CHILD-WHEN TO CALL THE DOCTOR; If the child is bleeding a great deal or has bleed­ing that cannot be halted; is inexplicably dizzy or unconscious; has a high fever (more than 102 degrees taken rectally ) ; has lost his appetite for more than a day; has suf­fered a burn that is more than slight or localized; has a respiratory disorder that persists more than a week; shows a radical alteration of behavior, becoming either ex­tremely overactive or inactive or behaving oddly or atypically; or if the child has any significant accident even if no symptoms of injury are evident.

SIGNS OF ORTHOPEDIC PROBLEMS: Typical orthopedic signs are a wryneck, an ob­viously curved spine, an oddly shaped chest, a lump in the spine, uneven skin folds at the buttocks, an extraordinary stiffness or looseness of any joint; a tightness of the skin in certain places, a redness, swelling, or pain in one or more joints, or an obvious defect such as clubfoot.

Additional orthopedic signs include dif­ficulty in walking or an odd walk (toe-in or toe-out, flatfeet, knock-knees, bowlegs, limp, a pelvis rotated forward with buttocks out); “bad” posture (one shoulder higher than the other, curved back, slumps con­tinually); pains in feet, shoulders, legs, hips, or back; excessive falls, incoordination, un-­athletic, frequent self-injuries; inability to touch toes, bend freely, or stretch normally, or other signs of muscle imbalance; foot trouble despite properly fitted shoes (shoes for children must be broad and flexible, offering protection but allowing the feet room to spread out and also to grow). “Toe­ing in” in an infant or young child may mean a bone abnormality in a child’s leg; orthopedic consultation should be obtained.

Pediatric medicine has advanced tremen­dously in this century, improving more than tenfold the chances for every newborn to survive into adulthood. By preventing dis­ease through proper health practices, treat­ing specific disorders promptly, and main­taining optimal growth and development of the whole child, every parent’s wish for a happy and healthy child will have the best chance of being realized.

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