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The most difficult question for parents and caregivers is when to call the doctor with concern about flu symptoms. Many people fear the child may have pneumonia. Here are some guidelines about when to call the doctor:

For children under 5 years of age and especially if under 2 years of age, and for children of any age who have chronic illnesses such as asthma, speak to the doctor early to decide if the child needs to be examined.

For those 5 years of age and older, call if you are worried or if

• fever continues after three days,
• nasal discharge lasts more than 10 days,
• nasal discharge becomes thick and yellow,
• discharge is coming from the eyes.

• The child has difficulty breathing or is breathing rapidly and does not improve even after nasal suctioning and cleaning.
• The child appears sicker than any previous episode of illness. The child may not be responding normally. For example, the child does not cry when expected or make good eye contact with the mother or the child is listless or lethargic.
• The child is not drinking fluids well or is showing signs of dehydration. Common signs of dehydration include absence of tears with crying, decrease in amount of urine (dry diapers), dry mucous membranes (lips, tongue, eyes), and dough-like skin that fails to snap back flat when pinched.
• Severe or persistent vomiting
• A fever that does not get better with appropriate dosing of acetaminophen (Tylenol) or ibuprofen (Advil)
• A seizure occurs.

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