Illnesses/First Aid

ER, Urgent Care, or Call the Doctor? How to Decide

Key takeaways: Call 911 for trouble breathing, unresponsiveness, seizures lasting more than 5 minutes, or blue or gray color. Go to the ER for fever in babies under 3 months (if you can’t reach your doctor), signs of dehydration, serious injuries, or a very ill-appearing baby. For most other concerns, call your pediatrician’s office first; many have 24/7 nurse lines.

When your baby is sick, deciding where to go can be stressful. Here’s a guide.

Call 911

  • Trouble breathing, struggling to breathe, or pauses in breathing.
  • Blue or gray lips or skin.
  • Unresponsive or very hard to wake.
  • Seizure lasting more than 5 minutes, or a first seizure with breathing trouble.
  • Severe allergic reaction.
  • Serious injury or heavy bleeding.
  • Suspected poisoning with symptoms.

Go to the Emergency Room

  • Fever of 100.4°F or higher in a baby under 3 months, if your doctor directs you there or can’t be reached.
  • Signs of dehydration: no wet diaper in 6 to 8 hours, no tears, sunken soft spot, very dry mouth.
  • Green or bloody vomit.
  • Blood in stool with a very fussy or sleepy baby.
  • Head injury with warning signs.
  • Swallowed button battery or magnets.
  • Rash that doesn’t fade when pressed, with fever.
  • A baby who seems very ill or isn’t acting normally.

Urgent Care

Urgent care can help with some minor problems in older babies, like minor cuts or mild illness, but many urgent care centers aren’t equipped for young babies. Call ahead and ask whether they see infants.

Call Your Pediatrician

For most concerns, call your pediatrician first. Many offices have after-hours nurse lines that can help you decide.

  • Mild fever in a baby over 3 months.
  • Cold symptoms.
  • Rash without fever.
  • Mild vomiting or diarrhea without dehydration.
  • Feeding questions.

Trust Your Instincts

You know your baby best. If something feels wrong, seek care.

Be Prepared

  • Save your pediatrician’s after-hours number.
  • Know your nearest ER, ideally one with pediatric care.
  • Keep Poison Control’s number: 1-800-222-1222.

The Bottom Line

Call 911 for life-threatening emergencies, go to the ER for serious symptoms, and call your pediatrician for most other concerns.

Want more support for your baby’s first year? My book, From First Breath to First Birthday, is available on Amazon.

Sources

  1. American Academy of Pediatrics. When to go to the emergency department. HealthyChildren.org. https://www.healthychildren.org
  2. Pantell RH, Roberts KB, Adams WG, et al; Subcommittee on Febrile Infants. Evaluation and management of well-appearing febrile infants 8 to 60 days old. Pediatrics. 2021;148(2):e2021052228.
  3. American College of Emergency Physicians. When to go to the ER. https://www.emergencyphysicians.org

This article is for general education and is not a substitute for individualized medical advice. Always talk with your baby’s health care provider or your own provider about your specific situation. If you think your baby or you may have a medical emergency, call 911.

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