Articles

Key takeaways

• Check your baby's temperature with a digital thermometer in their armpit.
• Manage fevers with hydration and appropriate pain relief for their age.
• Use an oral syringe for accurate medicine dosing, never a kitchen spoon.
• Seek urgent medical help for serious signs like breathing difficulties or rash.

Checking your baby's health and vital signs

You can check if your baby is unwell by feeling if they are hotter than usual on their back or chest. They might also feel sweaty or clammy, or have flushed cheeks. If you think your baby has a high temperature, it is best to check it with a thermometer.

A normal temperature for babies is about 36.4C. A high temperature, or fever, is usually 38C or above.

How to take your baby's temperature

You will need a digital thermometer for a fast and accurate reading. You can buy these from pharmacies or supermarkets. For children under 5 years old, always use the thermometer in the armpit.

1. Hold your baby comfortably on your knee and place the thermometer in their armpit. Gently hold their arm against their body to keep the thermometer in place.
2. Follow the manufacturer's instructions for how long to keep it there, usually about 15 seconds. The thermometer will beep when it is ready and show the temperature.

Some things can slightly change the reading. This includes if your baby has been wrapped up tightly or in a warm room. It can also happen if they have been very active or had a bath. If this is the case, let them cool down for a few minutes before taking their temperature again. Do not let them get cold or shivery.

Other types of thermometers

Other types of thermometers may not be as accurate. Thermometers that go in the ear (tympanic thermometers) are quick but can give misleading readings if not placed correctly. This is more likely with babies due to their small ear holes. Strip-type thermometers are held against the forehead. They show skin temperature, not body temperature, and are not accurate.

Never use old-fashioned glass thermometers that contain mercury. These can break, which is dangerous as they contain a harmful substance called mercury.

When a high temperature is a concern

• Under 3 months – a temperature of 38C or higher.
• 3 to 6 months – a temperature of 39C or higher.

Contact your GP or NHS 111 if your baby has a high temperature and other signs of illness, such as a rash.

Other signs of illness

Babies who are seriously ill may whimper and moan rather than cry loudly. Watch for these other signs:

• Breathing – rapid breathing or panting.
• Breathing noises – a throaty noise while breathing.
• Breathing effort – sucking their stomach in under their ribs.
• Skin colour – blue, pale, blotchy, or ashen (grey) skin. On brown or black skin, check the palms of their hands or soles of their feet.
• Responsiveness – hard to wake up or seems confused.
• Crying – crying constantly and cannot be comforted, or the cry sounds different.
• Vomit – green vomit.
• Feeding – not feeding normally.
• Nappies – drier nappies than usual, which can be a sign your baby is not getting enough fluids (dehydration).
• Temperature – a high temperature that doesn't respond to medicine, or is accompanied by cold feet and hands or shivering. Also, be concerned if the temperature is unusually high or low, especially in a baby less than 2 months old.
• Energy – unusually quiet and has no energy, even when their temperature is not high.

Caring for common baby ailments at home

You can usually care for your baby at home if they have a high temperature.

Managing a fever

Make sure your baby drinks plenty of fluids to avoid dehydration. If you are breastfeeding, offer plenty of feeds. A fever usually goes away after 3 or 4 days without treatment.

Do not wrap your baby up more when they have a fever. Extra layers or blankets will not stop a virus. Wrapping them too much can make them overheat and uncomfortable. It's important to avoid overheating. Overheating is linked to an increased risk of the sudden, unexplained death of a baby (Sudden Infant Death Syndrome, or SIDS). Regularly check the room temperature and your baby's temperature.

Giving fever medicine

Paracetamol and ibuprofen are safe for treating pain or a high temperature if your baby is distressed. Both are available as sugar-free liquid medicines. Sugar-free versions are best to protect your baby's teeth. Always check the label for the correct dose and strength for your baby's age.

• Paracetamol – can be given to children aged 2 months or older.
• Ibuprofen – can be given to children aged 3 months or older and who weigh more than 5kg (11lb). Do not give if your baby has chickenpox, is dehydrated, or has asthma (without medical advice).
• Aspirin – do not give aspirin to children under 16 unless prescribed by a doctor. It is linked to a rare but dangerous illness in children (Reye's syndrome).

The common cold

Coughs and colds are caused by viruses. Antibiotics do not treat viruses. Most cough and cold medicines sold in shops are not effective for children under six.

You can help your baby by making sure they drink enough. Offer plenty of breast milk or formula. If your baby is around 6 months old, you can offer water. Saline nose drops can help loosen dried mucus and relieve a blocked nose. A pharmacist or health visitor can advise on these.

Contact your GP or NHS 111 if your baby:

• cold symptoms do not improve or get worse.
• is not passing as much urine as usual. Also look for sunken eyes or a sunken soft spot, which are signs of dehydration.
• is wheezing or has difficulty breathing.

Nappy rash

Nappy rash is common and can usually be treated at home. Symptoms include red or raw patches on your baby's bottom, or the whole nappy area. Your baby might seem uncomfortable or distressed. The skin may also:

• Look sore or feel hot
• Appear scaly or dry
• Be itchy or painful
• Have spots, pimples, or blisters (these may be less noticeable on brown and black skin).

How to treat nappy rash

• Change wet or dirty nappies as soon as possible.
• Keep the skin clean and dry.
• Gently pat the skin dry.
• Leave nappies off when possible.
• Use extra absorbent nappies.
• Make sure your baby's nappies fit properly.
• Clean your baby's skin with water or fragrance-free and alcohol-free baby wipes.
• Bath your baby daily, but not more than twice a day. Washing too much can dry out the skin.
• Avoid using soaps, baby lotion, or bubble bath as they can irritate the skin.
• Avoid using talcum powder or antiseptics on nappy rash.
• Avoid putting nappies on too tightly.

Getting help for nappy rash

A pharmacist can recommend a nappy rash cream or medicine. They might suggest a thin layer of barrier cream. They may also suggest paracetamol (for babies over 2 months old) for pain relief.

See a health visitor or GP if the rash does not go away, gets worse, or spreads. Also see them if your baby has a high temperature or seems very uncomfortable. A GP may prescribe treatment if your baby is in a lot of discomfort or has an infection. This could include a steroid cream, antifungal cream, or antibiotics.

Giving your baby medicine safely

If your baby needs medicine, it is important to know how much to give and how often. You can record this in your baby's Personal Child Health Record (PCHR, or red book) to help you remember.

Always read the label on the bottle and stick to the recommended dose. If you are unsure, check with a pharmacist, health visitor, or GP.

Most medicines for young children come with an oral syringe. This helps you measure small doses accurately and makes it easier to give the medicine. Your health visitor or pharmacist can explain how to use it. Never use a kitchen teaspoon, as they vary in size.

When to call the doctor or seek emergency care

It is rare for babies to have life-threatening illnesses. However, it is important to know when to seek medical help.

When to call 999 or go to A&E

• Breathing problems – is working hard to breathe. This includes rapid breathing, grunting noises, or sucking their stomach in under their ribs.
• Breathing problems – stops breathing.
• Changes in appearance or responsiveness – has skin that is pale and cold, or is turning blue or blotchy. On brown or black skin, this may be easier to see on the palms of the hands or soles of the feet.
• Changes in appearance or responsiveness – is stiff and making jerky movements or rolling their eyes (having a fit or seizure).
• Changes in appearance or responsiveness – is floppy or drowsy and has no energy.
• Changes in appearance or responsiveness – is not responding to you or is difficult to wake up.
• Changes in appearance or responsiveness – will not wake up.
• Changes in appearance or responsiveness – has spots or a rash (spotty, purple, or red) anywhere on their body that does not fade when you press a clear glass against it. This non-fading rash is a medical emergency and could be a sign of a life-threatening infection like sepsis; call an ambulance immediately.
• Changes in appearance or responsiveness – is under 8 weeks old and you are very worried about them.
• Changes in appearance or responsiveness – has a severe allergic reaction (anaphylaxis).
• Changes in appearance or responsiveness – has a serious injury, for example from a fall or accident. You should also call if you are worried that you or someone else may have hurt your baby.
• Temperature concerns – is less than 3 months old and has a temperature of 38C or above, and has not had a vaccination in the past 2 days.
• Temperature concerns – is less than 3 months old and has a temperature of 36C or less, and has not had a vaccination in the past 2 days.
• Temperature concerns – has a fit caused by a fever (a febrile seizure) for the first time, even if they seem to recover.

When to contact your GP urgently

• The soft patch on the top of their head (the fontanelle) is bulging.
• They have blood in their nappy.
• They have any bruising, swelling, or bleeding.
• They have a high-pitched whimpering or moaning cry.
• They have difficulty feeding.
• They are being sick again and again (especially if their sick is an unusual colour).
• They are seeming less bright/awake or sleeping for an unusually long time.
• They are being irritable and unable to be comforted.
• They are having fewer or drier nappies.