Fever, Colds and Ear Infections: When to Call the Doctor (AAP)

Colds are common

• Babies and toddlers often get 8 or more colds a year, more in their first year of group care.
• A cold usually lasts 7 to 10 days. The cough can hang on for 2 to 3 weeks.
• Colds are caused by viruses, so antibiotics don't help them.

Easing a cold

• Saline drops and gentle suction for a stuffy nose, especially before feeds and sleep.
• A cool-mist humidifier in the room.
• Plenty of fluids: extra breast milk or formula for babies, water for older children.
• Honey can soothe a cough from age 1. Never give honey under 12 months (botulism risk).
• Don't give over-the-counter cough and cold medicines under age 4 unless the doctor says to; they don't work well in young children and can be harmful.

Fever

• A fever is a temperature of 100.4°F (38°C) or higher. It's the body fighting infection, and the number on its own matters less than how your child looks and acts.
• Fever medicine is for comfort, not to hit a number. Acetaminophen from 2 months with the doctor's OK and ibuprofen from 6 months, dosed by weight. Never give aspirin to children.
• Call the doctor for a fever of 101°F (38.3°C) or higher at 3 to 6 months, a fever that lasts more than 24 hours in a child under 2, or more than 3 days in a child 2 or older, or a fever that keeps going above 104°F (40°C).

Ear infections

• They often follow a cold. Signs: fussiness, trouble sleeping, fever, pulling at the ear, or fluid from the ear. Ear tugging on its own, without other signs, is often just teething or habit.
• The doctor needs to look in the ear to know. Many mild ear infections in older babies and toddlers clear on their own, so the doctor may suggest watching for a day or two before antibiotics.
• Pain relief helps either way.

Vomiting and diarrhea

• The main risk is dehydration. Offer small, frequent sips: breast milk or formula for babies, or an oral rehydration solution. Skip juice and sports drinks.
• Signs of dehydration: far fewer wet diapers (none in about 8 hours), no tears, dry mouth, sunken soft spot, or unusual sleepiness.

Call 911 or go to the ER

• Struggling to breathe: ribs pulling in with each breath, flaring nostrils, grunting, or blue or gray lips.
• Very hard to wake, floppy, or not responding normally.
• A seizure, a stiff neck, or a rash of small purple-red spots that don't fade when you press them.
• A high-pitched, noisy breath (stridor) when calm, often with a barky cough (croup).
• Signs of dehydration that aren't improving.
• If you're worried and can't reach the doctor, trust that worry and get your child seen.