Recognising signs of serious illness

If your baby has a serious illness it’s important to get medical attention as soon as possible.

The following symptoms should always be treated as serious:

• a high-pitched, weak or continuous cry
• a lack of responsiveness, reduction in activity or increased floppiness
• in babies, a bulging fontanelle (the soft spot on a baby's head)
• neck stiffness (in a child)
• not drinking for more than eight hours (taking solid food is not as important)
• a temperature of over 38°C for a baby less than three months old, or over 39°C for a baby aged three to six months old
• a high temperature, but cold feet and hands
• a high temperature coupled with quietness and listlessness
• fits, convulsions or seizures
• turning blue, very pale, mottled or ashen
• difficulty breathing, fast breathing, grunting while breathing, or if your child is working hard to breathe, for example, sucking their stomach in under their ribs
• your baby or child is unusually drowsy, hard to wake up or doesn’t seem to know you
• your child is unable to stay awake even when you wake them
• a spotty, purple-red rash anywhere on the body. (This could be a sign of meningitis)
• repeated vomiting or bile-stained (green) vomiting

It can be difficult to know when to call an ambulance or go to the Accident and Emergency (A&E) department, but use the following as a guide.

Call an ambulance for your child if they:

• stop breathing
• are struggling for breath (you may notice a sucking in under the ribcage)
• are unconscious or seem unaware of what's going on
• won’t wake up
• have a fit for the first time, even if they seem to recover

Take your child to A&E if they:

• have a fever and are persistently lethargic despite taking paracetamol or ibuprofen
• are having difficulty breathing (breathing fast or panting, or very wheezy)
• have severe abdominal pain
• have a cut that won't stop bleeding or is gaping open
• have a leg or arm injury that means they can’t use the limb
• have swallowed a poison or tablets

Above all, trust your instincts. You know better than anyone what your child is usually like, so you’ll know what’s different or worrying.

Spotting a rash

Rashes look different on different people. The colour of spots can vary and may be less easy to see on dark skin. If in doubt, check with your GP, health visitor or pharmacist.

Further information

• Looking after a sick child
• Treating a high temperature in children
• Children's medicines
• What to do if your child has an accident