Moms dread that wake-up call in the middle of the night that signals illness in their child. Whether it's a fever, vomiting or something else, a nighttime illness can be scary. But not all of them warrant a call to the doctor or a visit to the emergency room. A good pediatrician will consider it part of her job to offer after-hours advice - pediatricians should expect worried parents to call at all hours. In fact, many say they worry about those parents who never call. If you're awakened by your child's cry - and it's "that" cry, the one that alarms you - assess a few things before picking up the phone or rushing to the ER. First, is your child feverish? Take his temperature, and if a newborn has a temperature of 100.4 or higher, then it's time to call. If the baby older and has a rectal temperature of 104 degrees or higher, then call.
Watch for febrile seizures - these, too, warrant a call and usually an ER visit. In older children, look for an intense headache or neck stiffness that may accompany fever - this could signal meningitis. Severe abdominal pain on the right side may mean an inflamed appendix, which requires surgery. If your child is vomiting with severe abdominal pain, then call the doctor - he may have a blocked intestine. Difficulty breathing, swallowing or a change in color - red, blue, overly pale - are symptoms that you should call about. Look into the resources available in your area and from your pediatrician before you have to make that dreaded midnight call. But remember - most pediatricians appreciate your concern and trust your parental instincts. If you know something is just not right, then your hunch is probably correct.