A Parent’s Guide to Calling and Going to the Doctor

**By Carrie Jenner, MD**

If you’re a parent, you’re likely familiar with the woes of caring for your child when they become ill. For some, this time can be filled with a whirlwind of uncertainty and second guessing, particularly if your little one is very sick, or it’s lasted a long time. Questions start to surface like, should you wait it out or is it time to call your pediatrician?

While every situation is different, I’ve compiled the below guide that details some of the most common symptoms and issues and when it comes to your child getting sick. Here, I detail when it might be time to make an appointment or other medical intervention, so your focus can be helping your child feel better.

This guide is not meant to replace medical advice. For any concerns, please work directly with your provider.


Figuring out the best course of action when your child has a fever will depend on their age. If your baby is less than two months old and has a temperature of 100.4 F or higher, it’s imperative to head straight to the emergency room as they could have a serious infection. At the hospital, your baby will receive a full workup of tests to discover the root cause.

In older children, temperatures will vary a bit more (typically between 100-103 F), so pay attention to other factors as well, such as how your child is acting and how long their fever has been going on. For instance, if their fever is on the lower end but they’re irritable or not eating, it might be wise to give your pediatrician a ring. As a general rule of thumb, fevers tend to run for three days. If your child’s fever lasts longer than this, your pediatrician will be able to help you get to the bottom of it.

Coughing and Sneezing

Coughing and sneezing can be associated with upper respiratory infections such as colds, which children are highly prone to catching. Fortunately, the best thing to do here is to let the cold run its course – which can be up to 10 days for viral infections. As mentioned earlier, take your child in if a fever lasts more than three days.

If your child’s nasal discharge starts to thicken and turn green or yellow, this isn’t quite cause for concern as the cells in their body are likely in infection-fighting mode. However, if your child is struggling to breathe at any point or is flaring their nostrils or ribs when taking a breath, enlist your pediatrician as soon as possible. Additionally, if your child has developed a bluish color around their lips or nails, they’re not getting enough oxygen and you should call 911 right away.

Vomiting and Diarrhea

Generally speaking, stomach viruses typically last 2-3 days. They start with vomiting for 12-24 hours, then diarrhea develops and can last a few days. If your child is unable to hold down any form of liquid or solid for over 24 hours, call your pediatrician. Giving small amounts of clear liquids like Pedialyte frequently is the best way to keep your child hydrated during the illness.

While vomiting and diarrhea are fairly common symptoms, the main concern associated with these is dehydration. Some signs of dehydration to look out for include dark urine, sunken eyes, excess irritability, lack of tears if your child is crying or less than 3 wet diapers in 24 hours.

Rashes and Other Skin Conditions

These can be particularly puzzling as rashes come in many shapes and sizes and can be caused by a variety of things. If your child has a rash but doesn’t seem to be bothered by it, then it’s probably fine to treat it with over-the-counter skin creams. However, if the rash lingers for more than a few days and is accompanied by a fever, give your pediatrician a call as this could be a sign of a larger infection.

Other rash symptoms to make your pediatrician aware of include blistering or bubbling, oozing or bleeding, a rash in the shape of a “target” and rashes accompanied with difficulty breathing.


Though children of all ages can contract COVID-19, they typically do not get as sick as adults. Symptoms in children tend to be on the milder side and present in more of a cold-like fashion, including fever, sore throat, chills, muscle aches, nasal congestion or extreme fatigue. Lesser-common symptoms in children can include a new loss of taste or smell and gastrointestinal issues like vomiting and diarrhea.

Of course, children with underlying conditions like obesity, asthma or diabetes may experience more severe illness than children without. As we continue to navigate the pandemic, it’s better to play it safe and call your pediatrician if you suspect your child might have COVID-19, so they can be tested promptly.

It can be arduous discerning between simply letting your child’s illness run its natural course or involving your pediatrician. If at any point you’re unsure of what to do, it’s always a good idea to err on the side of caution and give them a call – they’ll be more than happy to help you identify the root cause so your child can get on the mend.

Carrie Jenner, MD, is board-certified in Pediatrics and currently practices at Franciscan Medical Clinic – University Place. Dr. Jenner enjoys working with children and their parents to develop healthy lifestyles that will continue into adulthood.

The COVID-19 Vaccine and Kids: A Pediatrician Weighs In

**By Derrick L. Soong, MD, FAAP**

As research on COVID-19 continues, how the virus affects adults is more widely apparent than how it affects kids. Preliminary studies have shown us that children are seemingly not transmitting the virus as easily as adults are, however, we’re still discovering the specific variants most commonly spread among kids.

While it’s true that kids who’ve contracted COVID-19 don’t exhibit as severe symptoms as adults, we must not downplay this result. A small percentage of children who’ve had the virus can develop MIS-C, multisystem inflammatory syndrome in children.

Being a pediatric doctor, I get questions from parents every day, ranging from if and when their kid needs to wear a mask, when the vaccine will be available for kids or when they can play with friends and hug their grandparents again.

To help parents navigate these tricky conversations with their young ones, I wanted to share some of the most common questions I’ve received from parents and the research that other doctors and I have been doing to understand more about kids and COVID-19.


Is it safe for my child to attend in-person school?

There are pros and cons when it comes to in-person learning, but as long as the child is following CDC guidelines, they should be safe. In-person learning provides an environment for kids to foster social interactions, make friends and build relationships, acquire critical thinking skills and participate in activities that children need to be successful later in life. Adding to this, not all children have the ability to self-motivate or the discipline to keep up with online school while avoiding surrounding distractions.

The progress that the U.S. has made in terms of vaccine rollout for teachers and essential workers is encouraging, and as long as those teaching in-person are vaccinated, parents can feel some ease sending their kids back.

Though children are generally at a lower risk of contracting COVID-19 than adults, this does not mean they are immune. If parents and households are following all CDC guidelines, such as unvaccinated people wearing masks when outside of the home, the risk for children is greatly reduced, even when attending in-person school. When at school, masks should be worn at all times, and kids should try to maintain social distance.

How safe is the vaccine for kids and when are kids able to get it? 

Given the mRNA mechanism for how Pfizer and Moderna vaccines work, I do expect that they will be safe for kids without causing significant issues. According to Pfizer, the vaccine has so far been 100% effective in trials for preventing COVID-19 in children aged 12-15. On Monday, May 11, the Food and Drug Administration authorized the use of the Pfizer vaccine for this age group in the United States, and on May 12, the Centers for Disease Control and Prevention approved the Pfizer vaccine for children aged 12-15.

For younger children ages 11 and below, Pfizer has said that it is currently testing the vaccine and performing trials on children as young as six months old. This group could become eligible as early as end of this year or early next.

For more information on mRNA vaccines, check out this blog written by Benaroya Research Institute at Virginia Mason Principal Investigator Adam Lacy-Hulbert, PhD.

Can my kids see their vaccinated grandparents?

Not traveling is the safest thing to do. If you must travel, you should take precautions.

Yes, grandkids may visit their vaccinated grandparents, but we still recommend masking up. Having to still wear a mask might be frustrating for some, but it’s important to understand that there is still a possibility you could get COVID-19 despite being vaccinated. This virus is still very new, and research is still being performed.

For vaccinated grandparents considering traveling to visit family and friends, driving is still the safest option. If you must fly, double-masking is recommended. Overall, I would advise holding off with traveling until cases drop down in your region/destination and more people are vaccinated.

What will summer look like?

Sentiments are largely positive heading into the summer compared to last year and will remain positive so as long as vaccine efforts continue. It’s imperative we continue encouraging hesitant members of our community to get the vaccine. This, along with more outdoor and socially distanced activities, will help to greatly reduce our positive-case counts this summer.

Hopefully, most of the population will have antibodies to the virus when June rolls around. Better weather and more activities and events outdoors should result in a happier summer for all.

Soong_Derrick_2017Derrick Soong, MD, FAAP, is board-certified in pediatrics and currently practices at the Virginia Mason Issaquah Medical Center. Dr. Soong specializes in obesity, ADHD, general pediatrics and primary care.

Q&A with a Family Doctor: Tips for a Happy, Healthy, Safe Birth

There are lots of articles out there about birthing styles, the best ways to give birth and how to prepare for birth. However, despite what they might tell you, it turns out there is not one “right” way to give birth.

We sat down with Dr. Juliana Wynne, a family doctor at Virginia Mason Edmonds Family Medicine, to talk about some of the choices when it comes to giving birth, common questions her patients ask her and any advice when it comes to handling the unexpected … when you’re expecting.

What are some ways patients can prepare for birth?
The best way patients can prepare for birth is by educating themselves. I recommend that patients bring up any questions they have about it with their provider. Patients can take birth classes – these can be accessed virtually, including at Virginia Mason. Expecting parents can talk to friends and family about their experiences. I recommend finding reliable resources about birth, such as the book “The Mommy Docs’ Ultimate Guide to Pregnancy and Birth” by Yvonne Bohn, MD; Allison Hill, MD; Alane Park, MD and Melissa Jo Peltier. In general, I think it’s important to feel informed going into labor.

What are some common questions your patients have? 
Patients often ask me about my role as an FM/OB (family medicine obstetrics) provider. I am a family doctor that provides prenatal, obstetric, postpartum and newborn/pediatric care. At my office, patients tend to see one prenatal provider. Our goal is to be the provider that is present for their labor and delivery in the hospital. I believe that the biggest benefit of seeing an FM/OB provider is the continuity of care, from the first prenatal visit, to the baby’s birth, to the newborn care in the office and the post-partum visit, to pediatric care as the child continues to grow older. I really get to know the patient and her baby, and often get to know the whole family. This leads to a whole-person and Ethnic toddler listening to her mothers pregnant tummywhole-family approach to care. 

Patients also ask about who will be in the room with them during the birth. Generally, the people in the room include their partner, me, their nurse, and a nurse for their baby. If needed, we have additional support staff available at all times, including additional nurses, the NICU (neonatal intensive care unit) team, and an obstetrician on call.

 What birthing styles are out there? 
Just like every mom and baby is unique and different, so is every birth. There is no one right way or style to give birth. As a provider who cares for women who are delivering babies, my goals are to do everything to ensure that mom and baby are safe, and that mom feels informed and in control.

How do you help moms choose the best birthing style for them? 
Again, there is no one right way to give birth and there are many options when making a plan. There are options for who you see for your care. You can see a midwife, an obstetrician, or a family medicine physician that does prenatal care, like myself and my colleagues at Virginia Mason Edmonds Family Medicine. There are options for where you give birth. You can give birth in a hospital, in a birth center, and some women choose to give birth at home. There are different people to lean on for support during labor, whether it be your partner, family, friends, doula, provider, nurse or a combination of all of these people. There are different ways to cope with pain during labor, which include utilizing a birthing ball, a hot bath, movement (walking, dancing), utilizing your breath, using nitrous oxide which is available in some birth locations, IV pain medicine or an epidural. When it comes to the actual delivery, there are also different positions to try.

A birth may not go as expected. How can patients prepare for this? 
It is helpful to keep an open mind going into your labor. Sometimes our plans change. For example, I hoped very much to have a natural vaginal delivery myself. However, after a long labor, I had a healthy baby via cesarean section. I felt that I did everything in my control to have a vaginal delivery, and yet was prepared for the possibility of needing a cesarean section (my little one was projected to be 9 pounds, and he was!). 

It’s important to share your goals with your provider so that we can best help you achieve them and advocate for you. Helping you to achieve your goals is our goal. 

Juliana WynneJuliana Wynne, DO is a family medicine doctor who provides prenatal, obstetric, women’s health, adult and pediatric care at Virginia Mason Edmonds Family Medicine. She is board certified by the American Board of Family Medicine.

Helping Your Child Wear a Mask During COVID-19

**By Rebecca Partridge, MD**

If you are a parent of a young child during the pandemic, you know firsthand how hard it can be to explain what is going on and why your child must wear a face covering when in public places or around people outside of your household. I’m sure many of you have felt like giving up on having your little ones mask up.

As a parent myself, I recognize that teaching children the importance of wearing a mask has its challenges. Still, I’m here to tell you that even if your child is struggling with this new directive, you can do it! It’s just going to take time and persistence. Current CDC guidelines state that anyone able to wear a mask, excluding children under 2 years of age, should do so in order to keep each other safe. Advice for younger children includes prioritizing mask wearing for times when it is difficult to maintain a distance of 6 feet from others, such as in carpools or when standing in line. 

mom-maskAs a mother and a physician who sees many parents struggling when it comes to teaching their young children why and how to wear their masks, I’ve come up with a few kid-friendly tips.

Get them excited about it

I’ve found that kids respond well to masks featuring their favorite cartoon characters or other designs that excite them. By providing your child with different choices in terms of the color, shapes, styles and features on the mask, you can turn something that is foreign and uncomfortable into something exciting and actually fun. Many children love to look like Spider-Man or Minnie Mouse; if their mask gives them an opportunity to “become” their favorite characters, your child is more likely to wear it. Parents should also express their own enthusiasm for masking up when around their kids to serve as an example that hopefully gets followed.

Gradually increase mask time

I’m hearing from many parents that their child is willing to try on the mask, but that they can only keep it on for a few seconds before they get bored and take it off. Parents should work with their child on wearing a mask for short periods of time to start and then graduate to longer periods of mask wearing. Try doing a countdown with your kids, distract them by playing their favorite video or giving them their favorite toy. Provide praise and positive attention when they keep the mask on. Do this until your child is able to keep the mask on for the time needed to run an errand in public or other activities you’d like to enjoy with your family.

Read stories with your child that include mask-wearing characters

For children who are having a really hard time tolerating wearing a mask, consider reading books to them about the topic. Book characters might go into the steps of putting on a mask or its importance to protect one’s health and those around them. Hearing and seeing these behaviors in a child-friendly format might resonate with your child, helping them better understand why mask-wearing is so important.

Don’t give up!

It will take time to get your child used to wearing a mask. Continue to employ these steps and your efforts will pay off. If your child is still having trouble after trying some of the advice above, you might consider a face shield. Although a mask is the best way to keep your child and others safe, a face shield is a good option for parents of kids who might be more sensitive to touch or having things touching their faces. In these cases, a shield can be a good introduction in teaching your child to wear a mask later on. 

Meanwhile, don’t forget to give yourself credit for everything you’re doing to support your family during such a challenging time. Good luck and be well!   

Rebecca Partridge

Rebecca Partridge, MD, is a Pediatrics specialist at Virginia Mason Issaquah Medical Center. Dr. Partridge is board-certified by the American Board of Pediatrics. Her medical interests includes general pediatrics, Down syndrome and emergency pediatrics.

Well-Child Checks Help Keep Kids Healthy Throughout Their Lives

**By David J. Schneider, MD**

Mercer Island resident Susan George is Mom to a 6-year-old stepson. But when she and her husband became parents to newborn son Kaden, Susan admits she found it a learning experience. After being referred by a friend to Virginia Mason Medical Center, the Georges chose me to be their son’s pediatrician.

Susan George and family

From left to right: Susan, Carter, Kaden and Jake George.

Like most initial clinic visits with a pediatrician, Kaden’s first appointment was scheduled as a well-child check. These exams – which are recommended every couple of weeks for infants, every few months for toddlers, and annually for young children and teens – follow guidelines developed by the American Academy of Pediatrics (AAP) that focus on recommended screenings and assessments based on age.

“Since I didn’t know what to expect, I’ve been very happy with how easy and helpful each of Kaden’s well-child checks have been. Not only do Dr. Schneider and the team provide excellent care, they’ve been great at putting me at ease,” said Susan. “I also really appreciate that at each well-child check, Dr. Schneider points out next steps so we know what to expect.”

Benefits of well-child checks

Although the AAP’s detailed well-child check guidelines vary depending on a child’s age, all care protocols include:

  • Prevention – Children get scheduled immunizations to prevent illness. Parents can also ask the pediatrician about nutrition, as well as safety in the home and at school.
  • Tracking of growth and development – The exams allow parents to see how much their child has grown since the last visit and provide an opportunity to talk with the pediatrician about a child’s development. Parents can also discuss their child’s milestones, social behaviors and learning.
  • Time to ask questions or raise concerns – The visits allow parents to make a list of topics they want to cover – such as development, behavior, sleep, diet or getting along with other family members.
  • A team approach – Regular visits create strong, trusting relationships between the pediatrician, parent and child. The AAP recommends well-child visits as a way for pediatricians and parents to serve the needs of children. This team approach helps develop optimal physical, mental and social health of a child.

“Having grown up with the same physician caring for me throughout my childhood and  teen years, I really appreciate the reassuring presence and guidance that pediatricians can provide,” said Susan.

Dr David Schneider_2019David J. Schneider, MD, is a board-certified pediatrician who practices at Virginia Mason Bellevue Medical Center and Virginia Mason Issaquah Medical Center. Areas of special interest include: sports and dance-related injuries, chronic medical conditions, childhood/adolescent obesity and nutrition, mental health concerns and LGBTQ health.