Call your doctor if your child has these symptoms

(Medical Xpress) -- Unfortunately, kids get sick. Fighting a virus or common cold is good for a child’s immune system and can help build antibodies that protect them from dangerous illnesses. Still, there are times when that tummy ache or cough may require medical attention.

“Parents know their child best and know when something is not right. The confusion comes from the next steps, like what do I do about it? When do I call the doctor?” said Hannah Chow-Johnson, MD, a pediatrician at Loyola University Health System and an assistant professor of pediatrics at Loyola University Chicago Stritch School of Medicine.

According to Chow, there are 10 symptoms and signs that a child may need more than fluids and rest and a parent should call the doctor.

1. Extreme changes in behavior

Not being aware of surroundings or familiar people

Changes in speaking, such as difficulty forming words or completing thoughts

A child who is truly lethargic - “I hear parents talk about their child being lethargic, but this term is often used incorrectly,” Chow said. “Lethargic is when a child sleeps a lot and barely can awaken despite plentiful sleep or has difficulty staying awake. If your child is tired but alert and aware of what is going on, this is reassuring."

2. Signs of dehydration

Unable to keep down liquids

Frequent vomiting or diarrhea

Diminishing urine output

Infrequent requests for fluids and a dry, sticky mouth

Urinating infrequently (less than every 8 hours in children younger than age 1, less than every 12 hours in children older than age 1)

3. Pains that awaken a child at night - “Headaches, stomachaches or muscle aches that awaken a child from a sound sleep should be taken seriously. Call and make an appointment to see your child’s doctor if this happens,” Chow said.

4. Abdominal pain that worsens and persists

If pain does not improve with child over-the-counter pain relievers

If a fever also is persistent

Pain with physical movement like walking

5. Blood in urine or stool

Blood in urine is very uncommon in children and could be a sign of infection or a kidney problem

Blood in stool when a child has not been constipated

Blood in stool when there is a history of travel

Painless bleeding without bowel movement

“There are several reasons why a child may have blood in his or her stool so it’s best to get it checked out to rule out anything serious,” Chow said.

6. Pain or frequency with urination

Going to the bathroom many times in an hour

Pain when trying to urinate

Eating and drinking a lot but still losing weight

If a child is not verbal, look for these clues:

Irritability

Crankiness

Fever for 2-3 days with no known cause

7. Fevers in certain age groups

Any child younger than 2 months with a rectal temperature of 100.4 degrees or higher should be evaluated immediately

Ages 2 months-3 years with a fever for 2 to 3 days but no known cause

Fevers lasting longer than 5 to 6 days

“Viruses are the most common cause of fevers. They tend to scare parents, but most likely they will go away when the virus is gone,” Chow said.

8. Breathing problems

If your child does not have asthma and any of the following are persistent

Rib-cage squeezing

Flared nostrils

Straining abdominal muscles

Audible wheezing, which is a noise that sounds like harsh air blowing through a straw

A tight whistling sound during inhalation. If this isn’t helped by a cool mist or humidity, seek medical attention immediately

Coughing that is so severe that your child can’t breathe

9. Difficulty drinking

Can’t drink enough to urinate every 3-4 hours

Going 8-12 hours or more without urinating

10. Parent’s gut instinct that something is wrong

“Generally speaking, if a healthy child is drinking well, urinating well and acting within normal limits, he or she is most likely doing fine,” Chow said. “Still, I tell my patients’ parents that if they can’t sleep through the night to give us a call and be reassured."