Shownotes
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If your child has ever came down with a fever out of nowhere, and you’ve questioned when to take your child to the doctor (or if you can wait it out at home), this episode will give you the calm, clarity, and confidence you need.
I’m joined by Dr. Ross Newman (Dr. Rossome), a board-certified pediatrician and father of six, who shares trusted pediatrician advice that helps every parent make informed, evidence-based choices.
Together, we talk about how to manage parental anxiety, understand fevers in kids, and use positive parenting tips to stay grounded when your child is sick.
In this episode, you’ll learn:
- How to know when to take your child to the doctor and what signs matter most.
- What every parent should understand about fevers in kids and when they become a concern.
- Why understanding normal illness patterns helps reduce parental anxiety when your child has a fever.
- The most practical pediatrician advice for hydration, fever, and common viral infections.
- How simple positive parenting tips can help you stay calm and confident even when things feel uncertain.
Parents often struggle with parental anxiety about when to take your child to the doctor, especially when symptoms are confusing. This episode helps you trust yourself again with the right pediatrician advice, clear insight into fevers in kids, and the kind of positive parenting tips that keep your home calmer and your confidence stronger.
Listen now for expert pediatrician advice and discover how to handle parental anxiety with clarity about when to take your child to the doctor and practical, positive parenting tips for real-life situations.
RESOURCES MENTIONED IN THIS EPISODE:
Read the full show notes HERE!
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Transcripts
[00:00:00] Leah Clionsky: Welcome to the Educated Parent Podcast. I'm your host, Dr. Leah Clionsky, and I am so excited about the guest I have today. Because this is definitely going to solve a problem that we have all had, so imagine it. It's the morning, it's Wednesday, you wake up and your child has a fever. Do you take them to the doctor?
[00:00:20] Leah Clionsky: You schedule an appointment immediately, or do you try to wait it out and see how they do? To be honest with you, I have no idea. So I brought on our amazing guest. So I am here right now with Dr. Ross Newman. He's a board-certified pediatrician and the proud father of six.
[00:00:36] Leah Clionsky: So he has the parenting side of things with a lot of experience and then sees a lot of kids as well, and his goal is to make kids' mental health. Simple, fun, and approachable for every parent. So blending medical expertise with real-life parenting experience. He shares practical guidance on child development.
[00:00:53] Leah Clionsky: Illness prevention and the everyday chaos of raising kids. So he's on TikTok on Instagram. We'll give you his handle at the end, but he's giving us amazing advice and I'm an avid follower, so thank you so much for coming on.
[00:01:06] Ross Newman: Of course. Thank you.
[00:01:07] Leah Clionsky: we always have to talk evidence-based medicine, always the most important thing to approach.
[00:01:11] Ross Newman: Yeah, I mean, it's the only thing that kind of keeps us centered when there's a lot of, flack flying all around us, right? That stake of evidence is what really gives us a basis of expertise and that we can be trusted.
[00:01:21] Leah Clionsky: Yeah, who knew all that research that's been going on for years?
[00:01:24] Ross Newman: Who knew you? A hundred years of science would actually count for something down the road.
[00:01:28] Leah Clionsky: Well, I'm so glad that you're here. I'm curious, do you ever have a problem deciding whether to bring your kids to the doctor when they're sick? Like has this ever been stressful for you?
[00:01:39] Ross Newman: Oh yeah. I can remember one time when my second kiddo, my son was vomiting on the floor and it was the middle of the night and he was rolled up in the fetal position, I was freaking out. I'm like, oh, do you have appendicitis? You know, All these diagnoses are running through my head. And I'm like, man, do I need to take him to the er?
[00:01:55] Ross Newman: So on a whim, I pull up my phone to look at the call schedule, and there's my name and my name. I'm on call. So if I take him to the er, they're gonna call me. So I was like, well, I better put on my big boy doctor pants and like figure this crap out because otherwise you know who else is gonna do it. And so that, that was a big moment of Clair Voy essence for me.
[00:02:11] Ross Newman: 'cause I was like, It's hard to keep it separated. Your objectivity of your pediatrician brain versus how much you stink and love your kid and worry about them, when they're actually going through it. So, absolutely. It's difficult for me too to keep that objectivity sometimes.
[00:02:25] Leah Clionsky: That is hilarious. Like I love that you would've been the person you were consulting with.
[00:02:30] Ross Newman: I mean, I probably could have called one of my partners, but like, you know, I don't wanna wake them up at 2:00 AM.
[00:02:34] Leah Clionsky: No, that's really funny. You know, I sometimes have this thought with my kids where I'm like, what would a child psychologist do right now? And I'm
[00:02:41] Ross Newman: Wish I knew one.
[00:02:42] Leah Clionsky: wish I knew. Luckily, actually, I do have a group chat. I could bother, not at 2:00 AM probably, but I'm like, no channel. Take a step back, like try to think like the clinician you actually are.
[00:02:54] Ross Newman: Yeah.
[00:02:54] Leah Clionsky: What did you do? Did you bring him into the
[00:02:57] Leah Clionsky: er
[00:02:57] Ross Newman: he was fine. But the next morning he was fine. His vomiting went away. It was a stomach bug. He got his diarrhea the next day that we'd expect. And, but in that moment he looked so pathetic and sad. And I was so worried that, overrode all what I would, what I would've said if I was the pediatrician in the er.
[00:03:12] Leah Clionsky: That's, so it's like your own, like emotional, the only, like the emotional intensity for you overrode all the clinical stuff.
[00:03:19] Ross Newman: Absolutely. And that's what I always tell, like when parents have their kids having like a first time febrile seizure, I'm always like, nobody's gonna blame you. When you go to the er they might say, why'd you bring him in? It's just a febrile seizure. But I'm like, seizures are scary.
[00:03:30] Ross Newman: Like if my kid starts seizing taking him to the er, I don't know when that thing's gonna stop. My objectivity goes out the window. So, there's never any blame from a parent pediatrician for people. Losing their cool, because it's tough when you love your kids so much to keep any type of objectivity.
[00:03:44] Leah Clionsky: Oh, absolutely. Especially, you and I are like, oh no, we can't access our training, but if you don't have the training in the first place, would be standing there too if my child were vomiting everywhere. We brought him to the ER on Christmas one year when he was two and vomiting because I didn't know if he would get dehydrated, and I didn't know how to assess any of
[00:04:03] Leah Clionsky: And I probably overreacted massively, but I didn't know what else to do.
[00:04:06] Ross Newman: with, with experience. , You know what's really bad and what's needs seen right away and what, can wait till tomorrow.
[00:04:12] Leah Clionsky: when you're like caring for yourself, are you someone who will wait longer to go to the doctor? Are you more of like protective with your kids than yourself?
[00:04:20] Ross Newman: I've had a knee pain for about six years and I started PT two weeks ago. luckily I don't get sick that often, thanks to my kids and my patients and maybe snacking off the clinic floor. So I don't get sick that often, but I feel like I very rarely will seek care for myself.
[00:04:34] Ross Newman: I do a lot of home care for my kids and try to avoid, antibiotics if we can and things like that. But I always bring 'em to my partners and there've been times when I've brought my kid in and be like, Hey, you know what? I think that I would say this, but I just want somebody else to tell me something that you know is more objective.
[00:04:48] Leah Clionsky: Isn't that like the doctor stereotype to like, not seek care for yourself,
[00:04:53] Ross Newman: Yeah. I mean, I'm not dying. why do I need anything? Don't wanna bother people.
[00:04:56] Leah Clionsky: I had to like actively have pneumonia the last time
[00:04:59] Ross Newman: You have to be pretty sick to overcome that.
[00:05:01] Leah Clionsky: I think the hard thing with kids too, depending on their age or developmental expressive ability, is they can't describe for you how sick they are. Right? You're like, you're watching them and you're like, like my daughter will say to me, my throat hurts.
[00:05:16] Leah Clionsky: My throat hurts, means. I don't wanna go to school today 'cause I'm tired, or it could mean I have strep throat or it could mean I'm going to vomit,
[00:05:26] Leah Clionsky: Or I yelled at my brother and now my voice hurts. Like it could mean lots of things. And now that she's a little older, I can like ask her more questions and try to figure out what was wrong with her.
[00:05:36] Leah Clionsky: But like, especially when they're super little, like they can't tell you at all what's going on.
[00:05:41] Ross Newman: I, that's the trouble with pediatrics, right? Pediatrics and veterinary medicine have that in common where we have to really pull off our experience as parents and as learning what sick kids look like and what signs and symptoms, which are oftentimes very subtle. Indicate your kid is sicker, and it's not always the number on the mom, right?
[00:05:55] Ross Newman: There are kids that are 105 degrees and I send them home and there are kids that are 99 degrees and I send them to the ER 'cause they're sick. Right? That's really what comes down to pediatrics is being able to recognize sick versus not sick. And a patient that can't tell you the difference between a retro pharyngeal abscess that's about to block their airway or a little runny nose.
[00:06:15] Ross Newman: Right. That's caused them a little throat pain.
[00:06:16] Leah Clionsky: Yeah, it's like really, really hard to get that information and then to get them to describe it. now that you're saying this, I'm like having this thought. Is there a clinical name for that? Like a glassy-eyed look? Kids get, you know what I mean? Where you look at their face and you're just like, there's something wrong around your eyes.
[00:06:31] Ross Newman: Yeah. You know, there's not a clinical name that I know we call it, you know, glossed over or Ill appearing. Right. We'll put that in our general exam. But there was one year with flu that me and my MA got so good identifying the kids that come in with flu 'cause they just look the sickest that we would have like an 80 to 90% accuracy.
[00:06:46] Ross Newman: We're like, you have the flu and we, you know, di rapid flu and we'd accurately guess it. 'cause flu is that classic example of those kids coming in looking like. Death. Right. That glassed over, you know, not all their look. but yeah, we normally call it ill appearing.
[00:06:59] Leah Clionsky: because sometimes I'll see it in my kids the night before they
[00:07:02] Leah Clionsky: get sick. Right? Like I'll say to my husband, I hope you brought your work computer home. Right? Like, I have a feeling one of us will end up at home with the kids today because there's just, I don't know how to
[00:07:12] Ross Newman: Dark circles around the eye. They're tired, their muscle tones just kind of droopy. They're cheeks are flushed, like Yeah, that look.
[00:07:19] Leah Clionsky: That look where you're just like, oh no, oh no, and will I get it next?
[00:07:24] Leah Clionsky: I mean, another thing I think that drives parents into the doctor's office too, is they're afraid that like every kid in their house is gonna get sick. Right? And then they're like, what do I do about ground zero patient?
[00:07:33] Ross Newman: I mean, that's the next question, right? You know, if one kid has strep, do I need to treat everybody for strep? Do I need to test everybody for strep or, you know, the virus, right? And that's the crazy part is viruses especially, and strep two will skip around, right? Some people will come off with scotch free, they'll clear the virus, you know, without any, any symptoms.
[00:07:50] Ross Newman: Some people have mild, some people have severe. And that's the tricky part we don't really know about immune systems is why some people never get cold sores, even though everybody else in the family has 'em, or warts or molluscum or any of these things. And some people get them so intensely because we don't have the knowledge yet, it seems like magical or mystical.
[00:08:06] Ross Newman: But I'm hoping that in 10, 20 years we'll have a better understand the immune system and how those decisions are made and how that happens.
[00:08:12] Leah Clionsky: Yeah, that's so interesting. I'm thinking about this time where both my kids were sick with like a fever, and then my husband had hand, foot and mouth and we realized the kids like he had the symptoms on his hands and feet. but you know, like he had that, but the kids didn't have those symptoms.
[00:08:26] Leah Clionsky: But then it was obviously clear that they must have had that as well, and that's
[00:08:30] Ross Newman: Yeah, it's that variable penetration of disease, right? Where some people will get very severe symptoms and some people have nearly nothing, are relatively disease free.
[00:08:38] Leah Clionsky: now that we're kind of laying the stage for this, help me figure it out. If my child wakes up with a fever. What are the three different things I need to be paying attention to or the framework you would advise for deciding whether I have to frantically schedule an appointment for day of, or whether I can give it a couple days and see what happens?
[00:08:56] Ross Newman: Yeah, I think most of the information you need to know comes from the knowledge of what a typical illness course for a child is. So the vast majority of illness in children because of vaccines and medicine is viral now. Right. Most of these are gonna start as viral, upper respiratory infections or colds.
[00:09:15] Ross Newman: if we think about the timeline of that, we can help understand the three things that we're gonna talk about that are gonna need to be seen. So most colds are gonna get worse for about three to five days. That's where you're gonna get your fever, your runny nose, your cough, your sore throat, headache.
[00:09:27] Ross Newman: Spotty aches, all these things, and they're gonna escalate and get worse, and they're gonna peak on that third to fifth day. after that fifth day, most people start to turn the corner. If it's flu or COVID or RSV, it might last up to seven days, but then you start on this long, recovery. Stretch, which is about one to two weeks. It takes about one to two weeks for all the inflammation, the runny nose and the cough, especially nighttime and morning to clear out. and that's your normal stretch. You know, three to five days of fever, one week of getting worse, and then one to two weeks of slowly getting better.
[00:09:54] Ross Newman: So when we think about what needs to be seen, we're looking for something that's not following that normal course. And we're really looking at three reasons that pediatricians need to intervene. And those three primary reasons are need for. Treatment of infection, like antibiotics or whatever need for hydration so they can't hydrate themselves via their mouth or need for help with respiratory support, right?
[00:10:18] Ross Newman: They are not able to keep breathing because those are the three systems that I know are most likely to cause your child harm. So first, let's go with the fever. Like I said, most kids are gonna have three to five days of fever. So in those first days, your first day of fever, oftentimes you're not gonna know what it is.
[00:10:34] Ross Newman: The fever will oftentimes appear before the other symptoms appear. You might not know if it's gonna be a vomiting, diarrhea, illness, a runny nose and cough illness, a rash illness like hand, foot, and mouth. So coming in on that first day of fever, unless your child is meeting one of the other criteria, oftentimes is not gonna be very rewarding.
[00:10:50] Ross Newman: I know thousands of pediatricians and they would all hold to this will never fault you for coming in. We just don't get upset about, we don't think you're ever wasting our time, but we won't be able to help you very much. So if you're taking time off of work or pulling a kid from, you know, they're resting.
[00:11:02] Ross Newman: We're not gonna give you much information. So the first day of fever oftentimes is not helpful. But if your kid is going past four or five days of fever. Or if you're coming up on a weekend and you're on day three or four fever and you're like, oh, I do not wanna go to an urgent care or ER, because I know they're probably gonna overtreat me or not have the best expertise.
[00:11:19] Ross Newman: Those are the two situations. I say, because of the fever, bring your kid in if it's going over four or five days, or if you're coming up against a weekend, there's not a number that I get worried about, and that's really controversial, but there's a lot of good evidence. There are kiddos that are 1 0 5 and are much healthier than the kiddo at 99.
[00:11:36] Ross Newman: There's no good scientific evidence that your body will raise a temperature that's gonna harm the brain on its own unless your child has brain damage or is in a hot car. Like there's a hot external environment. So kids can safely get to 1 0 5, even 1 0 6, sometimes with flu and not experience any negative side effects from that temperature.
[00:11:53] Ross Newman: that's a big old myth. If it's 1 0 4, you melt your brain, you need to go to the er.
[00:11:56] Leah Clionsky: All right, so let me repeat what I understood as a parent listening and make sure I understood you correctly. So, like what I'm hearing is that if my child has a fever, unless we are heading into the weekend, if it's day one, two, or three, no matter how high it is. I'm good. Like I don't need to be scheduling an emergency treatment.
[00:12:12] Leah Clionsky: So if it's Monday and you know it's first day and they just have a fever, I'm like, you're not gonna be able to help me anyway. I'm not rushing you to the doctor today. We're gonna just hang out.
[00:12:21] Ross Newman: Unless there's a severe other symptom that, and we're gonna talk about like the breathing and or, you know, they, they're not arousable or they're having other things, but if it's just a fever and they're breathing fine, they're drinking, okay. They're sleepy, but arousable. Yep, that's true.
[00:12:36] Leah Clionsky: Yeah, you just let them watch unlimited Netflix
[00:12:39] Ross Newman: Yeah. Bluey, whatever, K-Pop, demon hunter, whatever the fat is.
[00:12:43] Leah Clionsky: Perfect. Okay. That's actually very, very helpful. Good to know that. Unless it's like Thursday and I'm like, all right, let's just go in so that we can not be here on the weekend in case it happens to be strep or something like
[00:12:54] Leah Clionsky: that. Okay. Perfect.
[00:12:56] Ross Newman: so that moves on to number two, right? If you have a fever and you have one of these other severe manifestations of illness, then this is a reason to be seen too. So let's go to breathing, right? Since most of our illness is caused by upper respiratory infections, the breathing component becomes a very big one, difficulty breathing is one of those things that you should be seen immediately day or night.
[00:13:16] Ross Newman: Now that's hard because that difficulty breathing is subjective. Some people see, well, I'm struggling to breathe through my nose 'cause it's all a clogged. So I'm breathing through my mouth. Is that difficulty breathing? So the big thing we look for is what's called retractions. Retractions are when you are adding in your chest muscles to help you breathe.
[00:13:32] Ross Newman: So you oftentimes see them tugging underneath their belly, tugging in between their ribs, tugging above their collarbone, or breathing very fast. So most kids are gonna breathe between 20 to 40 times per minute. But if they're having a hard time breathing, that might get 50, 60, or 70 times per minute. So the fast breathing or the labored breathing with retractions are signs your child is having difficulty breathing.
[00:13:54] Ross Newman: and that may to be need to be seen Yeah, don't wait on that day or night. There is some tricks, like if your baby's a little baby and they are trying really hard to breathe through their nose. Sometimes if you clear out their nose with a nasal suction and some salt water, that will relieve the retractions.
[00:14:06] Ross Newman: Sometimes just fever by itself can cause increased labored breathing. So in that case, sometimes you treat with little ibuprofen or something or Tylenol, and that can relieve the work of breathing too. those are just kind of hacks, but when in doubt if your child's having difficulty breathing, have them seem day or night
[00:14:20] Leah Clionsky: Okay. Even fever or not fever. You're
[00:14:22] Ross Newman: fever or not wrong with your breathing. We're going in. Okay.
[00:14:26] Ross Newman: don't mess around with oxygen to the brain. It's just, it's just a no, no joke.
[00:14:29] Leah Clionsky: Yeah. It seems like we shouldn't mess around with oxygen to the brain when you put it that way.
[00:14:32] Ross Newman: Yeah. And the third one is hydration, right? We weren't thinking about hydration. We're talking about blood to the brain, right? If you don't have enough water, your blood gets thick and you get dehydrated and organs start to shut down. You mentioned vomiting? it's really hard for a child with just vomiting alone to get dehydrated because they have a pretty good reserve.
[00:14:50] Ross Newman: You know, children have a lot of fat. They have this special type of fat called white fat that stores water, and they can pull on that in need. So if they've just been vomiting for less than 24 hours, it's unlikely they're gonna get dehydrated unless they're losing some water somewhere else, like diarrhea or something, or a burn.
[00:15:05] Ross Newman: um. That being said, you're always gonna be monitoring their urine output. That's the most accurate representation of how hydrated they are, because their kidneys are gonna be filtering and if they're having less hydration, their kidneys are getting less blood. my goal is always for kiddos when they're sick, to have at least three urine outputs per 24 hours.
[00:15:23] Ross Newman: And this takes really close monitoring by the parents. that really is not a lot if you think about it, if your a kid pees at noon and then they pee once overnight. And they pee at noon. Again, that's 24 hours. That's our minimum. Healthy kids are hopefully pee five to seven times in 24 hours, and that's your other focus, right?
[00:15:38] Ross Newman: If your kiddo, for whatever reason, if you doubt they're making three Ps in 24 hours, they need to be brought in for evaluation of dehydration. 'cause they may not be able to keep something down. They may need medication, they may need an IV hydration to get them feeling better.
[00:15:50] Leah Clionsky: as you're talking, I'm like thinking that time at Disney World, when I did the. Christmas Eve rush
[00:15:56] Leah Clionsky: for, for vomiting was like a totally overreaction. We could have been in the Disney World and not in the er.
[00:16:03] Ross Newman: Vomiting is dramatic though. Like it is painful. It's dramatic and makes your kid look like garbage. And when they do it 12 times overnight, you're not sure if you're having exorcism or not. Right. And so it's, it's scary. Yeah.
[00:16:15] Leah Clionsky: And they're miserable. And I think too, like in my mind was somewhere about like kids dying of dehydration due to vomiting. And so like, it like just triggers, like an anxiety response.
[00:16:26] Ross Newman: And it takes a little bit of time, right? You know, they have to deplete their reserves. But when you're vomiting, remember you're only just decreasing the input. You're not outputting more, right? The vomits not, you're not pulling fluid from your system into the stomach to then vomit it out. You're just not getting anything in.
[00:16:40] Ross Newman: You know, the other thing to think about is, lots of times parents will come and they'll be like, well. I gave him something just vomited all back up. Well, the stomach is really good at absorbing water, especially when you're really dehydrated. So even if you give your child a small amount of liquid and it feels like they vomited all back up, if they're truly dehydrated, the stomach is gonna start absorption right there.
[00:16:59] Ross Newman: So you probably actually do absorb a little and then you do lose the rest of it. So what I suggest when kiddos are vomiting or they're concerned about dehydration, just give them really small sips, even like teaspoons or tablespoons of some liquid give it every five or 10 minutes instead of trying to get them to gulp down things 'cause that'll irritate the stomach less and allow them to absorb small amounts of fluid to keep them hydrated better.
[00:17:19] Leah Clionsky: Yeah, that's helpful to think about. It reminds me like as an adult when you're like, I didn't sleep at all last night, and then like your Fitbit or Apple Watch is like, you did sleep.
[00:17:28] Ross Newman: It calls your
[00:17:28] Leah Clionsky: I perceived that I was awake. And it's like, no, no, like biologically you did.
[00:17:33] Ross Newman: Yeah. One thing I always do when I have like little babies and their parents are concerned, they're spitting all their feeds up. I'll take a syringe, it's a 10 milliliter syringe, which is, and I spray it on the table and it makes this huge old spot. I'm like, well, how big was your baby's vomit?
[00:17:44] Ross Newman: Oh, so your baby's vomit was only like five milliliters, and their feed was actually 30 or 60. So your baby still got the majority of the feed, even though there was a large amount of spit up.
[00:17:52] Leah Clionsky: Oh, that's so interesting. This is really helpful. Like, p
[00:17:55] Leah Clionsky: parents are gonna listen to this and like, I am already feeling like I have a lot more, knowledge base frankly, about when to make and how to make these kinds of decisions. every single parent is gonna have sick kids. So this is really useful.
[00:18:08] Ross Newman: at least seven to 12 times per year is the average.
[00:18:10] Leah Clionsky: Dr. Ross Newman, thank you so much for coming on and sharing this information. Tell everyone how they can find you and follow you.
[00:18:17] Ross Newman: my tag is Dr. Roso, R-O-S-S-O-M-E, Dr. Roso. I'm on TikTok, Instagram, YouTube, Facebook. my platform is all about education, taking away the paywall between. Good information for pediatrics and parents so they can just access it in the palm of their hand and got playlists about, sick kids, about vaccines, about misinformation, about, you know, developmental milestones, all that stuff.
[00:18:42] Leah Clionsky: I find it to be so helpful personally, and I really appreciate you coming on and sharing this, and Dr. Ross Newman's tag is going to be in the show notes so you can find it and follow from there.
