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.
Spotting the signs of meningitis
Meningitis is an inflammation of the membranes that surround the brain. It’s a very serious illness, but if it’s diagnosed and treated early, most children make a full recovery.
In recent years there has been a lot of concern about meningitis in children. There are several types of meningitis, and some can be prevented by vaccinations. See Vaccines for kids for more information.
Early symptoms of meningitis may be similar to a cold or flu (fever, vomiting, irritability and restlessness). However, children with meningitis can become seriously ill in hours, so make sure you can recognise the signs.
The main symptoms of meningitis are:
- fever (a temperature of 38ºC or more in babies under three months and 39ºC or more in babies between three and six months) vomiting and refusing feeds
- cold hands and feet
- skin that is pale, blotchy or turning blue
- rapid or unusual patterns of breathing
- irritability, especially when picked up (this can be due to limb or muscle pain)
- a high-pitched, moaning cry
- shivering
- red or purple spots that don’t fade under pressure (do the glass test explained below)
- floppiness and listlessness, or stiffness with jerky movements
- children may be drowsy, less responsive, vacant or difficult to wake
- a stiff neck
- a bulging fontanelle (the soft spot on a baby's head)
Not all children will develop all the symptoms listed above. If your child develops some of these symptoms, especially red or purple spots, get medical help urgently.
If you can’t get in touch with your GP, or you're still worried after you’ve spoken to them, take your child to the Accident and Emergency (A&E) department of your nearest hospital.
The glass test
If your child has red or purple spots press the side of a clear drinking glass firmly against the rash so that you can see whether the spots fade and lose colour under pressure. If they don't change colour, contact your GP immediately.
This rash can be harder to see on darker skin, so check for spots over your baby’s whole body. They may show up on paler areas such as the palms of the hands, the soles of the feet, the tummy, inside the eyelids and on the roof of the mouth.
For more information, contact one of the following organisations:
- Meningitis Research Foundation. Phone the free 24-hour helpline on 0808 800 3344, or go to www.meningitis.org.
- The Meningitis Trust. Phone their free helpline on 0800 028 1828 or go to www.meningitis-trust.org.
You can also contact your GP, practice nurse or health visitor for advice, or call NHS Direct on 0845 4647.
Further information
