how sick their baby is.
http://www.nicutools.org/default.html?./MediCalcs/BabyCheck.php3

★ Symptoms of a Seriously Ill Toddler

- see your doctor if your toddler:

* is very lethargic and uninterested in her surroundings
* has difficulty breathing - her ribs are very prominent with each breath and she is struggling to breath
* is cold to touch - press your thumb over her breast-bone for 5 seconds until the skin goes white. Take your thumb off and count in seconds until the color returns to the skin. (1000-1, 1000-2, 1000-3 etc is equivalent to 1 second, 2 seconds, 3 seconds etc). If the color has not returned within 3 seconds (1000-1, 1000-2, 1000-3), she needs urgent medical attention
* is very irritable and difficult to settle
* is blue in color around the lips or mouth
* is grey or mottled in color
* has bile-stained vomiting
* is complaining of a headache, particularly if first thing in the morning and associated with vomiting
* has a stiff neck
* has a red rash that does not blanch (go away) when pressed
* has fever and misery for more than 5 days

If you think you have a sick toddler, see your doctor urgently

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When Your Newborn Gets Sick
* Dehydration, jaundice, diarrhea
* Ear infections, colic

It's inevitable—your baby will get sick sometime. Whether it's a cold, an ear infection, colic or something else, you need to be prepared. If your baby exhibits any of the following symptoms, call your doctor. Any of these could be an indication your baby is ill.

* fever higher than 101F (38.3C)
* inconsolable crying for long periods
* problems with urination
* projectile vomiting, in which stomach contents come out with great force
* baby appears lethargic or floppy when held
* severe diarrhea
* unusual behavior
* poor appetite

★ Dehydration
Dehydration in an infant can be very serious. If you think your baby may be dehydrated, call your pediatrician immediately. There are some warning signs to watch for, including those below.

* Baby wets fewer than five or six diapers a day.
* Baby's urine is dark yellow or orange; it should be pale yellow.
* Baby has fewer than two loose stools a day.
* Baby seems to be having trouble sucking.
* The soft spot on baby's head is sunken in.
* Baby is listless or otherwise appears unhealthy.

If you're concerned, call your doctor. A change in the number of diapers used or the consistency of the bowel movement is the first clue.

During pregnancy, your liver takes care of bilirubin for your baby. After delivery, if baby's liver isn't mature and can't handle the bilirubin, jaundice occurs.

★ Jaundice
Jaundice is a yellow discoloration of the skin, sclera (eyes) and deeper tissues of the body. The baby looks yellow because excess amounts of bilirubin, a breakdown product of blood, has accumulated in her system. The baby is unable to filter it from the blood. It can be dangerous for the baby if left untreated.

If your pediatrician and the nurses in the hospital suspect your baby has jaundice, they will test her and keep her under observation. They will determine what type of treatment is necessary.

Phototherapy is used to treat jaundice. The baby is placed under special lights, which penetrate baby's skin and convert the bilirubin to a form that is passed in the urine. In more severe cases, blood-exchange transfusions may be necessary.

In some parts of the world, special lights may not be available. In these cases, the baby is placed outside in the sunshine for very short periods of time, and the sunlight destroys the excess bilirubin.

★ Diarrhea
Your baby may experience diarrhea—it's not uncommon. She'll need extra water and minerals to prevent dehydration. Your doctor may recommend an electrolyte solution to help replenish your baby's lost fluids and minerals.

★ Ear Infections
It may be difficult for you to determine if your baby has an ear infection. Symptoms that may indicate an ear infection in babies less than 6 months of age include irritability that lasts all day, sleeplessness, lethargy and feeding difficulties. These symptoms may be hard to discern and may not be accompanied by fever.

For babies between 6 and 12 months of age, the symptoms are similar, except that fever is more common. The onset of ear pain may be sudden, acute and more noticeable, and baby may pull at her ears. If you suspect baby has an ear infection, call your pediatrician. He or she can look into your baby's ears and will prescribe treatment.

★ Colic
Colic is a condition marked by episodes of loud, sudden crying and fussiness, which can often last for hours. About 20% of all babies experience this unexplained pain and crying. In full-blown colic, the baby's abdomen becomes distended, and the infant passes gas often. The only way to know if your baby has colic is to visit your pediatrician or family physician. He or she can determine if it is colic or if your baby is having some other problem.

Colic usually appears gradually in an infant about 2 weeks after birth. As time passes, the condition may worsen; however, it often disappears around age 3 months but occasionally lasts until 4 months. Colic attacks usually occur in the late afternoon and early evening, and can last as long as 3 to 4 hours. Attacks cease as quickly as they begin.

Researchers have been studying the causes of colic for a long time, but we still have little understanding of why it occurs. Theories about its causes include: immaturity of the digestive system, intolerance to cow's-milk protein in formula or breast milk, and fatigue in the infant.

At this time, we cannot offer a definitive answer on how to stop the colic. Most doctors recommend using a variety of methods to try to ease the baby's discomfort. Some of these ideas are:

* Offer baby the breast or a bottle of formula.
* Try noncow's milk formula, if you bottlefeed.
* Carry your baby in a sling during an attack. Motion and closeness often help somewhat.
* Give baby a pacifier to help soothe her.
* Put the baby on her stomach across your knees, and rub her back.
* Wrap the baby snugly in a blanket.
* Massage or stroke baby's tummy.

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Alternative remedy tips for parents with sick kids
Keeping Your Kids Well
* Posted on Oct 21, 2008 12:00 PM by Michele Borboa, MS

Cold and flu season is fast approaching, and, with school and play, your kids will be in the thick of it. Do you plan on treating them with the usual over-the-counter cold and cough medicines or have you decided you'd rather treat them -œnaturally- with alternative remedies? Before you reach for the bottle of cold medicine or herbal supplements, take the following tips into consideration and talk to your healthcare provider about the best - and safest - treatments for your family.

★ Conventional versus alternative

Over-the-counter cold and cough medicine sicken some 7,000 kids a year, mostly because of overdoses.

Given the FDA's warnings, parents are turning to natural, alternative remedies. Unfortunately, this is a confusing, unregulated territory, and some natural remedies can be potentially harmful to kids.

Here are few tips from Dr Rachel Schreiber, board-certified physician in allergy and immunology as well as internal medicine, and Dr Jamie Freishtat, board-certified pediatrician at the Children’s National Medical Center in Washington, DC.

Dr Schreiber and Dr Freishtat are also known as the Mommy Docs – they have dedicated their careers to providing parents with tried and true healthcare on their website Mommydocs.com, which offers practical information, blogs, and podcasts on keeping your children healthy.

★ Alternative remedy tips for parents

● Capsules, powders, and potions beware

Keep in mind that herbal supplements should not be given to children.

Vitamins should only be given under the direction of the pediatrician. The FDA doesn't regulate OTC supplements.

Because young bodies process drugs differently, your kiddos may be especially vulnerable to side effects.

● No honey for infants
Despite being a soothing remedy for sore throats and cough, honey should not be given to children under the age of one as it may contain bacterial spores that can cause infant botulism, a rare and serious form of food poisoning. Infant botulism affects a baby's nervous system and can result in death.

● Water is good for you, but not for your baby
Drink eight (8-ounce) glasses of water each day as it flushes out toxins and serves to rehydrate the body.

Keeping your body hydrated through water consumption is important so that mucus membranes are also, in turn, hydrated and thus able to effectively expel virus particles.

Make sure your adolescents are well-hydrated, especially when they are sick. However, babies under the age of one should not drink water unless advised by a pediatrician.

● Bacteria-free humidifiers
Humidifiers are a good solution to coughs and stuffed up noses as they hydrate mucus membranes and help the body expel germs more effectively.

Opt for humidifiers that have bacteria-eliminating features, like the Vicks GermFree Humidifier, which has a patented UV light chamber that kills up to 99 percent of bacteria, mold and spores in the water vapor that enters the air.

And for maximum safety in the nursery for your little one, use a Vicks Cool Mist Humidifier.

● Saline Drops or saline spray
For nasal congestion in babies, consider using nasal saline drops, which are gentler, and a bulb syringe to help loosen and clear mucus.

And for your older children, you can use a nasal saline spray.

知识上的武装:

Your baby's first year   这个最新版好像是2010年出的第三版。内容非常详细和实用。记得我们当时只要出现了什么我们不知道的问题，第一步就是去翻这本书。

Link： 点击这里