should I stay or should I go?
When not to rush your baby to the ER (and when you must)
Diarrhea Another diaper dilemma. Remember that babies often have soft, seedy stools — yellow if they’re breastfed, green if bottle-fed. That’s normal. If, however, the stool is watery or contains blood, call the doctor. Your baby may have a bacterial infection.
Every baby spits up — some even make it a mealtime habit. This dribble of undigested food is usually nothing to fear. But if your baby spits up more than usual after several feedings or throws up with force (projectile vomiting), call your pediatrician to check it out.
Poor appetite One sign of a healthy baby is a healthy appetite. An infant who doesn’t seem hungry for two or more feedings could be sick. On the other hand, a 2- or 3-week-old baby who consistently cries after eating may have colic. A doctor can usually tell the difference.
After the first few weeks, most parents begin picking up the nuances of baby talk. A whiny cry means fatigue; an angry wail is “Feed me!” If your baby cries inconsolably, first check her hands and feet — a stray hair may have knotted itself around a finger or toe. Also check your baby’s diaper: Is a plastic tab rubbing, or a safety pin poking, sensitive skin? If not and if you can’t think of a reason for your baby’s cries, call your pediatrician or head to the ER.
Research hospitals now
Find out which hospital your pediatrician is associated with; for insurance purposes, that may be the one you must go to. If you have a choice (many pediatricians are affiliated with more than one), remember that today — long before that scary crying bout — is the time to locate the best ER. Like doctors, no two hospitals are exactly alike. What’s more, no national standards for emergency pediatric care exist.
When it comes to pediatric care, an ER needs two things: training and equipment. Babies aren’t little adults; from CPR to surgery, treatments for grown-ups and infants differ. You want an ER staff that knows how to treat the smallest patients.
Large cities usually have children’s hospitals with pediatric trauma centers and neonatal units. And in Los Angeles and Chicago, hospitals can apply to the local emergency medical services (EMS) authority for voluntary pediatric credentials. Approved hospitals post signs reading “Emergency Department Approved for Pediatrics (EDAP)” or “Pediatric Critical Care Center (PCCC).”
Neighborhood urgent-care clinics may be convenient but should be avoided, according to Bob Wiebe. Many are not equipped to handle pediatric emergencies, and the quality of care can be inconsistent.
If your baby truly needs to go to the ER, it’s worth braving the risks of infection. But do take precautions. “Don’t let other patients or their family members handle your baby,” says Brad Schwartz, M.D., a partner in the California Emergency Physicians Medical Group in San Diego. “Don’t let your child play on the floor, and try to stay away from anyone who’s coughing or any child with an obvious rash. In fact, once you register, if the weather permits, you could wait outside.”