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The question

We're new parents and our doctor says we're overly worried about every cough and sneeze. Can you give me 3 things to really watch out for?

The answer

One of the joys of being a pediatrician is to help parents understand when they should be calm and when they should be concerned. I love seeing parents gain confidence over time.

In the old days, Dr Benjamin Spock's book saved many parents from worrying; now we have the Internet. I am a keen supporter of parents using that resource - but it should never replace a doctor who listens to your concerns and support you in a time of need.

Being new parents often is associated with conquering many unknowns. You may feel at times that people judge you when you truly worry about potential stressful situations.

When you hear about a friend's child who ended up with pneumonia, it may make you extra concerned.

Three things to look out for:

- Associated fevers over 39 C in a child who looks sick / exhausted.

- A consistent fast respiratory rate in a child who struggles for air.

- A child who refuses fluids and food (Dehydration associated with the cough must be prevented)

Most coughs and colds are due to viruses. These usually end up running its course and resolve without any complications.

If the child is prone to asthma and has a past history of pneumonia or middle ear infections then pay extra attention when he coughs and sneezes -especially if those symptoms are associated with the three signs mentioned above.

A child who sneezes often for no good reason may also have allergies. Look for things such an associated itchy nose, runny eyes, congestion of the nose and a clear discharge coming out of the nose all day.

Many asthmatic children who only cough and have no wheezing have associated nasal symptoms and if the focus is only on the child's chest, you might miss the nasal symptoms.

Send pediatrician Peter Nieman your questions at pediatrician@globeandmail.com. He will answer select questions, which could appear in The Globe and Mail and/or on The Globe and Mail web site. Your name will not be published if your question is chosen.

Read more Q&As from Dr. Peter Nieman.

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The content provided in The Globe and Mail's Ask a Health Expert centre is for information purposes only and is neither intended to be relied upon nor to be a substitute for professional medical advice, diagnosis or treatment.

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