Going into late fall, here is general guidance on when to be concerned about symptoms, instances in which you should always call the pediatrician and preventative practices you should take to keep your kids healthy all winter long.

When you should be concerned about symptoms

There are a few things to keep in mind when wondering if you should be concerned about your child’s symptoms. First, age is a factor. A teenager with a nasal condition is different from a 2-month-old with nasal congestion. For the first few months of life, infants are nose-breathers, so any congestion in the nose may lead to some respiratory distress. In most cases, suctioning the nose can be very helpful.

At all ages, a cough and congestion are usually caused by a virus, which typically just needs to run its course. In the case of most viral upper respiratory infections, you do not need to visit the pediatrician but rather trust your child’s own immune system to clear the infection. It may be helpful to treat fever and pain with either acetaminophen or ibuprofen to help your child feel more comfortable while the infection resolves.

Another common question is how to determine if it is a virus or just allergies. This is not always easy to distinguish, but a simple rule of thumb is that allergies will improve with an antihistamine and allergy treatments, while a cold or virus usually does not.

When you should always call the doctor

Some specific instances are usually a clear indication that you should see the pediatrician:

1. Ear infections: It is a good idea to call the pediatrician when your child has symptoms of an ear infection, such as ear pain, trouble hearing, loss of balance or drainage from the ear. Some ear infections can clear up without antibiotics, so if the child is verbal and the ear infection is one-sided, you can wait a couple of days to see if it improves. However, if the child is nonverbal, the infection seems severe or it has been going on for multiple days, it’s time to call the doctor.
2. Bacterial sinusitis: This is another bacterial infection that occurs in the sinuses and may require treatment from a doctor. If symptoms persist after a couple of weeks — such as fever, sinus pressure, pain or headaches — make an appointment with the pediatrician.
3. Exposure to or symptoms of strep: If your child was exposed to someone with strep throat or is experiencing symptoms of strep, including painful swallowing, red and swollen tonsils or swollen and tender lymph nodes in the neck, call the doctor immediately.
4. Respiratory distress: Any time your child is experiencing respiratory distress — including wheezing, a high breathing rate, increased work of breathing or nasal flaring — call your pediatrician.
5. Influenza: Even though influenza is caused by a virus, it is one that is treatable with an antiviral medication. Anti-flu treatments are most effective if started within 48 hours of symptom onset, so if suspected, call your pediatrician. Common flu symptoms include high fevers, body aches, chills, sore throat, cough, nausea, vomiting and abdominal pain.

Best preventative practices

Never undervalue the importance of good preventative practices, including washing hands and getting a good night’s sleep to bolster the immune system. In addition, this is the best time of year to get your annual flu shot, which will help keep you healthy and reduce the spread of the flu virus to others.

If your child does get sick with the flu, a cold or another contagious sickness, try to keep them home from school and social activities for a few days. Most upper respiratory infections are contagious for up to five to seven days, so keeping them home from school beyond that (even if they still have lingering symptoms) may not be necessary. Call your pediatrician if you are not sure.

Use these tips to make wise judgment calls, but trust your instincts as a parent. If you decide it’s time to call the pediatrician, Utah Valley Pediatrics is ready to help your child return to health.

Dr. Ryan Gottfredson DO, MPH, is a pediatrician with Utah Valley Pediatrics, which serves Utah families in nine locations throughout Utah Valley.

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