Lots of illnesses can be managed at home with just a little time and TLC, and fighting off a minor cold helps make your child’s immune system stronger. But Hannah Chow-Johnson, MD, assistant professor of pediatrics at Loyola University Chicago Stritch School of Medicine, says there are 10 signs and symptoms that should definitely prompt parents to pick up the phone and at least chat with their child’s doctor.

1. Extreme changes in behavior. If your child doesn’t seem to be aware of her surroundings or to know familiar people, if she has trouble forming words or completing thoughts, or if she is truly lethargic, she needs medical attention. Lethargy is more than just being tired. True lethargy means a child can barely wake up or stay awake, despite plenty of sleep.

2. Signs of dehydration. You’ll know your child is dehydrated if he can’t keep down liquids, has frequent vomiting or diarrhea, is urinating less than once every 12 hours (or less than every 8 hours in a child younger than age 1), or has a dry, sticky mouth.

3. Pains that interrupt sound sleep. These include headaches or muscle aches that wake a child up at night.

4. Abdominal pain that gets worse and persists. Pain that doesn’t improve after treatment with children’s over-the-counter pain relievers, comes along with a persistent fever, or comes along with physical movement like walking is cause for a call to the doctor.

5. Blood in the urine or stool. In the urine, blood could be a sign of infection or a kidney problem. Blood in the stool, especially if a child has not been constipated, or if the child has traveled recently out of the country, is worth checking out.

6. Painful or frequent urination. If your child is too young to tell you about this, watch for irritability, crankiness, or fever for two to three days with no known cause.

7. Fever in certain age groups. Any child younger than 2 months with rectal temperature of 100.4 degrees Fahrenheit or higher should be seen by a doctor immediately. A child ages 2 months to 3 years with unexplained fever for two to three days, or any child with fever lasting longer than five to six days, should also be evaluated.

8. Breathing problems. Audible wheezing that sounds like air blowing through a straw, a tight whistling sound during inhalation, or coughing so severe your child can’t breathe are reasons to seek medical attention. And if your child doesn’t have asthma but experiences rib cage squeezing, flared nostrils or straining abdominal muscles while trying to breathe, it’s time to see the doctor.

9. Difficulty drinking. If your child can’t drink enough to urinate every three to four hours, or goes eight to 12 hours or more without urinating, it’s a sign of trouble.

10. A gut instinct that something is wrong. You know your child like no one else does. If you really feel there is something wrong, it’s worth a call to your doctor – even if it’s just for reassurance.