Looking after an unwell baby
Knowing how to look after your baby when they are unwell can be an anxious time for parents. It is important to remember that as parents you will know your baby better than anyone else and you must trust your instincts as you will be the first ones to notice any changes in the way that your baby is acting.
When should I seek medical advice?
- Your baby is sleeping more than usual
- Your baby is unusually lethargic
- Your baby is difficult to feed
- Your baby’s nappies are drier than usual, they are not producing tears when they cry or their soft spot is sunken
- Your baby feels hot and has a temperature
If your baby has any of the above symptoms it is important that you seek medical advice and speak to your GP or Public Health Nurse (Health Visitor) or ring 111. If you think your baby is seriously unwell call 999 or go to your nearest A&E department.
Managing common ailments and high temperatures
There are a number of different conditions which you may hear referred to as minor ailments which can usually be treated by yourselves at home. However, please remember that your GP, public health nurse (health visitor) and pharmacist are available to offer advice and support if you need it.
Additionally you may want to consider using the HANDI phone app which is free that has been designed for parents offering simple and straightforward advice about how to deal with a range of common childhood illnesses.
If your baby develops a cough, cold or earache they may also develop a temperature or a fever. This is usually a common response to your baby being unwell and your baby’s bodily response to fighting an infection.
Your baby’s body temperature will vary but a reading of 38 degrees celsius means they have a temperature.
Temperatures and fevers are usually very easy to manage and usually resolve within 3-4 days. You might notice that your baby feels hot to touch and they are generally unsettled and irritable. You should check your baby’s temperature using a digital thermometer.
- Observe your baby during the day and night for any changes in their health
- Offer regular fluids
- You could offer your baby infant paracetamol or ibuprofen suspension but always make sure that you follow the manufacturers guidelines. Do not give paracetamol and ibuprofen suspension together. Never give aspirin to babies and children under the age of 16 years
- If your baby is under 6 months of age it is advised that they are seen by their GP
- If your baby’s temperature doesn’t respond to self care management after 3-4 days it is advised that they are seen by their GP
If your baby develops a cough and cold they might have a blocked or runny nose, be sneezing and may also have a temperature. Coughs and colds usually resolve within a few days.
Treat your baby’s cold symptoms
- Let them rest and sleep
- Offer regular fluids to prevent them from becoming dehydrated
- Keep your baby away from smoky atmospheres
- Give baby paracetamol or ibuprofen suspension but always make sure that you follow the manufacturers guidelines for the products that you buy. Never give your baby aspirin.
- Be aware that some over the counter remedies which you can buy from the pharmacist may not be suitable for babies so always make sure that you check the product guidelines before giving them to your baby
Croup is a condition which affects your baby’s upper airways and is common in young babies. It usually gets better on its own. Sometimes it may look like your baby has a cough and a cold when in fact there may be a possibility that your baby has croup.
You will notice that your baby may have a very distinctive barking cough, hoarse voice and make harsh noises when breathing in. These symptoms are often more noticeable at night.
You can help to manage your baby’s symptoms by
- Remaining calm
- Keeping your baby in an upright position
- Reassure and calm your baby
- Offer regular fluids
We’re seeing an increase in severe respiratory illness 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.
What is RSV?
Respiratory Syncytial Virus (RSV) is one of the common viruses that cause coughs and colds in winter.
It's a common seasonal winter virus which causes mild respiratory infection in adults and children, but it can be severe in infants who are at increased risk of acute lower respiratory tract infection.
RSV is the most common cause of bronchiolitis in children aged under 2 years.
The RSV season in the UK typically begins in the autumn, earlier than the adult flu season, and runs through winter.
During the last year there has been a remarkable reduction in respiratory viral infections other than COVID-19. This means that there's an increasing number of young children who have never been exposed to these common viruses.
Around the world we have seen evidence of unseasonal outbreaks of these infections as measures such as social distancing and mask wearing are relaxed.
What are the symptoms of RSV?
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).
While respiratory infections are common in children, last winter saw much fewer infections in younger people due to COVID-19 restrictions. This means many children will not have developed immunity and may be at higher risk of severe illness. We may also see more cases than in a typical season.
For the majority of children, these illnesses will not be serious and they'll soon recover following rest and plenty of fluids.
What is bronchiolitis?
Bronchiolitis falls into the group of viruses known as RSV.
There are many common respiratory viruses seen in children, which most will have had by the time they turn 2.
However, in children under 2, the more serious consequences can lead to bronchiolitis, infection of the lower airways, that can make the airways inflamed and mucusy making it harder to breath.
The early symptoms of bronchiolitis are similar to those of a common cold, such as a runny nose and a cough.
Further symptoms can develop over the next few days, and may include:
a slight high temperature (fever)
a dry and persistent cough
rapid or noisy breathing (wheezing)
Most cases of bronchiolitis are not serious and clear up within 2 to 3 weeks, but the symptoms can be very worrying for parents.
Contact your GP or call NHS 111 if your child:
struggles to breath
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
has a persistent high temperature of 37.8C or above
your child seems very tired or irritable
Dial 999 for an ambulance if:
- your baby is having difficulty breathing
- your baby's tongue or lips are blue
- there are long pauses in your baby's breathing
Some children under 2, especially those born prematurely or with a heart condition, can suffer more serious consequences from these common respiratory infections.
Find out more about the symptoms and what to do here.
How to prevent the spread of RSV
Good respiratory and hand hygiene can reduce the spread of these infections. Parents are advised to carry tissues and use them to catch coughs or sneezes, bin the used tissues as soon as possible and wash your hands with soap and warm water to kill the germs.
Children with flu or bronchiolitis symptoms should stay home and reduce contacts where possible.
It is perfectly okay for parents to ask people with colds to keep away from newborn babies, particularly in the first two months, and for babies born prematurely.
Further useful resources
When to call the emergency services
If you are worried about your baby’s symptoms contact your GP or call 111 for further advice.
If your baby is struggling to breathe or you feel that their symptoms are getting worse then either call 999 for an ambulance or take your baby straight to the Accident and Emergency Department.
More minor ailments
You may have noticed that since your baby has been born they may vomit frequently after their feeds. It is very common for newborn babies to vomit after their feeds and it is usually something that usually gets better as they get older.
Diarrhoea and vomiting is different to vomiting after a feed. You can expect your baby to get better within 5-7 days.
Treat your baby’s diarrhoea and vomiting symptoms by
- Continuing to offer your baby their milk feeds to prevent them from becoming dehydrated
- If your baby is on solid food, offer them small sips of fluid
- If your baby attends nursery it is important that they stay off nursery until they have been free from symptoms for 2 days
- Maintain strict personal hygiene and handwashing to prevent the risk of the symptoms being passed on or your baby catching it again
Earache is common in babies and is usually associated with an ear infection but earache can cause your baby to be in pain.
When your baby had ear ache you might notice them pulling at their ears, they may be irritable and unsettled, have a discharge from their ears and have a temperature. The symptoms can last a few days.
Treat your baby’s earache symptoms by
- Giving baby paracetamol or ibuprofen suspension but always make sure that you follow the manufacturers guidelines for the products that you buy. Never give your baby aspirin
- Avoid putting anything smaller than your baby’s elbow in their ear canal
- If you notice that your baby’s symptoms aren’t getting better, or your baby has recurrent ear ache, it is advisable to see your GP
The only thing that teething causes is teeth. There are some babies who do not experience any pain or discomfort whilst teething. However, every baby is different and you may notice that your baby’s gums look red and sore, their cheeks may feel hot and look red, your baby may be chewing on different things and your baby may be generally unsettled.
Treat your baby’s teething symptoms by
- Massaging their gums with a clean finger
- Offer them a cooled teething ring which has been in the fridge (never put your baby’s teething ring in the freezer as this could damage their gums)
- If your baby is over 6 months of age you could offer them long cut pieces of raw fruit and vegetables for them to chew on whilst they are being supervised
- Avoid offering your baby sugary and sweet foods including baby rusks because they can cause your baby’s teeth to decay
- Teething gels are not recommended. If you do choose to use teething gels it is important you discuss this with a pharmacist first to make sure they are appropriate for your baby
- Whilst non-medical teething options are preferred if your baby is in pain and they are over 3 months of age you could give them sugar free pain relief making sure that you follow the guidelines that come with the pain relief
A lot of new babies will have dry peeling skin after they have been born. Your baby’s top layer of skin will shed after the first few days of life and as your baby’s skin matures it will develop its own natural protective barrier. Every baby’s skin is different and there will be some baby’s who will only have small areas of dry skin whilst other baby’s skin may be red and inflamed.
Treat your baby’s dry skin by
- Avoid using baby shampoo, bubble bath lotions and perfumed soaps
- Avoid using sensitive and perfumed wash detergents
- Avoid overheating your baby
- Avoid certain fabrics such as wool and nylon because they may irritate your baby’s skin
- Be aware of potential triggers which could be irritating your baby’s skin. It may be useful to keep a diary to see if you can identify any potential issues which may be causing problems for your baby’s skin
- Avoid using Aqueous cream as this can cause stinging and irritate your baby’s skin
When your baby is born their skin is very sensitive and it is common for your baby to develop different types of spots and blotches which often disappear without any treatment.
There are some rashes which require immediate medical treatment. If your baby develops a rash which does not disappear when you press a glass against it then you must take your baby directly to Accident and Emergency as this can be a symptom of meningitis.
Nappy rash is very common and it is likely that at some point your baby will develop nappy rash. Nappy rash usually happens as a result of their skin being irritated by their wee or poo. You will notice that your baby’s skin on their bottom will look red and sore.
Treat your baby’s nappy rash by
- Changing their nappies often
- Allowing your baby to have some nappy free time
- Use a barrier cream when you have cleaned and dried your baby’s nappy area
- Seek medical advice if your baby’s nappy rash spreads or the nappy rash is causing your baby’s bottom to bleed
It is common after your baby has been born for their eyes to be sticky this is usually associated with their tear ducts not being fully developed. Sticky eyes usually resolve without any specific treatment.
Treat your baby’s sticky eyes by
- Bathing their eyes with cotton wool and cool boiled water
- Wipe each eye from the corner of the nose outwards
- Use a separate piece of cotton wool for each eye to prevent contamination
- If you notice that your baby’s eyes are sticky with green like puss and the whites of their eyes look red and inflamed then it is advised to seek medical advice from your GP
It is a good idea to have a first aid kit available to help you treat some of your baby’s minor ailments. It is advised that you keep this out of reach and sight of your baby.
You may want to include some or all of the following items
- Cotton wool balls
- A thermometer
- Infant paracetamol and Ibuprofen suspension
- Barrier creams