Recognising serious illness in small children

Written by: 
Dr Knut Schroeder, General Practitioner and Author, Diagnosing Your Health Symptoms For Dummies

Looking after children can be among the most rewarding and magical experiences in life. But children are not well all the time. Even if you’re the best parent in the world, you’d be extremely lucky if your child didn’t suffer from occasional coughs and fevers. Such symptoms are a normal part of growing up and are usually due to common viral infections. Illnesses like these help your child with building up immunity and will typically get better by themselves. But occasionally, such symptoms may be caused by more serious conditions, such as meningitis.

So how can you tell the difference? It’s easy to worry that something serious may be going on, especially when you’re tired and exhausted after yet another sleepless night,. Knowing what to do next can be tricky, and so being able to recognise symptoms and signs of serious illness in young children can go a long way in reducing your fears – and helping you decide what to do next.

The following symptoms and signs in a feverish child (more than 38°C/100.4°F in babies under 3 months, or 39°C/102.2°F in 3 to 6 month olds) may suggest a more serious underlying cause – seek medical advice urgently: 

  1. Skin colour: Your child looks unusually pale or blotchy.
  2. Behaviour and response: Your child doesn’t respond to you in the normal way. Or you have to try quite a bit harder than usual to wake your child. Your child is much less active than usual, doesn’t look content and doesn’t smile. Your child just doesn’t stop crying (particularly if it’s high-pitched or weak).
  3. Breathing: Your child’s nostrils flare, and the breathing appears much more laboured and faster than normal (more than 60 breaths per minute in infants under 5 months, more than 50 breaths per minute in children between 6 and 12 months, or more than 40 breaths per minute in kids 12 months or older).
  4. Hydration: Your child feeds poorly and has a dry mouth – and you don’t get as many wet nappies anymore.
  5. Other signs of potentially serious illness: Your child has a fever for five or more days. You notice a swollen limb or joint, or your child doesn’t use a limb as normal. 
The tumbler test: If your child is clearly ill and you notice a new purplish or red rash, press the side of a glass tumbler firmly against the skin. If you can see the rash through the glass, your child may suffer from septicaemia (bloodA fluid that transports oxygen and other substances through the body, made up of blood cells suspended in a liquid. poisoning) – take your child to your local hospital Emergency Department or call the emergency services number (999 in the UK, 911 in the US). 

Remember that most childhood illnesses are harmless – but trust your instincts. If you suspect that your child may be seriously ill, don’t hesitate to call your doctor – or dial the emergency services number (999 in the UK, 911 in the US) in an emergency.