How Do You Know when your child is sick?

By Dr Julie Taylor

When your child is ill, it is worrying and it can often be difficult to know when to seek medical advice. This article explains how to manage common problems and how to recognise when your child is really unwell.

Temperature A temperature is part of the body’s normal immune response to infection and helps the body fight infection. It does not harm your child, although when they have a high temperature they tend to seem less well. If your child has a temperature, take off their outer clothing to allow them to cool down. You can give paracetamol or ibuprofen if your child seems bothered by the temperature but you do not need to treat it.

Young children can sometimes have a fit when they have a temperature. Although this is scary, it is usually not serious and will normally stop in 5 minutes. Unless your child has previously had a febrile convulsion and you know what to do, call 999 for an ambulance. Make sure they can’t injure themselves on anything and roll them onto their side in the recovery position. Bringing a temperature down does not prevent febrile convulsions.

Coughs and colds Children often get a noisy or rattly chest with a cold, but this does not mean they have a chest infection. Children with a chest infection will often be more unwell. If your child has difficulties breathing, seek urgent medical attention. Children will get 8 or more coughs and colds a year and these can last for 2-3 weeks. Snot can be anything from clear to green or yellow. Antibiotics are often not needed and cough syrups do not really help. If a cough lasts for more than 3 weeks, speak to your GP surgery.

Croup is a bark-like cough that usually affects children under 3, but can occur in older children. It is usually worse at night. Try to keep your child calm, croup is worse if they are upset or anxious. Sitting up can help with the cough. Give them plenty to drink to keep them hydrated. If your child is having problems breathing or is not settling, seek medical advice.

Sore throat Most sore throats will get better on their own after 3 days without treatment, but some can last longer. Many children have big tonsils and they can look red when they have a throat infection. Most throat infections are caused by viruses and do not need antibiotics. If your child seems very unwell or has a sore throat and temperature for more than 3 days without a cough, speak to the GP surgery or call 111. Giving paracetamol or ibuprofen can help ease symptoms.

Ear ache Ear infections are often caused by viruses and don’t need antibiotics. Some children complain of ear ache when they have a sore throat. Give paracetamol or ibuprofen to settle the pain. The symptoms usually get better in less than one week. If your child has a discharge from the ear or is under two and has infection in both ears, then they may need antibiotics so seek medical advice.

Not eating and drinking Children often go off food and drink when they are unwell. Most children can go a few days without eating much – they often regain any weight

lost when they recover from their illness. However, it is important to encourage them to drink and to look out for signs of dehydration.

Rashes Lots of childhood illnesses are accompanied with rashes. You do not need to speak to your surgery if they have a rash unless they are unwell or you are concerned. Please be aware of the rash associated with meningococcal septicaemia, which doesn’t disappear under pressure (the glass test – see picture). If your child develops a rash like this, they need urgent medical attention.

General advice on caring for your ill child Most children will get better on their own, given time. Know what signs might suggest your child has a more serious illness and needs medical assessment. You can help your child by making sure they drink plenty, eat healthy food and get some rest when they feel unwell. Paracetamol or ibuprofen can be used, if needed, to treat pain or a When to seek further help Speak to your GP practice if: • Your child has a cough that last for more than 3 weeks • If they have a temperature for more than 24 hours with no obvious cause (cough, runny nose, ear ache etc) or if they have a temperature for more than 5 days • If your child loses weight and does not regain it in 2 weeks if under 5 or 4 weeks if older

Signs that your child may have a serious illness and needs urgent medical advice include: • Being very drowsy, or if they are drowsy and irritable and not improving with paracetamol/ ibuprofen. • Problems breathing: breathing rapidly, working hard to breath – you can sometimes see the tissues between and beneath the ribs or in the neck (where the Adam’s apple is) pulling in when they breathe. • Cold or discoloured hands and feet. • Having a fit. • Unusual skin colour (pale, blue or dusky around the lips). • Temperature of more than 39oC in a child aged 3-6 months (more than 38oC if under 3 months). • A baby that is feeding significantly less than usual or any child that seems dehydrated (dry mouth, sunken eyes, no tears, peeing less). • Symptoms related to meningitis o Unusually severe headache o Stiff neck (difficulty putting their chin to their chest) o Dislike of bright lights o Rash that does not disappear with pressure ‘the glass/ tumbler test’

Parents know their child and we always listen to your concerns. In most cases we can reassure you that they will get better on their own. If you are worried it could be serious but you aren’t sure, you can call 111 or go online to 111.nhs. uk for advice.

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