My 5-year-old has several swollen glands

Book a review appointment for the lump rather than waiting it out — and when you book, say in one sentence that the swollen glands are above the collarbone, not just in the neck, and ask what the clinic wants to see and by when. That is the single highest-value thing you can do this week, and it takes about five minutes on the phone.

I am not diagnosing your son, and nothing here changes the antibiotic or any other medicine — those calls belong to the prescriber. This is about what to do at home, what to write down, and exactly when to stop waiting. It is not a substitute for the clinician who examines him.

1. What you have already tried, and the better version of it

"Waiting silently for six weeks if new symptoms appear." This is the one to replace. Silence is the thing that makes a six-week wait turn into a crisis visit. The better version is the same wait, but with a booked date on the calendar and a written return list the whole household can read — so "new symptoms" never depends on one tired adult noticing them alone.

"Measuring the nodes weekly, noting fever, night sweats and weight." Keep the log — that is genuinely useful and doctors do ask for exactly these. Two adjustments: measure and weigh on the same day of the week, same scale, same time of day, and take a photo each week with a ruler or a coin next to the lump so there is a picture to compare. Treat all of it as a record for the clinician, not as a number you act on. A measurement is not a pass/fail line, and neither is a thermometer reading — what a clinician acts on is appearance and behaviour, plus the trend over weeks.

"Antibiotics from the ER, said to be viral." Leave that exactly as the prescriber set it — do not start, stop, extend, or double anything. Do keep the slip or the bottle, the name, and the dates it was given. If you are going to ask for tests, it is fair — and useful — to ask the prescriber one question: whether finishing or adjusting that course changes what tests can usefully be done, and when. That is their call, asked in advance, not a change made at home.

What to add: the location. A lump above the collarbone gets treated differently from a lump in the neck — clinicians generally take that location more seriously and often want to look again rather than close the file. You are not saying it is something bad. You are making sure the person booking the appointment hears the exact location, because "swollen glands" without it sounds routine.

2. Tonight and today — under 25 minutes total

Tonight, 10 minutes

• One line in a phone note or on the fridge, dated: *"Lump above collarbone, right/left side. ER [date]: said viral, antibiotic given. Review booked for [date]."* One adult in the house owns this note.
• Take one photo with a ruler beside it, in the same light if you can.

Today, 15 minutes

• Call or message the clinic or the ER follow-up line. Use this script, screenshot-ready:

> "Hi, my son is 5. He has swollen glands above his collarbone on the [right/left] side, first noticed [date]. We were seen at the ER on [date] — they said it was viral and gave an antibiotic, which we're giving exactly as prescribed. We'd like a review appointment to have it looked again. Can you tell me how soon you'd like to see him, and what you'd like us to bring or note?"

• Then add, before you hang up: "And if any of these happen, we come straight in — can you confirm that's the right number for us?" Get the answer written down on the fridge note.
• Set the weekly rhythm, all three on the same day: photo, weight, and a one-line note (fever? night sweats? how he's playing and eating?).

Normal life, on purpose

• Regular meals from what you already have, regular fluids, normal play, normal bedtime. Nothing about swollen glands needs a special diet, a supplement, or a "detox" — and anything sold online as a "gland cure" or a "lymph cleanse" is not a treatment.
• Keep the rest of the household's routine steady. A school week is easier when one of those weekly checks is already on the calendar, not invented at 9pm on a bad night.

3. What to avoid

• Do not squeeze, press, poke, massage, or "drain" the lump, and do not put heat packs or strong creams on it. Anything that irritates the skin over it makes the next look harder to read, and none of it changes what is underneath.
• Do not start, stop, extend, or double the antibiotic, and do not add leftover antibiotics from a previous illness as a "just in case" trial.
• Do not give aspirin for a fever in a child, and do not alternate two fever medicines or add a second one on your own.
• No alcohol wipes and no cold baths for a fever.
• No buying prescription medicines online and no "mystery powders" or herbal gland remedies.
• Do not use the numbers as a decision rule — not the lump's size, not the weight change, not the thermometer. They are evidence for the clinician, not a threshold for you.
• Do not keep it between you and one adult. The return list below goes on the fridge, where the school-morning adult sees it too.

4. Decision tree — the three tiers

Tier 1 — go now, do not wait for the appointment

Call your local emergency number now, or go straight to the nearest emergency department, if any of these are happening:

• He cannot drink, or cannot keep fluids down.
• He is floppy, unusually sleepy, hard to wake, or not himself in a way that worries you.
• Breathing fast, working hard, grunting, or the skin around his lips or mouth looking blue or grey.
• A rash of red or purple spots that does not fade when you press a clear glass firmly against it.
• A fit or seizure.
• Severe pain anywhere, or getting rapidly worse over hours.

These are the same signs the hospital uses to send a family straight back in. Do not wait for a fever to rise, and do not wait for the appointment.

Tier 2 — call the clinic the same day, or go in that day

• The fever comes back, or the fever never settles.
• The lump is clearly bigger than last week, or it is hard, fixed in one spot, or starts to hurt.
• New drenching night sweats, or a definite downward trend in weight across two weigh-ins rather than one.
• He limps, refuses to walk, or will not use an arm or leg — or a joint looks hot and swollen.
• A belly that is swelling or a persistent belly ache, back pain, unusual bruising or bleeding, or he looks unusually pale or tired.
• He is off food or off play for more than a day, more than a single bad night.

Any one of these gets a phone call to the clinic that day. You do not need to be certain it is serious — the whole point is that the clinic decides, not you.

Tier 3 — the booked review

• The lump is still there at the review appointment even though he seems completely well. Go anyway. "He seems fine" is the reason for the appointment, not a reason to skip it.
• Bring: the photo series, the weekly weight numbers, every temperature with its time and how it was taken, the name and dates of the antibiotic, any other medicines and any allergies, and any sick contacts, travel, or animal exposures.

5. What success looks like in the next 24 hours

Not a cure — I can't promise one, and neither can the visit. Success in a day is three things:

1. The appointment is booked, and the location "above the collarbone" is on the record in the clinician's own notes.
2. You have one photo and one log line dated today.
3. The Tier 1 and Tier 2 lists are on the fridge, in language everyone in the house can act on.

If all three are done tonight, you have moved from "waiting and hoping" to "watching with a plan" — which is the biggest difference available to you from the kitchen, and it is the one that makes the next appointment worth going to.

No coverage in this reply: which tests are needed, what the possibilities are, and what any of it means — those are the examining clinician's job, not a phone reply's. If a part of this does not match what you are seeing tonight, the signs lists above win over my wording.

One thing that would help: which country and city are you in? I do not want to guess from the language you wrote in. If you tell me, I can point you at the right official door and confirm what the local emergency number and the clinic's follow-up route actually are — I will not print a number from memory.