It’s pretty difficult to get a GP appointment at short notice these days. Often you get asked the question “is it an emergency?” by the receptionist and if you are anything like me, I think medical emergencies are best placed with A & E, so my reply is “no” and I am then offered an appointment date in three weeks time with a doctor I’ve never seen before. Sound familiar?
So I guess under these circumstances you end up asking yourself if you can cope at home with your baby, who is very unsettled, not sleeping well and not feeding well. So, here are a few things that I used to put in place when a GP appointment was not possible. It may help you to rationalise your circumstances or at least play devil’s advocate to decide whether you are justified to say “yes it’s an emergency” when you are asked by the GP’s receptionist.
Temperature – One of the biggest clues to suggest your baby is under the weather and needs to see a medical professional soon, is a fever (high temperature). It’s not very common for a baby suffering with reflux to have a fever, so it does need to be considered as a sign that something else is going on. Things like teething and response to inoculations can result in an higher temperature than normal, which can make the baby feel unwell and agitated. So, if your refluxing baby has a high temperature and they are not teething or have anything obvious to consider, then go for that appointment. In children under five, a fever is considered to be a temperature higher than 37.5C (99.5F)
Extra sick – You get to know how much sick your baby can produce at any one time. You know the smell of a routine reflux projectile vomit, so when there are extra volumes and more frequent sickness episodes, then something has changed. Sometimes teething can bring on a reflux flare up, sometimes a cold or cough can bring it on. If there is increased sickness and it smells like unwell sick and your baby has a fever, then it;s fair to say that something else is going on. if you give baby paracetamol to control the temperature, and it comes back up – if may be a tummy upset. Keep your baby hydrated and watch their temperature. In this case, I would see if things improve after 24/36 hours and if not, I’d be calling for an appointment.
Excessive crying – Now here’s a tricky one. All babies cry, because they can. It’s their way of exercising the lungs and communicating with us. Babies with reflux symptoms tend to cry more than most because they are uncomfortable, frustrated, agitated or sometimes even hungry. The trick is to work out if the excessive crying is more than usual. Is it accompanied by fever or cold symptoms, perhaps even teething or constipation? It is very difficult to separate the reflux symptoms you know from typical baby activities like crying or being sick in the regular way.
My checklist to deciding when to push for a GP appointment went something like this:
- My baby is crying and out of sorts generally – make a note of symptoms and your suspicions about what is wrong.
- Check things like nappy (dry/wet/constipated/loose/colour), skin condition (pink, elastic, clammy, dry, rash)
- Is there a high temperature? Has this temperature responded to infant paracetamol? How long has the fever been?
- Any weight loss over the last week?
Hope this helps.