when should I bring my child to the office?

You should schedule an appointment for your child to be seen in the office whenever you feel uncomfortable or worried about your child's medical condition.  A list of a few particularly troublesome concerns that would prompt you to schedule an appointment include:

1. High or prolonged fever (or any temperature over 100.4 rectally if less than 4 months old).
2. Persistent headache lasting more than 12 hours or persistent chest pain.
3. Vomiting that is persistent (more than every 1/2 hour or 6 times over 24 hours) or projectile (past the child's outstretched hand) or green (bile) fluid.
4. Diarrhea (stools more often than 1 per hour)
5. Unusual drowsiness or sleepiness.
6. Rapid breathing or difficulty breathing, chest retraction at rest.
7. Wheezing.
8. Inconsolable crying for more than 3 or 4 hours.
9. Croupy, hoarse, barking cough.
10. Drools excessively and cannot swallow.
11. Seizure.
12. Severe fall or injury associated with loss of consciousness or vomiting.
13. Cuts possibly needing stitches.