When Should You Take Your Child to the Doctor?

Children often develop coughs, colds, fevers, stomach bugs, rashes and minor injuries as they grow. Many childhood illnesses are mild and improve with rest, fluids and careful monitoring, but some symptoms need medical assessment—especially when a child is very young, becoming progressively worse or behaving differently from usual.

Hout Bay Family Medical Clinic provides medical care for babies, children and teenagers, including the assessment of acute illnesses, ear infections, asthma, allergies, skin conditions, growth concerns and childhood development. Knowing which warning signs to look for can help Hout Bay parents decide when to arrange a doctor’s appointment and when more urgent care may be necessary.

Trust Your Instincts as a Parent

Parents and caregivers know their children best. A child may not always be able to explain what hurts or how unwell they feel, particularly when they are very young.

Changes in behaviour can therefore be as important as physical symptoms. A child who is unusually quiet, difficult to comfort, extremely irritable, less responsive or much sleepier than normal may need medical attention—even when the individual symptoms do not initially seem severe.

The World Health Organization identifies feeding difficulties, reduced activity, breathing difficulty, fever and seizures among the danger signs requiring prompt medical care in newborns and young children.

Fever in Babies and Children

A fever is usually the body’s response to an infection. Although many childhood fevers are caused by ordinary viral illnesses, the child’s age, behaviour and accompanying symptoms are important.

Arrange a medical assessment when:

• The fever is persistent or repeatedly returns;
• Your child appears increasingly unwell;
• The fever is accompanied by significant pain;
• Your child is refusing fluids or feeding poorly;
• There is persistent vomiting or diarrhoea;
• Your child has an underlying medical condition;
• The fever is accompanied by a rash; or
• You are concerned about a baby or very young child.

Babies under three months with a temperature of 38°C or higher should receive prompt medical advice. Fever accompanied by breathing difficulty, unusual drowsiness, a stiff neck, seizure or a rash that does not fade under pressure requires urgent assessment.

Coughs, Colds and Breathing Problems

Coughs and colds are common in children, particularly those attending school, crèche or playgroups. A mild cough with a runny nose and otherwise normal behaviour can often be monitored at home.

Arrange an appointment if your child:

• Has a cough that is worsening or not improving;
• Is wheezing;
• Has recurring coughing episodes;
• Complains of chest pain;
• Is coughing through the night;
• Has asthma or another respiratory condition;
• Develops a persistent fever; or
• Initially improves and then becomes unwell again.

Breathing difficulty requires more urgent attention. Warning signs include rapid breathing, ribs or the lower chest pulling inward, nostrils flaring, grunting, difficulty speaking or feeding, pauses in breathing, or blue-grey lips.

RSV and other respiratory viruses can cause more severe illness in babies, particularly those younger than six months. Irritability, reduced activity, poor feeding and breathing difficulty may be the only early signs in very young infants.

Vomiting, Diarrhoea and Dehydration

Stomach infections are common in children, but babies and young children can become dehydrated quickly because their bodies are smaller.

Contact a doctor when vomiting or diarrhoea is persistent, severe or accompanied by fever, abdominal pain, blood in the stool or worsening weakness.

Signs of dehydration include:

• A dry mouth or tongue;
• Fewer wet nappies or less frequent urination;
• Dark urine;
• Sunken eyes;
• No tears when crying;
• Poor feeding or refusal to drink;
• Unusual sleepiness; and
• Weakness or reduced responsiveness.

The Western Cape Department of Health advises urgent assessment when a child has persistent vomiting and diarrhoea, signs of dehydration, difficulty waking, refusal to drink or feed, blood in the stool or convulsions with fever.

Ear Pain and Ear Infections

Ear infections are particularly common in babies and younger children. Symptoms may include ear pain, crying, irritability, difficulty sleeping, fever, reduced hearing or repeatedly pulling at the ear.

Arrange an appointment when ear pain is severe, persists, is associated with fever or discharge, or when your child appears generally unwell. Babies and children who experience recurring ear infections may also need further assessment.

Sore Throats and Tonsillitis

A sore throat may accompany a cold or other viral illness, but tonsillitis and some bacterial infections can cause significant pain, fever and difficulty swallowing.

Medical assessment may be needed when your child:

• Is struggling to swallow;
• Is drooling because swallowing is painful;
• Has swollen glands or visibly enlarged tonsils;
• Has a persistent fever;
• Develops a rash;
• Is refusing food and fluids; or
• Has breathing difficulty.

Urgent help is required if swelling affects breathing or if the child cannot swallow saliva.

Rashes and Skin Changes

Many childhood rashes are harmless, but others may be related to infection, allergy or a more serious illness.

Arrange a medical consultation if a rash:

• Spreads rapidly;
• Is painful, blistered or infected;
• Is accompanied by fever;
• Persists or repeatedly returns;
• Causes significant itching or swelling;
• Appears after new medication; or
• Is associated with facial or throat swelling.

A red, purple or spotty rash that does not fade when pressed should be treated as an emergency, particularly when accompanied by fever or an unwell child.

Sudden swelling of the lips, tongue, mouth or throat, wheezing or difficulty breathing may indicate a severe allergic reaction and requires immediate emergency care.

Head Injuries

Children frequently bump their heads while playing, but some injuries require medical assessment.

Seek advice when a head injury is followed by:

• Loss of consciousness;
• Repeated vomiting;
• A worsening headache;
• Confusion or unusual behaviour;
• Difficulty walking or speaking;
• Excessive sleepiness;
• A seizure;
• Weakness in an arm or leg;
• Bleeding or clear fluid from the nose or ear; or
• A significant fall or forceful impact.

A child who becomes difficult to wake or progressively less responsive requires emergency care.

Abdominal Pain

Mild stomach pain can occur with constipation, gas or viral illness, but recurring or severe abdominal pain should be assessed.

Take your child to a doctor when the pain:

• Is severe or steadily worsening;
• Is concentrated in one specific area;
• Prevents normal movement;
• Is accompanied by persistent vomiting;
• Occurs with a swollen or hard abdomen;
• Is associated with blood in the stool;
• Is accompanied by fever; or
• Continues without a clear explanation.

Asthma and Allergies

Children with asthma or allergies may experience coughing, wheezing, shortness of breath, nasal congestion, itching or recurring rashes.

Arrange a consultation when symptoms are becoming more frequent, disrupting sleep or exercise, or requiring increased use of reliever medication. A doctor can review triggers, medication and inhaler technique and help develop a practical asthma or allergy management plan.

Urgent care is required when a child is struggling to breathe, cannot speak normally, appears exhausted or does not improve with prescribed reliever treatment.

Behavioural and Emotional Changes

Not every reason to take a child to the doctor is physical. Persistent emotional, behavioural or developmental changes also deserve attention.

Speak to a doctor if your child experiences:

• Ongoing anxiety or sadness;
• Significant changes in sleep or appetite;
• Withdrawal from family or friends;
• Difficulty coping at school;
• Sudden changes in behaviour;
• Persistent attention or concentration difficulties;
• Loss of previously acquired skills; or
• Concerns about growth, speech or development.

A family doctor can provide an initial assessment and recommend appropriate psychological, developmental or specialist support.

Symptoms That Persist or Keep Returning

Even mild symptoms may need investigation when they continue for an unusually long time or repeatedly return.

Examples include:

• Recurring fever;
• Persistent tiredness;
• Ongoing headaches;
• Repeated infections;
• Unexplained weight loss;
• Persistent swollen glands;
• Easy bruising or bleeding;
• Bone or joint pain;
• Unexplained lumps; or
• Changes in balance, vision or speech.

The Western Cape Department of Health recommends medical evaluation when children develop persistent unexplained fever, weight loss, fatigue, pallor, lumps, unusual bleeding, prolonged headaches or neurological changes.

These symptoms do not necessarily mean that a child has a serious condition, but they should not be ignored.

When Is Emergency Care Needed?

Seek immediate emergency assistance if your child:

• Stops breathing or is struggling severely to breathe;
• Has blue, grey or unusually pale lips or skin;
• Is unconscious or cannot be woken;
• Has a seizure, particularly a first seizure;
• Develops a non-fading red or purple rash;
• Has severe facial, tongue or throat swelling;
• Has uncontrolled bleeding;
• Shows signs of severe dehydration;
• Has a serious injury;
• Becomes suddenly confused or unresponsive; or
• Deteriorates rapidly.

Do not use an online form or email for an emergency.

Caring for a Mildly Unwell Child at Home

A child with a mild cold or viral illness who is alert, drinking fluids and breathing comfortably can often be cared for at home.

Helpful measures may include:

• Encouraging regular fluids;
• Allowing adequate rest;
• Offering smaller, more frequent meals;
• Using fever or pain medication only as directed;
• Keeping the room comfortably ventilated;
• Monitoring breathing, temperature and urine output; and
• Keeping the child home from school or crèche while infectious.

Never give a child medication intended for an adult, and do not use leftover antibiotics or another person’s prescription.

Children’s Healthcare in Hout Bay

Hout Bay Family Medical Clinic provides caring, family-focused healthcare for babies, children and teenagers. Our children’s health services include:

• Newborn and infant care;
• Assessment of childhood illnesses;
• Fever, cough and cold treatment;
• Ear infection treatment;
• Asthma and allergy management;
• Skin-condition assessment;
• Childhood vaccinations;
• Growth and developmental assessments;
• School medicals; and
• Support for behavioural and emotional concerns.

Parents do not need to wait until a child is seriously ill before arranging an appointment. Early assessment can provide reassurance, appropriate treatment and clear advice on what to monitor at home.

Contact Hout Bay Family Medical Clinic to arrange an appointment if your child’s symptoms are persistent, worsening or causing concern.