THE SICK BABY AND CHILD: RECOGNISING SERIOUS ILNESS
Drowsiness The baby is less alert than usual. He makes less eye contact, and is generally less aware of sounds and movement and the immediate environment. The more drowsy the baby, the greater the chance of serious illness being present.
Decreased activity The baby is less active, and moves arms and legs less. He may just tend to lie around, or want to be cuddled by a parent rather than be involved in activities that are normally of interest.
Breathing difficulty This is an important sign of a potentially serious illness, and may take several forms. The baby may be breathing very quickly, or grunting with each breath. He may be coughing non-stop, and with each breath you may notice the muscles between the ribs being sucked in, or else he may be blue around the mouth. Sometimes it is difficult for parents to assess the baby’s breathing, and you should not hesitate to seek immediate medical advice if you are unsure. Poor circulation The baby may look paler than usual, and this can last for up to several hours. In addition, you may notice that his hands and feet may be cold or even blue.
Poor feeding The baby drinks much less than usual. Breastfed babies suck less strongly and for shorter periods of time. Bottle-fed babies take less than half the normal amount of milk that they normally drink in 24 hours. The baby may not be very interested in feeding in general.
Poor urine output The baby has fewer than four wet nappies in 24 hours.
The more of these signs the baby or young child has, the more chance there is that he has a potentially serious illness. You should see the doctor if any one of these signs is present in your child. If the child shows more than one of these signs, you should seek urgent medical attention.
A doctor should also see the baby as a matter of urgency if any of the following
occur:
• the baby vomits green fluid;
• the baby has a convulsion (fit);
• the baby has a very high temperature (fever). (Note that a high fever is potentially much more serious in a baby of less than 6 months than it is in an older child. Fever in a baby always needs medical attention as it is more likely to indicate a significant and potentially serious infection.);
• the baby stops breathing for more than 15 seconds (apnoeic episode);
• the baby has a lump in the groin area (hernia).
Remember that in babies and young children illness can progress more quickly. If in doubt, seek medical advice.
Sometimes parents may put off seeking advice for a variety of reasons. They may not want to worry the doctor with what may turn out to be a trivial illness, especially at night or if they think that he or she is very busy. They may be anxious that their fears are groundless and that they will appear foolish if the baby turns out to have a minor illness. In addition to diagnosing and treating illness, one of the most important things that a doctor should do is to reassure parents that their child is in fact well. This can alleviate a lot of unnecessary anxiety.
If you are concerned, for whatever reason, you should seek medical advice. Usually this will mean taking the child to your general practitioner. Most doctors repeated difficulty getting a rapid appointment for your baby to be seen by a doctor, or if you are made to feel guilty for ‘wasting the doctor’s time’, then it may be time to find a different doctor.
If you are worried about your baby or young child for any reason, do not hesitate to seek medical advice.
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