When your child is unwell - North East London Health & Care Partnership

We are seeing an increase in children coming to hospital and parents asking for advice on how to care for their unwell children.

During the last year, there has been a remarkable reduction in children with respiratory, stomach bugs and infections that cause high temperature (fever) as there are many young children who have never been exposed to many common viruses. This means that parents have not seen their children with these symptoms before and do not know what to do or when to worry.

As we interact more with other people and infections rise, it is vital that parents know how to manage common complaints, recognise severe symptoms that need treatment and know what to do if they have concerns.

Childhood illness is normal and a vital part of developing a mature immune system, but the spread of many unwanted infections can be prevented through these simple actions:

wash hands frequently
wash and wipe toys and shared surfaces regularly
keep infected children at home until symptoms have improved
keep newborn babies (who are particularly vulnerable) away from people with colds or flu
avoid smoking around your child and do not let others smoke around them

Useful resources

Respiratory Syncytial Virus (RSV)

Respiratory illness (bronchiolitis) is increasing in children as restrictions ease and people mix more, with cases higher than usual for this time of year and further increases expected over winter months.

Parents are encouraged to look out for symptoms of severe respiratory infection in at-risk children, including a high temperature of 37.8°C or above (fever), a dry and persistent cough, difficulty feeding, rapid or noisy breathing (wheezing).

For the majority of children, these illnesses will not be serious and they will soon recover following rest and plenty of fluids. Most cases of bronchiolitis (common respiratory infection) are not serious and clear up within 2 to 3 weeks, but parents should contact their GP or call NHS 111 if:

Their child struggles to breath
Their child has taken less than half their usual amount during the last 2 or 3 feeds, or they have had a dry nappy for 12 hours or more
The child has a persistent high temperature of 37.8C or above

Some children under 2, especially those born prematurely or with a heart condition, can suffer more serious consequences from these common respiratory infections.

Dial 999 or go to A&E if:

your baby is having difficulty breathing.
your baby’s tongue or lips are blue.
there are long pauses in your baby’s breathing.

Find out more about the symptoms and what to do here.

For simple advice on what to do and what to look for download this bronchiolitis advice sheet (PDF).

Diarrhoea and vomiting

Diarrhoea and vomiting are common in children and babies. They’re often caused by a stomach bug and should stop in a few days. You can usually treat your child at home and can speak to your pharmacist about the best way to care for your child. The most important thing is to have lots of fluids to avoid dehydration.

In adults and children:

diarrhoea usually stops within 5 to 7 days
vomiting usually stops in 1 or 2 days

For the majority of children, these illnesses will not be serious and they will soon recover following rest and plenty of fluids, but parents should contact their GP or call NHS 111 if:

you’re worried about a baby under 12 months
your child stops breast or bottle feeding while they’re ill
a child under 5 years has signs of dehydration – such as fewer wet nappies
your child (over 5 years) still has signs of dehydration after using oral rehydration sachets
your child keeps being sick and cannot keep fluid down
your child has bloody diarrhoea or bleeding from the bottom
your child has diarrhoea for more than 7 days or vomiting for more than 2 days

Call 999 or go to A&E if your child:

vomits blood or has vomit that looks like ground coffee
has green or yellow-green vomit
might have swallowed something poisonous
has a stiff neck and pain when looking at bright lights
has a sudden, severe headache or stomach ache

To prevent the spread of bugs that cause diarrhoea and/or vomiting it is important to keep children home from school until they have not been sick or had diarrhoea for at least 2 days.

Find out more about the symptoms and what to do here.

Find out more about common causes of stomach ache here.

For simple advice on what to do and what to look for download this diarrhoea and vomiting advice sheet (PDF).

High temperature (fever)

A high temperature is very common in young children. The temperature usually returns to normal within 3 or 4 days. A normal temperature in babies and children is about 36.4C, but this can vary slightly from child to child.

A high temperature is 38C or more.

A high temperature is the body’s natural response to fighting infections like coughs and colds. Many things can cause a high temperature in children, from common childhood illnesses like chickenpox and tonsillitis, to vaccinations.

For the majority of children, these infections will not be serious and they will soon recover following rest and plenty of fluids, but parents should contact their GP or call NHS 111 if your child:

is under 3 months old and has a temperature of 38C or higher, or you think they have a high temperature
is 3 to 6 months old and has a temperature of 39C or higher, or you think they have a high temperature
has other signs of illness, such as a rash, as well as a high temperature
has a high temperature that’s lasted for 5 days or more
does not want to eat, or is not their usual self and you’re worried
has a high temperature that does not come down with paracetamol
is dehydrated – such as nappies that are not very wet, sunken eyes, and no tears when they’re crying

Call 999 or go to A&E if your child:

has a stiff neck
has a rash that does not fade when you press a glass against it (use the “glass test” from Meningitis Now)
is bothered by light
has a fit (febrile seizure) for the first time (they cannot stop shaking)
has unusually cold hands and feet
has blue, pale or blotchy skin, lips or tongue
has a weak, high-pitched cry that’s not like their normal cry
is drowsy and hard to wake
is extremely agitated (does not stop crying) or is confused
finds it hard to breathe and sucks their stomach in under their ribs
is not responding like they normally do, or is not interested in feeding or normal activities