We go to the doctor when we’re sick. We know when we’re sick. So that is ok. In these Covid times many of us have been a bit hesitant to seek medical care for non-Covid issues and, as understandable as this hesitancy is, it is in fact a mistake. It now seems pretty clear that the risks associated with avoiding healthcare visits probably outweigh the benefits of avoiding Covid exposure. We are all starting to understand this and as adults we are able to make informed decisions for ourselves.

But what about children? Especially babies and small infants. They cannot really tell us when they are sick and they cannot really make balanced risk-adjusted healthcare-seeking decisions, can they!? So in these times it is especially important to understand the signs that indicate baby is actually quite sick and requires medical care. As parents it has never been more important to get this right…

When to worry?

Some of the most worrying symptoms in babies and infants are:

  • Lethargy. Babies do sleep a lot we know, but if baby seems more lethargic, less active, or seems to sleep too much, you should worry. Reduced activity (lethargy) is a non-precise (there are many causes) but important sign of what could be a serious condition.
  • Shortness of breath. Breathing difficulty is always serious. A baby that is battling to breath will breathe very quickly (more breaths per minute than normal) and the breathing may seem laboured and difficult. You may hear a wheeze or whistling noise with breathing. There may or may not be a cough. These are all signs of breathing difficulty and should be taken seriously.
  • Fever. Any temperature over 37C is high and is a “fever”. In babes and infants this is most commonly caused by some form of infection (cold, flu, tonsillitis, gastroenteritis, etc.) and that in itself may be serious. But in addition, we know that high fevers (over 38C) can actually be dangerous for babies, causing seizures (febrile convulsions). The emergency care of a baby with fever usually includes sponging with tepid water and the use of paracetamol. Please see your doctor about any fever in a baby or infant.
  • Babies cry. We know this. But if baby seems to cry excessively and for no obvious reason (nappy, hunger, boredom) it could indicate some underlying medical problem that you should take seriously.
  • Not eating. Any reduced appetite is a worry. Babies and infants key task is to grow so they are “wired” to eat (drink, but you get the idea). Any change here is almost always caused by some physical condition, which may be serious.
  • Dehydration. Babies are small and at risk of losing too much fluid thereby becoming dangerously dehydrated. This is why gastroenteritis is such a dangerous condition for babies (and quite benign for the rest of us). The signs of dehydration in baby include dry skin, sunken eyes, lethargy, reduced urine, dark urine, etc. Any baby who loses fluids from diarrhoea, vomiting, or sweat, should be watched carefully and taken for medical care if there is any doubt.
  • Other. There are other worrying symptoms such as skin rashes, dry skin, jaundice, but since these are less common and often obvious, we will not go into them here.

Parenting has never been easy. It may well be the single most challenging human endeavour. This has never been truer than in these changing and difficult times. Knowing when to worry about medical care may help you make good decisions for your family.