When to Call the Doctor

Certain conditions and symptoms demand professional attention. In general, call your pediatrician if your child has any of the following:

• A fever greater than 100 degrees Fahrenheit
• Sweaty or clammy skin
• Unusual and persistent crying
• An injury that causes more than 15 minutes of crying
• Disruptions in feeding patterns, especially a sudden loss of appetite
• Ingestion of anything you suspect may be poisonous
• Vomiting that differs in force or volume from normal spitting up
• Diarrhea that smells foul or shows blood or mucus or is accompanied by a fever
• Constipation that is accompanied by vomiting
• Signs of blood in the urine or bowel movements
• Unusual listlessness or inactivity
• Convulsions or twitching fits
• Marked changes in color or behavior
• Any unfamiliar or widespread rash
• Any burns that result in blisters
• Difficulty in breathing
• A persistent cough
• Redness of the eyes or the discharge of pus from the eyes
• Discharge from the ears or ear pain, which you may be able to recognize by the baby's constant turning of his head or pulling at his ear
• Swelling or sinking of the fontanels (the two soft spots in your baby's head)

Of course, just because a symptom is not on the preceding list doesn't mean you shouldn't call. Feel free to call your child's doctor whenever you have concerns that cannot wait until the next scheduled visit.

Immunizations

The frequency of well-baby visits during your child's first year is largely determined by the immunization schedule. At almost every visit, your baby gets a shot and/or an oral vaccine to help prevent certain childhood illnesses. Immunizations help your baby develop the antibodies that protect her from such diseases as the following:

• Hepatitis
• Diphtheria (a bacterial infection that attacks the throat and airway)
• Tetanus (lockjaw)
• Pertussis (whooping cough)
• Hemophilus influenzae type B (HIB) (a bacterial infection that can cause meningitis)
• Polio (a viral infection that attacks the central nervous system, causing nerve damage and possible paralysis)
• Measles
• Mumps
• Rubella (German measles)
• Varicella (chicken pox)

Dead or weakened strains of the germs, when introduced into the body orally or through an injection, stimulate the protection of antibodies that fight disease. If your child later comes in contact with the germs that cause these diseases, she will get either a mild case of the illness or not get it at all.

To Immunize or not to Immunize?

Many parents today are reluctant to immunize their children against childhood diseases. Why? Let's enter into the debate:

POINT: Many of these diseases are now all but eradicated, and even on those rare occasions when they do occur, medical interventions now significantly reduce the risk of long-term damage. Some of these diseases are common only among certain segments of the population. Unless your child is at risk, why should you agree to have your child vaccinated?

COUNTERPOINT: Although some of these diseases may have all but disappeared, the germs that cause them have not been eliminated. The fact that children rarely get these diseases demonstrates the effectiveness of widespread immunization programs rather than a complete victory over the disease itself.

POINT: Some children have poor reactions to certain vaccines. For example, the side effects of the DPT shot (a combined vaccine against diphtheria, tetanus, and pertussis) include anywhere from one to three days of fever, loss of appetite, and general irritability.

COUNTERPOINT: Pediatricians can make adjustments to the vaccine to lessen the side effects. If, for example, your two-month-old seems particularly out of sorts for an extended period of time following her DPT immunization, your pediatrician will probably agree to eliminate the pertussis vaccine, the most likely cause of this reaction, from all subsequent immunizations. Or your doctor may suggest switching to a new acellular pertussis vaccine that involves much less risk of side effects.

Ultimately, you will need to make your own decision about whether or not to immunize your baby. Discuss your concerns with your pediatrician, who may help you weigh the potential risks of vaccination against the risks involved in not immunizing.

Excerpted from:

Excerpted from The Complete Idiot's Guide to Bringing Up Baby © 1997 by Kevin Osborn. All rights reserved including the right of reproduction in whole or in part in any form. Used by arrangement with Alpha Books, a member of Penguin Group (USA) Inc.

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