Warning Signs of Severe Illness

We’d like you to be familiar with a few warning signs of severe illness.  Just because your child has one or more of these signs doesn’t necessarily mean a severe illness is present.  However, it could be the case.  Call us if you note any of the following warning signs:

  • Temperature of 100.4° F (37° C) or higher, for a baby less than three months old.
  • Vomiting (not just spitting up) repeatedly (more than six episodes per day), especially if it is green or bloody or leads to decreased urine output.
  • Profuse diarrhea (more than six episodes per day), accompanied by dark red mucus, blood, or decreased urine output.
  • Refusal to take feedings (two or more in a row).
  • No energy, no play, no pleasurable interaction or self-expression.
  • Your baby is inconsolable (meaning not distractible, not soothable, incessantly crying).
  • Unusual rash (peeling, blistering, painful, non-blanching, looking ill, or rapidly spreading).
  • Less than four wet diapers per day.


Some cases that require hospitalization can be treated at our hospitals.  However, the following cases will be referred to Texas Children’s Hospital:

  • Requires closer observation.
  • May progress to more serious situations.
  • Requires expertise from specialty care.
  • Requires critical care.


If you suspect that your child has swallowed a medicine or poison, call poison control immediately at 1-800-POISON-1 or 1-800-222-1222, then contact us.  All of your family’s medications should have child-proof caps.  They should be kept in locked or out-of-reach cabinets.  You should also store soaps, cleaning agents, and painting supplies in a secure place.  It’s surprising how quickly little fingers become nimble enough to open drawers and doors and pry the lids off of things. This can lead to a major emergency or even death.


We think it’s important for you to know that we are evidence-based doctors.  What this means is that we will only advise you to use a medication if there is clear evidence that the benefits of the medicine outweigh the possible side effects.  There will be times when you will come to our office, and we will thoroughly examine your child and find that the best therapy is tender loving care.  This does not mean your child is not sick!  It simply means that modern research has yet to find a quick solution to your child’s ailment.  A good example of this is the common cold.  We have yet to read a single piece of evidence that supports using medications for colds.  On the other hand, if there is a medicine available that research clearly shows will benefit your child, we will, of course, prescribe it.

We want what is best for all of our patients. We think it is important that you understand why we do what we do. Please ask if you do not understand what we are recommending for your child. Our policy is to always explain what is going on rather than quickly write a prescription just so you do not go home empty handed.  In the short-term and especially the long-term it is best that we communicate effectively so that you have a growing knowledge of the medical care of your child.