Call immediately if the child: is seriously injured has a high fever has difficulty breathing has blood in urine or prolonged diarrhea has an unusual rash has a gray or ashen skin color refuses to eat for three or four feedings is extremely lethargic

If bleeding persists, or you need to hold the skin together to stop the bleeding, the child may need stitches. Call the doctor if you can; otherwise, go to the emergency room.

Always call the doctor when the child is under a year old or when the eye is injured. In other children, call immediately if there are any of the following symptoms:

loss of consciousness vomiting behavior alteration troubled breathing

Fever is a sign that the body is fighting infection and is a normal part of the recovery process. However, call the doctor if the fever is unusually high - generally above 101 degrees, 100 degrees in newborns - or if it lasts longer than three days. Call immediately if the fever is accompanied by any of the following:

pain on urination drooling or refusal to swallow liquids breathing difficulty seizures

Make sure it isn’t caused by poisoning. If the child has swallowed a potentially toxic substance, call the poison center immediately. (Keep the number of the regional poison center next to the phone.) For vomiting from overeating, give the child liquids to prevent dehydration. Call the doctor if the vomiting continues after a few hours.

In infants, call the doctor if the child vomits or has diarrhea and then doesn’t urinate for eight hours. Call if there is repeated vomiting in a brief period of time. In older children, call if you see the following:

Child doesn’t urinate for eight to 12 hours Child doesn’t drink Child loses fluids through vomiting or diarrhea Child has sunken eyes or “doughy” skin that doesn’t return to normal when pinched Child is not behaving normally, is unusually lethargic or irritable

A cough that appears only at night, especially if it sounds like barking, could be a sign of croup. A persistent cough could indicate chest or sinus infection. Call the doctor in either case.

Call the doctor if the cold lasts more than a week, if there are unusual symptoms or if there is a high fever.

The following are immunization times recommended by the American Academy of Pediatrics:

DTP: 2 months, 4 months, 6 months, 15-18 months, 4-6 years Polio: 2 months, 4 months, 15-18 months, 4-6 years Measles: 15 months, 11-12 years Mumps: 15 months, 11-12 years Rubella: 15 months, 11-12 years Haemophilus: 2 months, 4 months. The schedule for additional shots varies. Tetanus-diphtheria: 14-16 years

Near each telephone, you should post the following:

Name, telephone number and address of pediatrician Location of nearest emergency room Telephone number of local poison center Mother’s work number Father’s work number

SOURCE: THE AMERICAN ACADEMY OF PEDIATRICS