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What to do when children are ill

Having an ill child is a very scary experience for parents and carers. Understanding more about how a child feels when they are ill can help you feel more in control.

Before we begin, use the comments section below to write the things you normally expect to see if a child is unwell. See if they match the advice below!

How do I know if a child is unwell?

Fever (high temperature)

black and white image of a child with a thermometer in mouth

Image from Victoria_Borodinova on Pixabay.

  • A high temperature is a normal response that can help the child fight off an infection.
  • If the child seems uncomfortable, you might want to try to bring down the child’s temperature with paracetamol and / or with ibuprofen - your setting may have a process for administering medication if a child has a fever so please ensure you follow these procedures. Don’t wrap children with fever with blankets, but instead you may want to take off excess outer clothing.
  • Sometimes young children can have a seizure when they have a high temperature. This can be very scary for parents and carers, but is usually not serious. If this happens call 999 immediately to ensure the child can be checked over in a hospital.

Irritable and grizzly

image of baby crying

Image from joffi on Pixabay.

  • It is normal for children to feel upset or irritable when they are feeling unwell. Try to be patient with them and reassure them as much as you can.
  • If they seem very distressed or won’t stop crying seek medical advice. If they become drowsy, floppy or have a seizure call 999 immediately.

Refusing to eat and drink

image of child looking drowsy and unhappy

Image from anandart on Pixabay.

  • They may also refuse to eat and drink. Try to encourage them to keep drinking, and watch out for signs of dehydration such as drowsiness, dry eyes/mouth or decreased urination. This is especially true for younger children (under 1 years) who are at high risk of dehydration when they are unwell.
  • If you are concerned, seek medical advice.

When should I be worried and seek help?

If you are worried about a child’s behaviour or illness always seek advice from a medical specialist. The NHS 111 telephone line can be a helpful way to get advice about how to manage an unwell child. In an emergency always call 999.

Here’s a checklist of warning signs that might be serious:

image of checklist: Temperature - high temperature, but cold feet and hands; high temperature that does not come down with paracetamol or ibuprofen; very high or low temperature; child feels hot or cold to touch, or is shivering; child is quiet and floppy, even when their temperature is not high; high temperature in a baby less than 8 weeks old. Breathing - Rapid breathing or panting; throaty noise while breathing; child is finding it hard to get their breath and is sucking their stomach in under their ribs

Other signs

  • Blue, pale, blotchy, or ashen (grey) skin
  • The child is hard to wake up, or appears disoriented or confused
  • The child is crying constantly and you cannot console or distract them, or the cry does not sound like their normal cry
  • Green vomit
  • The child has a febrile seizure for the first time
  • The child is under 8 weeks old and does not want to feed
  • Nappies that are drier than usual – this is a sign of dehydration

If a child has any of these signs, get medical help as soon as possible.

When should I call an ambulance?

Call 999 for an ambulance if a child:

Stops breathing or is clearly struggling to breathe
* Will not wake up
* Has a spotty, purple or red rash anywhere on their body that does not fade when you press a glass against it – this could be a sign of blood poisoning (sepsis)
* Is under 8 weeks old and you're very worried about them
* Has a febrile seizure for the first time, even if they seem to recover
* Has a severe allergic reaction (anaphylaxis)
* If you think someone may have seriously injured a child

Above all, trust your instincts. You know what’s different or worrying behaviour for the children you look after.

How long should children be excluded from childcare facilities for?

Link to a helpful document which provides the recommended exclusion time for children according to their illness.

Link to COVID-19 guidance for childcare facilities.

The see also and downloads sections below have links to further reading you may find useful.

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This article is from the free online course:

Preventing and Managing Infections in Childcare and Pre-school

BSAC