What common symptoms would you look for when diagnosing an infant that seems to be ill?

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My son has always been a happy, easygoing kid. But at 4 months, Samuel was really cranky for a few days. I called the pediatrician's office, and the nurse said it sounded like teething. That, though, didn't seem right, so I asked to come in for a doctor's take. I felt awkward. After all, I'd been a mom for a fraction of this nurse's career. Who was I to second-guess someone with so much experience?

What I didn't consider was that I'd developed my own expertise on Samuel. I could differentiate his feed-me wails from his cuddle-me whimpers and his I'm-so-sleepy sobs. Turns out, he wasn't teething. He had an ear infection, one we were able to catch and treat early.

Knowing your own baby and following your parental instincts can be helpful in guiding an expert to the correct medical diagnosis. "To understand when a baby is sick, you have to understand what he's like when he's well—and that's something a parent knows best," says Paul Horowitz, M.D., a pediatrician in Santa Clarita, California.

To help you and your doctor figure out a plan for your little one when they're under the weather, you can follow this guide to common childhood illnesses, how to treat them, and when to see the doctor.

1. Fever

A fever is a sign of an underlying problem rather than an illness on its own. "The body raises its temperature because the enzymes that fight infection work better at higher temperatures," Dr. Horowitz says. A fever can be related to an ear infection, a cold, the flu, or it can be a reaction to a vaccine. Feverish kids are lethargic and irritable.

How to treat a fever

Some parents may worry about fevers, especially if it's their first time encountering one. But low-grade fevers (101 degrees or below) in babies over 3 months old typically aren't dangerous. To help your little one feel more comfortable, you can administer infant Tylenol (check with your doctor beforehand and confirm the dose), undress your baby, encourage feedings as normal, and bathe them in tepid water. "Just wiping her down could lower her fever by a degree or two," says Christopher Tolcher, MD, a pediatrician in Agoura Hills, California.

When to call the doctor for a fever

If your baby is a newborn (3 months or younger) and has a fever of 100.4 or higher, if your child is younger than 1 year and has a fever of 102 degrees or higher, if a child has a fever of 104 degrees or higher, or if the fever (even a low-grade one) lasts more than three days. Drastic changes in behavior—such as your child's becoming very lethargic—are also cause for calling up a medical professional.

2. Cold Symptoms

'Tis the season for sniffling. Young children get six to eight colds a year, primarily during fall and winter. That's a lot of colds, so sometimes it can be hard to know when an illness is more than "just" a cold. One way to tell is by how symptoms progress: With a cold, symptoms (a stuffy or runny nose and sneezing, coughing, and sometimes a fever) usually build for two to three days, peak for three to five, and then subside.

How to treat cold symptoms

First things first, it has to be said: COVID-19 symptoms and the common cold symptoms can often be exactly the same, especially in babies and toddlers. So you'll want to either call your pediatrician about testing or administer a home test, just to be sure.

Next, to treat symptoms like a stuffy or runny nose, coughing, and fever, avoid cough or cold meds. If your pediatrician gives you the go-ahead, you can administer infant Tylenol for fever. Dry air worsens congestion, so run a humidifier in your baby's room during sleep. Keep your baby hydrated by encouraging regular feedings with breast milk or formula. If your child is over 1, an electrolyte drink like Pedialyte may also help.

When to call the doctor for cold symptoms

Be sure to keep in touch with your pediatrician if your sniffling baby is a newborn or under 3 months old, has a high fever, does not improve after a few days, or tests positive for COVID-19. Seek emergency medical attention if your baby appears lethargic or is having trouble breathing.

3. The Flu

This very contagious virus travels quickly through daycares and families. An infected baby will be cranky and will lose interest in playing or eating. Then they may develop a fever followed by a runny or stuffy nose and a cough. A flu-related fever can last three to seven days, and kids can continue to feel cranky for a few days after that.

How to treat the flu

Care for your child as if they have a cold: Give your baby plenty of liquids and watch out for severe coughing or breathing problems. To prevent a future bout, get your child vaccinated with the flu vaccine, which experts recommend for all adults and kids over 6 months.

When to call the doctor for the flu

Call your doctor if your baby is a newborn and sick, if it's flu season and your child spikes a fever, or if symptoms don't improve within five days.

4. Respiratory Syncytial Virus (RSV)

RSV is a common virus affecting the lungs and breathing passages; it's so common, in fact, that nearly every child will have RSV by the time they reach two years old. While most kids will recover with no problems, some children will develop complications from RSV. Preemies are especially vulnerable because their airway and immune system aren't completely developed. RSV generally begins like a cold does; by day three, a strong cough and wheezing-like breathing begin. Symptoms recede after a few days, but the cough can linger for up to two weeks. Kids who have a bad episode have an increased risk of developing asthma.

How to treat RSV

Use a cool mist humidifier to help keep the air from getting too dry. If your doctor approves it, offer infant Tylenol for fevers and discomfort, as well as extra fluids.

When to call the doctor for RSV

Call your doctor if your child is a newborn and sick, shows signs of dehydration, or is not acting like themselves. Seek emergency medical attention right away if your baby's skin, lips, or tongue appear gray or blue, or if they have severe nonstop coughing or trouble breathing. "Notice if he's using extra muscles to breathe," Dr. Horowitz says. "Take off his shirt. If the spaces between his ribs get sucked in with each breath and his nostrils are flaring, call your doctor right away."

5. Ear Infection

Baby body language is tricky because sleepy kids often rub their ears. But if your baby tugs their ears and also has a stuffy nose and a fever, an ear infection might be the culprit. Infants are especially prone to these.

How to treat an ear infection

Some infections clear up on their own. "To avoid the overuse of antibiotics, we've gotten less aggressive about treating ear infections," Dr. Horowitz says. But a doctor will prescribe an antibiotic to relieve ear pain. They may also recommend infant Tylenol to help your baby feel more comfortable.

When to call the doctor for an ear infection

If you suspect an infection, you'll need to call your pediatrician. "The only way to diagnose is for your doctor to look in your child's ear," Sue Hubbard, M.D., a Dallas pediatrician. "One day the ear can look normal, and the next it might be infected. Give it a few days to see if symptoms improve. If they don't, visit your doctor again." A severe, untreated ear infection can lead to a ruptured eardrum, and repeat ear infections can lead to hearing loss. You should also call your doctor if your baby or toddler has recurrent ear infections.

6. Diarrhea

Changing diapers—especially if they're runny—is not one of parenthood's joys. Watery and frequent bowel movements are often caused by a virus; but a bacterial infection, allergy, food intolerance, or medicine could also be to blame.

How to treat diarrhea

Diarrhea usually lasts five to ten days. Dehydration is the main concern, so give your baby lots of fluid. Is your little one also vomiting? If they're over the age of one, 30 minutes after they throw up to offer small, frequent doses of an electrolyte drink. Start with a tablespoon, slowly increasing the dose over time.

When to call the doctor for diarrhea

If your sick baby has a high fever, exhibits signs of dehydration (fewer wet diapers, sluggishness, skin that's not as elastic as usual), or if there is any blood or pus in the stool.

7. Conjunctivitis (Pinkeye)

Known as pinkeye, this condition makes your child's eyes look red and puffy. It's an inflammation of the eye's mucous membranes and usually affects both eyes at once but sometimes starts in one eye only. The cause can be a bacterial or viral infection: yellow or green drainage signals bacterial; no tearing or pus indicates viral. Another way to differentiate: viral infections usually come with cold symptoms. Both are very contagious and spread quickly.

How to treat pinkeye

A viral infection usually clears up on its own within a week. Keep your baby's eye area clean by gently washing it with warm water. If the infection is bacterial, your doctor will treat it with an antibiotic eyedrop. For either infection type, a warm compress will make your baby feel better.

When to call the doctor for pinkeye

As soon as symptoms appear. There are other eye problems that can occur in babies, but you'll want to consult a doctor to ensure the cause isn't bacterial and to get antibiotics if needed.

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