As part of Dr. Bella's series on Infant concerns, she tells us what to look out for if we are worried about serious illness in babies.
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As parents we are aware that our babies will pick up coughs and colds from time to time as they build their immune systems.
Most of the time these mild illnesses are self-limiting and will be managed at home with some calpol, oral fluids and some TLC.
But what happens when our children are REALLY sick?
How will we know and what should we do? This can be very frightening for parents regardless of their training and expertise and the reason for this is the unconditional love that we have for our children that can get in the way of decision-making.
I am talking from experience as I myself have had to turn to my husband to make a decision when my 4 year old son was going blue from croup and having severe difficulty breathing. I was unable to make a decision on what to do and I have been a Doctor for 14 years! My husband works in the City with no medical training and was calm and knew to call the ambulance!
The best advice really is to trust your instinct as a parent.
You know your child better than anyone and if you feel they are not themselves then you must get them checked.
So, for example, if they are coughing but are eating and drinking well, and behaving normally, then the chances are this is an upper respiratory infection that will be self-limiting.
But crucially if they are coughing but are crying, drowsy, not drinking or not eating this is ‘different behaviour’ that is important to recognize.
It is harder when babies are ill as they can’t communicate with us and we all have a lower threshold for seeking advice.
I would follow these few steps when your baby is poorly:
1) Do they have a fever? – Buy a thermometer from a chemist and check their temperature. I like the ear thermometers, as these are very easy to use as long as you point them straight at the eardrum. A ‘high temperature’ is anything above 37.5 degrees C. You will probably never hear a Doctor telling you an exact temperature to worry about, and the reason for this is the temperature alone is not so important. It’s the bigger picture together with the temperature that matters. Some children can be ill with a low temperature or vice versa they could be fine with a high temperature. It the child does not seem well AND the high temperature does not come down with Calpol, then this could be a worrying sign. If the temperature is high give them some Calpol and recheck it half an hour later to ensure that it comes down. Try to encourage them to drink fluids and keep them cool.
2) Are they behaving differently? Is your baby crying inconsolably or does the cry sound different? Are they vomiting, off their food or milk? Are they more drowsy or floppy than normal? Do they seem breathless or fighting for air? Are they making different noises?
3) Do they look different? Do they have a rash or look pale. Do they look blue? Are their cheeks flushed or blotchy? If you feel their skin are their feet and hands cold despite having a temperature. Generally we advise that any child who has a rash AND a fever should be reviewed by a healthcare professional.
Children are often ill in the middle of the night and the dilemma is ‘do I need help now or should I wait until morning?’
Every situation is different and so again you need to trust your instinct. But the options you have are the following:
1) You could call 999 and ask for an ambulance. People often think that if you call an ambulance that a big van-style ambulance will arrive and whisk you off to hospital. This is not always the case. On two occasions my little asthmatic son has been seen by a brilliant paramedic, who arrived on a motorbike. This paramedic gave my boy a nebulizer in his bedroom, checked him over and then went on his way. But yes if you are worried it is very urgent then you should call 999. If you have a car handy and feel you can drive then often driving yourself to A&E can be much quicker but it does depend on where you live and how life-threatening the situation.
2) You could phone 111 – This is the out-of-hours GP service and you can speak to someone any time of day or night. You can have ‘over the phone advice from a GP’, or you may be asked to come into a base for an assessment or you may have an Out-of-Hours GP come out to visit you. This service is run by local GPs that are working from 6:30pm at night till 8am the next day. Your own GP or the Duty Doctor at your surgery will receive a fax first thing the next morning with a summary of the medical problem and treatment so that they can then be in touch with you first thing if need be.
3) If you feel that it's not urgent and you could wait till morning and then you can phone your own GP and book an appointment for that next day. Every GP surgery has a Duty Doctor who will take urgent calls and see all emergencies during the day. You should never be asked to wait if you have a sick child that needs to be seen.
4) The internet is very useful if you want to refer to NHS approved websites about signs of a sick child or tips in recognizing signs. For example www.meningitis.org is great for looking at symptoms and signs of meningitis or septicaemia.
5) Finally I think it is so important that all parents should enrol in a first aid course so that they know what to do in an emergency and help their own children or someone else’s.
The bottom line really is to keep a close eye on your child, trust your instincts, and if in any doubt seek medical advice.
Remember you are not alone, us parents have all been there and equally are still going through it!