Infant emergencies

Being a new parent can be pretty overwhelming at times. It may feel like every peep or squeak your baby makes is the first sign of something serious. And while most rashes, upset tummies and yucky diapers are just part of raising a little one, there are certain signs and symptoms that should prompt parents with babies to head straight to the emergency room.

One unfortunate result of social distancing is that kids’ routine well care, and even emergency care, are being put off in fear of the virus. Just like routine well-child visits help keep your child healthy and track their development, emergency care can detect underlying issues you may not see with the naked eye after a fall, vomiting spell, or high fever. And with some symptoms, it’s best not to wait to seek care.

The fear with fevers

Daniel Thimann, MD, is a board-certified pediatric emergency medicine specialist who practices at Wolfson Children’s Emergency Centers. When asked what parents should be worried about, he said their primary concern in their little ones is fever. It can be a sign of a complex condition that needs treatment right away.

“Definitely, in babies two months old and younger or those who are not immunized, the recommendation would be to bring them to the ER for fevers,” he said. “Infants are at increased risk of having fevers that are the sign of more complicated conditions than older kids or those who received their vaccines. Basically, if you vaccinated your child, you have protected them from more serious conditions. In immunized children with a fever, they typically have a virus or a UTI.”

The doctor will see you now

Other reasons Dr. Thimann would want to see your baby include:

• Animal bites or scratches
• Falls, drops and other types of trauma
• Hyperthermia (overheating)
• Near-drowning
• Skin rashes that cause your baby discomfort
• Vomiting or diarrhea, especially if it has a red or black appearance

“We do see a fair share of babies who fall from beds, from the car, somebody holding them, counters or down the stairs, and the vast majority of these kids are going to be just fine, but you really need a professional opinion from a pediatric trauma expert to make sure your child is OK,” said Dr. Thimann. “If your child falls and hits their head, especially if they have a ‘good egg,’ bring them to the ER. Chances are they’ll be fine and we won’t need to do anything, but we want to see that child.”

Dr. Thimann added that vomiting and dehydration are serious concerns for infants. Skin rashes may also be a concern, but only if they seem to bother your little one.

“With infants, persistent vomiting and inability to take in fluids are causes for concern. Abdominal pain is also very important for us to examine because it could indicate appendicitis, intussusception (intestinal obstruction) or malrotation (intestine is positioned incorrectly). Or it could be as simple as colic or milk protein allergy. Bleeding from the rectum in infants is not common, and it’s always something that needs to be addressed,” he said. “With skin rashes, our general train of thought is that if it doesn’t bother the child, he or she is probably OK. If the rash bothers the child, that could be different.”

How urgent are these emergencies?

Parents may wonder when it’s best to take their child to the nearest pediatric ER versus calling 911. Dr. Thimann said, in most cases, taking your baby yourself is usually a perfectly safe option.

“It’s almost always OK to bring your child by private vehicle, and may even be safer because you can strap them into their own car seat. However, if your child isn’t acting like themselves, falls from a great height, or if you’re concerned about your child receiving life-sustaining care, definitely call 911. It’s never wrong to call the ambulance.”

But what about COVID-19?

Of course, your baby getting sick during a global pandemic adds an extra layer of stress and concern. Is it better to manage his or her symptoms at home and not chance exposure to the virus? What is the most responsible thing to do?

“Our hospital is very well prepared to care for COVID and non-COVID patients,” said Dr. Thimann. “We’re doing everything we can to prevent the spread of disease and following all the CDC guidelines. If parental concern is there and you want to bring them into the ER, the last thing you have to worry about is the spread of COVID to your child. I feel very confident we can keep your kids safe.”

Ultimately, Dr. Thimann urges parents to listen to their gut instinct. If you think your child may need to go to the ER, it’s best to err on the side of caution.

“It’s hard for parents to know what to do because every child is so different, and you get advice from the grandparents, someone you know who is a nurse, or your sister, brother or friend. Just bring them in. We’ll talk and make sure your child is OK.”

If your baby is experiencing symptoms that are concerning to you, please take him or her to the nearest pediatric ER. Visit wolfsonchildrens.com/emergency to find the Wolfson Children’s Emergency Center nearest you and see current wait times.