| URGENT: Call 999 or go to A&E now if: |
- Breathing & Effort: Breathing that stops or pauses for 10 seconds or more; breathing very fast; or significant
struggle (severe sucking in under the ribs, head ‘bobbing’, or a grunting noise with every breath).
- Colour: Looks pale, blue, mottled, or feels unusually cold to touch.
- Responsiveness: Very difficult to wake, unusually confused, or won’t wake for feeds.
- Headache: Sudden, severe “thunderclap” headache; a headache with a very stiff neck, constant vomiting, or
bright lights hurting their eyes.
- Fever: Over 38°C in a child under 3 months old.
- Rash: A rash that does not fade under pressure (the glass test).
- Tummy & Dehydration: Severe/constant tummy pain, greenish vomit, or no urine passed for 12 hours.
| The Glass Test: Press a clear glass firmly against the rash. If it does NOT fade, seek help immediately. |
| Contact your GP or call 111 today if: |
- Headache: Waking the child from sleep; worse in the morning or when lying down; or associated with change in
vision/balance.
- Breathing: Breathing a little faster than normal or mild increased work of breathing (mild ‘tugging’ at the ribs).
- Hydration & Illness: Drinking less than 50% of normal fluids or no urine for 8 hours.
- Vomiting & Diarrhoea: Persistent vomiting (unable to keep fluids down), more than 5 vomits in 24 hours, or
more than 10 watery stools in 24 hours.
- Dehydration Signs: Sunken eyes, dry mouth, or a sunken ‘soft spot’ on the head.
- Fever: A temperature lasting for 5 days or more.
- Concern: You feel they are significantly less well than when you last sought advice.
If your child is alert, smiling, and staying hydrated:
- Fluids: Small, frequent sips. Continue breast or formula feeds. Avoid fruit juice/fizzy drinks.
- Comfort: Use paracetamol if they are distressed or in pain.
- Environment: Keep them away from tobacco smoke and monitor them through the night.
Based on NHS ‘Healthier Together’ clinical guidelines.
If you are worried your child is deteriorating, trust your instincts.
