When your child gets sick with a bad cough and it’s late at night, it can be hard to know what to do – should you take her to a children’s hospital’s emergency room or wait until morning and call the doctor? We talked to pediatrician Christine Darr, MD, to get answers.

“If they’re having trouble breathing you need to take your child to the hospital,” says Dr. Darr, who is medical director of the pediatric division of Rocky Mountain Hospital for Children in Denver. Breathing problems can be a sign of a serious health concern, including pneumonia, bronchiolitis, bacterial tracheitis and epiglottitis. Croup, RSV and asthma also can cause breathing problems.

If you have a young child, it can be hard to know for sure if they’re having trouble breathing. According to Darr, other serious respiratory infection symptoms that warrant a trip to the emergency room include:

  • Breathing fast or harder than usual
  • Leaning forward to catch a breath
  • Blue skin
  • Extreme fatigue
  • Inability to speak in complete sentences
  • Head bobbing with breathing
  • Nasal flaring
  • Muscles contracting in the neck or
  • between the ribs
  • Grunting
  • High fever over 100.4° F

Home treatments

If your child has a barking cough, he or she may have croup. Croup can be mild, moderate or severe. For mild or moderate croup, home remedies may work. Try taking your child into a steamy bathroom for about 15 minutes. If it’s cold out, bundle your child up and stand outside or near an open door or window for a few minutes. According to Darr, both steam and cold air help decrease respiratory distress. If these measures don’t work—if your child displays any of the symptoms above—either call your pediatrician or go to the emergency room.

At the ER

Bringing your child to the emergency room is always scary, but it doesn’t have to be traumatic. Come prepared to answer questions, says Darr, and you’ll be able to help the doctors and nurses treat your child better.

Questions you’ll probably be asked include:

  • What symptoms does your child have?
  • When did the symptoms start?
  • Does your child take any daily medications? If so, what are they and how much do they take?
  • Did you give your child any medicine before you came?
  • Does your child have allergies to medicine?
  • Has your child had previous or chronic health problems?
  • Has your child had surgery recently?
  • Has your child been around cigarette smoke?

Be prepared

If your child takes medicine on a regular basis, keep a list at home of what is taken and how much and take it with you to the children’s hospital. Also, when symptoms start, write down what they are and when they started. Also record what medications you’ve given your child to treat the symptoms and how much.

Your child will no doubt be scared. Do your best to stay calm and reassure your child that it’s okay to be scared but the doctors and nurses are there to help him or her feel better.