A parental checklist: when to seek medical attention for infants
It's 2am and my husband and I are both up. Tom, our nine -month-old baby, is crying inconsolably and has full-blown diarrhoea.
We live five minutes' walk from a 24-hour clinic but I don't want to bother the doctor unless this really is an emergency.
I turn to First-time Parent by Lucy Atkins - a great, no-nonsense parenting book listing when to seek medical attention. Her list includes vomiting with diarrhoea, refusing feeds for more than six hours and being excessively fussy or irritable. Check. Check. Check.
We head to the emergency clinic. Despite the 3am wake-up call, the doctor is professional and kind. He checks Tom out and diagnoses him with gastroenteritis.
As we walk home, we agree that even though Tom is not in any immediate danger, it was good to go to the clinic. Neither of us would know how to spot an emergency.
The best advice I've been given about sick babies is from another mother who is also a doctor. She says, 'trust your mummy instinct'.
However, as a new mum, my instinct isn't perfectly honed yet.
So I consult Rebecca Lau, a highly recommended family doctor.
She sends me this checklist for when you should take your baby to the doctor: refusing food/ milk; being unable to keep fluids down; diarrhoea causing dry nappies; projectile vomiting; being irritable without cause; prolonged illness or fever without cause; pain (pulling at ears, refusing to swallow, and crying); red eye or eyelids that stick together despite wiping; swollen joints; not using limbs; blood in urine or stools; animal or human bites; an unusual rash (not eczema).
Some of these make me feel weak at the knees. But Lau's next checklist for when to go straight to hospital is even worse: allergic reactions with swelling/breathing difficulties; fever in a baby under three months; fever with a stiff neck; rash or abnormal behaviour; vomiting green bile or blood; abdominal pain with bloody diarrhoea; floppiness; breathing difficulties or bluish discolouration; being lethargic and difficult to rouse; or inconsolable crying; falls or head trauma under a year old and for any age if associated with loss of consciousness or lying motionless afterwards; repeated vomiting; blood from ears; dizziness/inability to walk steadily; unusually drowsy or irritable; seizures; burns; swallowed poison/alcohol/sharp objects; bleeding that won't clot after 30 minutes.
'The younger the baby, the lower the threshold to seek a medical opinion,' says Lau. 'If you are concerned, no-one is going to sleep anyway, so you may as well go.'
The postscript: it turned out Tom had salmonella, which we managed to treat with antibiotics.
I try to take comfort in the fact that with each bout of sickness his immune system is developing and growing stronger. So too, I hope, is my mummy instinct.