WHEN TO SEE A DOCTOR GENERAL SIGNS THAT A COLD SHOULD BE EVALUATED BY A DOCTOR

If your child doesn't really fit into any of the four above complications and yo
u still aren't sure if he should see the doctor, here are 6 signs to watch for:
1. Temperature and length of fever. Fever greater than 103 for more than 3
days, or fever greater than 101 for more than 5 days. Remember, it is normal for
a cold virus to cause fever through 5 days. However, if your child keeps gettin
g fevers more than 103 for more than 3 days, it would be prudent to take him to
the doctor to be sure there are no bacterial complications yet. It could still j
ust be the cold virus, but it is better not to go more than 3 days with such a h
igh fever without seeing a doctor. See fevers for a detailed discussion on evalu
ation and treatment.
2. Unusual lethargy and irritability. Especially in infants. Lethargy means
more than just not wanting to run around and play. It means your child can't ma
ke eye contact or is unable to focus on you or doesn't respond to your voice. Sh
e simply lies on your lap limp and lifeless with her eyes barely open.
3. Ear infections. Your child has a history of frequent ear infections.
4. Moderate to severe ear pain. Remember, infants and young children may tu
g at their ears simply due to ear congestion, not infection. See ear pain for in
fo on how to treat ear pain overnight.
5. Overall acting sick. If you have a gut feeling that you child is unusual
ly sick, take him to the doctor.
6. Wheezing. This does not mean the junky, rattling sound of chest or nasal
congestion. Wheezing is a high-pitched whistling sound, when your child takes a
breath. If your child is a "happy wheezer" then do not worry. If your child is
struggling to breathe, then seek medical attention.
URGENT SITUATIONS THAT REQUIRE IMMEDIATE EVALUATION
You should seek medical attention if:
After hours, your child has one of the four complications of a cold (ear infecti
on, sinus infection, pneumonia, bacterial bronchitis) with a fever for more than
5 days over 101 degrees. Your doctor may call in an antibiotic and check your c
hild during regular office hours, or he/she may want your child evaluated in a c
linic or ER first.
Your child has moderate wheezing that is causing some tugging in the front of th
e neck and ribs, but it doesn't seem to be slowing him down or causing much dist
ress. Your doctor can probably prescribe some medication over the phone to help
with the wheezing until the morning. If this happens in the middle of the night,
try steaming him before you page the doctor. No need to page the doctor if the
wheezing is mild and not troubling your child at all. This can wait to be seen i
n the office.
Your child has moderate croup. See Croup for more info on how to treat this and
what signs warrant a call to your doctor.
You should take your child into an ER right away if:
Your child has severe wheezing that is causing him significant difficulty breath
ing.
Your child has severe croup and is having significant difficulty getting air in.
Your child's lips or mouth are turning blue due to labored breathing or shortnes
s of breath.
Your child's breathing is rapid and labored. Count the number of breaths he take
s in 30 seconds, multiply it by two, and this gives you his breaths per minute.
Go to the ER right away if the breaths are greater than 60 per minute for childr
en under a year, greater than 50 for children 1 through 4, and greater than 40 f
or children 5 and older. Be aware that fever alone can cause rapid breathing (an
d a rapid heartbeat). Reduce the fever first and then evaluate your child's brea
thing.
Your child seems to have whooping cough and during these severe coughing fits tu
rns blue around the mouth and lips.
Above all, if you are not certain about the status of your child's breathing, an
d feel he is in urgent need of an immediate medical decision, then call your doc
tor.

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Antibiotics do not work at all in treating the common cold. A net designed to tr
ap a human could let a tiny mouse escape. Antibiotics are medicines that kill ba
cteria, not viruses. Many antibiotics work by disrupting the bacteria's cell wal
l. Viruses don't even have a cell wall.
Antibiotics can actually make colds worse. By indiscriminately killing the benef
icial bacteria, an environment more hospitable to the cold viruses is created.
To make matters worse, all antibiotics have side effects. All antibiotics harm b
eneficial bacteria, and can cause diarrhea, yeast infections, and bacterial supe
r-infections. Even something as 'mild' as amoxicillin has been known to cause bo
ne marrow toxicity, seizures, acute interstitial nephritis, neuromuscular sensit
ivity, nausea, vomiting, urticarial rashes, pseudomembranous colitis, thrombocyt
openic purpura, anaphylactic shock, and even death.
If the one billion colds in the U.S.this year were 'treated' with antibiotics, b
illions of dollars would be spent, at least 100 million people would suffer from
side effects, some would even die, and ZERO people would have their cold end qu
icker or even have milder symptoms.
If you want to buy a lottery ticket for your child, choose one with a better pri
ze.
The greatest danger of using antibiotics to treat the common cold is the emergen
ce of resistant bacteria. Over time, the bacteria in your community will develop
resistance to the antibiotics most commonly used there. Then, when your child r
eally needs them, antibiotics, the once powerful defenders, will be a shadow of
their former strength.