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How can I tell if my baby has a cold or something more serious?

Neal Kaufman pediatrician and public health planner

It may be hard for you to distinguish between a "common cold" — which can make your baby miserable but isn't dangerous — and a more serious illness.

Parents often look first at whether their child has a fever, but that doesn't necessarily tell a doctor much. Pediatricians focus on three things, which I also recommend to parents:

1) How is your child acting? A very, very sleepy or very irritable baby is a bad sign. We expect small children to be sleepy and irritable when they feel sick (everyone is!), but either state in exaggeration should be cause for concern — and a trip to the doctor.

2) How is her breathing? Many conditions are characterized by irregular, difficult, or rapid breathing. If your baby is sick, it won't hurt to monitor her breathing. Simply use a watch or clock with a second hand and count how many breaths she takes in 10 seconds. Then multiply that number by six so you can tell your doctor how many breaths she's taking per minute. (It should be around 50 or 60 breaths per minute for a newborn, and 30 to 40 per minute for an older baby.) Also, check to see whether the triangular shape between your baby's ribs caves in when she breathes; if you can see the ribs and if the chest seems to pull in when she's breathing in and out, tell your doctor.

3) Is she taking liquids? Although a child doesn't have to eat when she's ill, drinking fluids is a must to avoid dehydration. In a 24-hour period, a young child needs to get about 1.5 ounces of liquid per pound of body weight. For example, a 10-pound baby needs about 15 ounces of liquid per day, and a 20-pound child needs about 30 ounces. If your baby refuses to drink (or can't keep liquid down) for several hours, I'd recommend calling your doctor.

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