Mother on the phone with her child's pediatrician while her young daughter rests beside her on the sofa, cozy home watercolor illustration

When to Call the Pediatrician, Use Urgent Care, or Go to the ER

ByFamily Healthy Guide Team

Quick Answer

If your child is sick or hurt but does not seem to be in serious danger, the American Academy of Pediatrics (AAP) says it is usually best to reach out to your child’s doctor first. That holds even after hours: the AAP encourages parents to call the pediatrician’s office even when it is closed, and many offices have after-hours lines with nurses who can guide you.

Call 911 right away for an emergency, including if your child can’t breathe, has a seizure, loses consciousness, has a severe injury, is bleeding and you can’t stop it, has a serious burn, has swallowed something poisonous, has a serious allergic reaction, or is choking on something you can’t get loose. If you are not sure what is wrong but believe your child is in danger, call 911.

Start With Your Child’s Pediatrician

For health problems that need attention but are not emergencies, the AAP considers your child’s pediatrician’s office — what it calls the “medical home” — the best place for care. When your child is sick or hurt but does not seem to be in serious danger, reaching out to the pediatrician is usually the right first step.

That applies outside office hours too. The AAP encourages parents to call even when the office is closed, and many practices have after-hours lines with nurses who can guide you.

The pediatrician’s office is also the place for follow-up visits and ongoing health issues. AAP guidance gives examples of problems that usually fit here:

  • Constipation, when your child has had trouble passing stools for several days but is otherwise well and not in severe pain.
  • A mild rash that is not itchy or only mildly itchy and is not spreading rapidly.
  • Ear infections that keep coming back over several months.
  • Growth concerns, such as slower height or weight gain than expected.

The next sections cover when urgent care, the emergency room or 911 is the better fit.

When Urgent Care Makes Sense

According to AAP guidance, urgent care can be a good option for illnesses and injuries that aren’t life-threatening but can’t wait a few days. Many urgent care clinics offer extended hours, including evenings and weekends. If a pediatric urgent care center is available, the AAP prefers it, since these centers specialize in care for children.

Examples the AAP gives for urgent care include:

  • Ear pain with symptoms of a possible infection (see Ear Pain in Children).
  • A sprained or injured ankle with noticeable swelling or bruising; your child may be unable to put weight on it.
  • A cut that needs stitches, deep cleaning or glue.
  • Flu symptoms — fever, chills, body aches and cough — in a child who is drinking fluids, urinating normally and breathing comfortably.
  • Mild breathing trouble, when your child is breathing faster than usual with mild noise or effort.
  • A suspected broken bone without an obvious deformity or bone poking through the skin.
  • A suspected allergic reaction, such as swelling, rash or hives.

Breathing trouble that is more than mild, or a serious allergic reaction, is covered in the 911 and emergency room sections below.

For children under 2, the AAP recommends against care at retail-based clinics, such as those inside pharmacies or stores, at acute care services without pediatric expertise, and through telehealth services outside your child’s medical home.

When to Call 911

Call 911 right away if your child:

  • Can’t breathe
  • Has a seizure
  • Loses consciousness
  • Has a severe injury
  • Is bleeding and you can’t stop it
  • Has a serious skin burn, or has escaped a burning room in a closed space
  • Has swallowed something poisonous
  • Has a serious allergic reaction
  • Is choking on something you can’t get loose
  • Is found unresponsive after being underwater

If you are not sure what is wrong but believe your child is in danger, call 911.

When a child is seriously ill or injured, the AAP notes that it is safer for them to be taken to the emergency department by ambulance.

Poison Control is covered in a later section.

When to Go to the Emergency Room

The emergency room is for severe or potentially life-threatening problems that need immediate care. Examples from AAP guidance include:

  • Breathing distress: the ribs visibly pull in with each breath, the lips look blue, or your child can’t speak in full sentences.
  • A seizure — abnormal body movements or stiffening with a loss of consciousness — in a child without a known seizure disorder.
  • A serious injury: a head injury followed by vomiting, confusion or loss of consciousness; a suspected broken bone with an obvious deformity; or a suspected spinal injury after a fall or collision.
  • Dehydration with prolonged vomiting and/or diarrhea, in a child who is too weak or drowsy to drink (see Signs of Dehydration in Children).
  • Severe abdominal pain: your child is in significant discomfort and grimaces when you press on their stomach area.

When a sign on this list also appears in the 911 list above, follow the 911 advice.

Fever with warning signs

AAP guidance also says to go to the emergency room right away for a child with a fever and any of the following:

  • Trouble breathing, such as breathing fast or the chest pulling in between the ribs
  • Unresponsiveness or extreme sleepiness — hard to wake even after gentle shaking
  • Vomiting that keeps any fluids from staying down
  • A stiff neck and sensitivity to light
  • A purple or bruise-like rash that appears suddenly

For what a fever reading means and how to care for a fever at home, see Fever in Children.

Babies Under 3 Months With a Fever

AAP guidance says to go to the emergency room right away if a baby younger than 3 months has a temperature of 100.4°F (38°C) or higher.

For how to take a baby’s temperature, see How to Take a Child’s Temperature. For what a fever reading means, see Fever in Children.

Croup: Matching Care to Severity

According to AAP guidance, mild croup is common. Croup can cause stridor, a coarse, musical sound each time a child breathes in. Stridor is common with mild croup when a child is crying or active, but stridor while resting can be a sign of more severe croup.

Contact your child’s doctor, your local emergency department or 911 — even in the middle of the night — if your child:

  • Makes a whistling sound that gets louder with each breath
  • Can’t speak or make sounds because they are out of breath
  • Seems to be struggling to catch their breath
  • Has bluish lips or fingernails
  • Has stridor while resting
  • Drools or has extreme difficulty swallowing saliva

For coughs in general, see Cough in Children.

Before and After the Visit

If your child is seen somewhere other than their pediatrician’s office, the AAP suggests telling the clinic:

  • Whether your child’s immunizations are up to date
  • Any allergies to medicines
  • The medicines your child is taking, including when the last dose was given
  • Any ongoing conditions, such as asthma or diabetes

Ask the clinic to send information about the visit to your pediatrician. At the emergency department, share your pediatrician’s name and contact information with the emergency team.

Mental Health Crises and Possible Poisoning

For a mental health crisis, you can call, text or chat 988, the Suicide & Crisis Lifeline, where trained counselors are available 24/7. The AAP lists situations such as suicidal thoughts or actions, the urge to harm themselves, a desire to hurt others, dangerous mood swings, outbursts of rage, anger or grief, extreme anxiety or sadness, and any mental health concern that affects a child’s daily life.

The AAP lists swallowing something poisonous among the reasons to call 911. It also advises calling Poison Control at 1-800-222-1222 for immediate help if your child swallows something that could be toxic, even if they show no signs or symptoms of sickness.

For more on children’s emotional health, see Signs of Anxiety in Children by Age, How to Help an Angry Child and How to Build Resilience in Children.

Symptom Guides

For details on specific symptoms, including what to watch for and how to care for your child at home:

FHG Science Note

This guide is based on parent guidance from the American Academy of Pediatrics (AAP) and an AAP policy statement. AAP pages written at different times do not always use the same wording or age cutoffs. For the age cutoff on fever in young babies, this guide follows the AAP’s 2026 page on where to take a sick or injured child. For croup, it follows the AAP’s guidance that distinguishes signs by severity. Our symptom guides cover each condition in more detail.

Sources

This article is for general information and does not replace advice from your child’s doctor. If you think your child may have a medical emergency, call 911.

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