12 signs and symptoms to help you decide if you need to call the doctor from – Dr Howard Lee

If your baby is sickening, it’s often difficult to know whether the symptoms are severe enough to need medical attention.

You need urgent medical help if your baby:

• Has a fit
• Can’t be woken up
• Stops breathing or goes ‘blue’
• Doesn’t respond (not aware of what’s going on around them)
• Looks glazed, with staring eyes that don’t seem to focus
• Has been seriously injured

If you think it’s a life-threatening condition, telephone 999 – requesting an ambulance for your baby.

If you think your baby’s unwell, but doesn’t need immediate attention
Keep a careful watch. Make a note of the symptoms, so that if they get worse, you can call your doctor and describe what’s happening.

Here’s a checklist of symptoms to help you assess the situation:

1. Has your baby got a temperature?
Feeling your baby’s skin won’t tell you if he or she has a high temperature. If you miss a high temperature – and it’s easy to do – you may also miss a serious illness. The only way to know is to take your baby’s temperature.

‘Fever scan strips’ do give some idea, but are not really accurate enough. Some parents are now starting to use the aural (ear) thermometer, which can cost anything from £40-£80, but digital thermometers are quick and accurate and much cheaper. Single-use disposable thermometers are available, which are also accurate and easy to read. They are also safe for a baby because they’re not made from glass.

How to take a baby’s temperature
Taking your baby’s temperature by putting a thermometer under the armpit isn’t accurate. The only accurate way to take your baby’s temperature is by placing the thermometer tip just inside the back passage. It’s quite safe and won’t cause your baby any pain. A significant temperature rise is over 38.3ºC (100.8ºF)

More symptoms on the next page:

2. Feeding
Take note of how much fluid your baby has taken during the previous 24 hours. If the amount is significantly lower than normal, this is important. If the amount is only marginally less than usual, try to increase the fluid intake a little, and continue to monitor your baby.

3. Are your baby’s nappies wet?
Keep an eye on the amount of urine your baby is passing and whether the colour is more concentrated than usual. Is there any blood in the nappy? Small traces of blood may just mean that there’s a tiny split at the opening of the back passage – this is not uncommon, after a hard stool has been passed. Large amounts of blood could be serious and indicate some form of intestinal (gut) damage.

4. Vomiting
Babies will often vomit small amounts of milk, even when they are fit and well, usually after feeds. So don’t be alarmed. If they’re vomiting large amounts after several consecutive feeds, then this can be significant, particularly if the vomited liquid becomes ‘green’. This usually means bile is present (from an area of the gut below the stomach), and may indicate that there is some bowel obstruction.

5. Is your baby crying?
You will be well aware of the ‘hunger’ and ‘tiredness’ cry of your baby. Any unusual cry – weak, moaning, high-pitched or painful could be important.

6. Is your baby drowsy?
Healthy babies are normally alert and responsive when they’re awake. If your baby seems drowsy and needs much more than their normal amount of sleep, this can indicate that he or she is ill.

7. Does your baby seem floppy?
You will soon become aware of just how ‘firm’ your baby usually is to hold. Be alert if s/he seems more floppy than is usual.

8. Is your baby ‘focusing’ visually?
Normally, babies will look at you when you talk to them. If this doesn’t happen, as you would expect, then it may be relevant.

More symptoms on the next page:

9. Is your baby having difficulty breathing?
A healthy baby will take shallow, easy breathes. Remember that babies will often make ‘snuffly’ noises, when they breathe and then sneeze to clear the upper nose passages. They can also make noises in the back of their throat, if they have just been feeding.
Wheezing is different. It’s a whistling noise, when breathing out, indicating some obstruction to the flow of air leaving the lungs.
Croup, a common condition in young toddlers, often hits hardest in the winter and spring months. It can appear suddenly at night, when the baby has a sudden spasm of coughing with ‘noisy’ breathing.
If your baby is breathing deeply, taking in sharp breaths, this could signal a serious chest infection and you need to call the doctor.

11. Has your baby got good circulation?
Squeeze your baby’s big toe. It won’t hurt – it should go ‘white’ and clear quickly, usually within 3 or 4 seconds, returning to a healthy ‘pink’ when you let it go.

12. Has your baby got ‘blue’ nails?
Healthy babies have healthy pink toe and finger nail beds. Look at your own, and compare them. If your baby’s nail beds seem blue, this may indicate some problem affecting circulation.

Always ask for help if you have any continuing worry. Babies often develop conditions such as ‘thrush’, ‘sticky eyes’, rashes, spots, lumps or swellings at some time or another, and they all get colds and coughs. (It’s been demonstrated recently that, babies who get infections of the upper airways when they’re young, are less likely to develop more serious problems when they’re older.) Although rarely serious, these conditions may need medical attention if they persist, so do contact your doctor for advice if you’re at all concerned.