When to seek paediatric care for an infant’s illness

When to take an infant to the pediatrician and who to contact?

Getting sick is a natural part of life, and sooner or later, your infant will likely catch common infections circulating in your home or environment.

As a new parent, you may feel more concerned about your child's health and frequently seek reassurance from a paediatrician. In families with older children attending daycare or school, it is almost inevitable that an infant will be exposed to illnesses from siblings. 

One challenge is that infants cannot verbally express their discomfort, so parents must rely on visible and audible symptoms and instinct. Understanding the most common warning signs that indicate a need for medical attention can help you make informed decisions about your child’s care and provide inner peace. If you are ever in doubt, do not hesitate to call your paediatrician for guidance.

The most common symptom that indicates a child's illness is fever.

Fever in an infant

Fever, defined as a body temperature above 38.0°C (measured under the armpit), is a natural immune response that helps fight infection. While fever is a common reason for paediatric visits and a frequent concern for parents, it is not always an emergency, unless it is an infant under three months old. Infants experience fevers more often than adults, and their temperatures tend to spike higher. 

Infants under 3 months old and fever

If your infant is younger than 3 months and experiences fever, seek urgent paediatric advice and schedule an appointment. If your paediatrician’s office is closed, contact the on-call paediatrician or the paediatric department of the nearest hospital for immediate guidance.*

Seek urgent paediatric help if, in addition to fever, the infant appears lethargic and does not respond to stimuli, develops a rash, shows signs of dehydration (dry mucous membranes, crying without tears, extreme sleepiness, or skin that does not bounce back when gently pinched), or experiences febrile convulsions (shaking episodes with loss of consciousness).

Infants older than 3 months and fever

For infants older than 3 months who have no other concerning symptoms, you can try reducing the fever with common physical methods (these can also be used for newborns but should never replace a paediatric evaluation):

• gently wiping the child with a damp cloth or sponge
• giving a lukewarm bath
• keeping the child in a warm, well-ventilated room
• dressing the child in breathable, lightweight clothing
• partially undressing the child and covering with a light blanket

 Fever can also be managed with fever-reducing medications (antipyretics). Always consult a paediatrician before giving your child fever medication for the first time, and follow the recommended dosage carefully. Giving a lower dose than prescribed is ineffective and will not produce the desired results.

Contact a paediatrician immediately, regardless of the child's age, if the fever (above 38°C) persists for more than 3 days, if it exceeds 40 °C, and if the child behaves unusually, has difficulty waking up, appears restless, or seems confused. 

Other concerning symptoms in infants

Regardless of your child's age, seek immediate medical attention if you notice any of the following symptoms:

• rapid or laboured breathing even after the fever has subsided
• heavy or uncontrolled bleeding, or small pinpoint skin or mucous membrane bleeding that does not fade under pressure
• angioedema – swelling of the lips, ears, or eyelids, difficulty swallowing
• loss of consciousness or episodes of shaking, appearing disoriented or unresponsive
• prolonged, inconsolable crying that is unusual or different from the child's typical crying
• fever in a child with a pre-existing chronic condition (e.g., congenital heart defect, lung disease, or a malignant illness)

If you experience extreme discomfort, anxiety, or a strong feeling that something is wrong with your child—even if the symptoms are not listed here—do not hesitate to consult a paediatrician, at least by phone. Trust your parental instinct! 

* In Zagreb, several hospitals provide paediatric care, so depending on your child's symptoms, you may have multiple options for seeking medical help. In other cities with only one hospital, contact the hospital's unified emergency department (where a paediatrician is on duty) or the paediatric department directly. In areas without a hospital, reach out to the nearest hospital or the emergency service of the local health centre for guidance and assistance.