5. You're changing a diaper and see red welts all over your toddler's chest and tummy -- help! Head to the ER?
No. Hives are very common, and most cases resolve on their own, though they can be prolonged -- coming and going for a few weeks -- and uncomfortable for your child. "Parents are always freaked out by hives, mostly because they can look incredibly impressive," notes Dr. Zibners. "The hallmark feature that distinguishes hives from other rashes is that the spots move around. They will appear, gradually fade, and then reappear in a different spot."
Hives are sometimes a type of allergic reaction (some doctors prefer the term "hypersensitivity"), but to what may never be known. While typical allergens like foods or medicines can cause hives, so can external irritants like soap, shampoo, sunscreen, blankets, and new clothing, as well as changes in temperature and viruses, all of which make outbreaks of hives among children during cold and flu season a predictable occurrence at daycare centers and preschools. Doctors will usually recommend an oral antihistamine to minimize the reaction and soothe the itching -- topical creams and lotions aren't usually helpful because hives are an internal reaction, adds Dr. Zibners. Rarely, a case of hives will occur as part of a more serious allergic reaction (see bee stings, above), so if your child is also having breathing difficulty, has swelling of the lips or tongue, or begins vomiting or passing out, call 911.
6. Your 2-year-old topples out of the shopping cart. The goose egg is huge and he's hysterical. Head to the ER?
Probably not -- screaming is a perfectly healthy reaction. "The vast majority of kids with head injuries are fine, and the size of the bump rarely has anything to do with the extent of the injury," says Dr. Zibners. There are loads of blood vessels in the head and face, so the swelling can be dramatic. The exception: Any child under a year of age who experiences head trauma should always be checked out by a physician because signs of injury are harder to detect in a young infant, she emphasizes.
For kids older than 12 months, you can take a watch-and-wait approach. "If your child is crying but can get up on his own and is moving about, he's probably just fine," notes Dr. Zibners. Keep an eye on him for the next few hours to make sure he doesn't limp or favor one arm; vomit, especially after some time has passed; or become sleepy (and it's not his usual naptime) or especially irritable. If you see any of these signs, call the doctor. And, of course, if your child is motionless or unconscious, or refuses to move after his fall, you should call an ambulance right away.
