Stay alert

Don’t hesitate to seek medical advice if you’re worried about the symptoms described below.

Fits and fevers

A sharp increase in temperature can cause a febrile convulsion, or fit. The child goes stiff, loses consciousness, throws their head back and their limbs jerk.

They go pale and may foam at the mouth. The attack ends after a few minutes, and the child returns to normal colour and consciousness or falls into a deep sleep. Up to one in 20 children aged 1 to 4 are affected. These fits are scary to watch but usually harmless.

Here’s what to do

  • Keep the surrounding area safe and allow them to have the seizure; once the seizure stops, place them into the recovery position
  • Loosen clothing but don’t try to hold them down.
  • Don’t put anything into their mouth, and remove anything they might swallow.
  • Always dial 999 if your child has a convulsion.

Always report a convulsion to your GP

The following are signs of possible serious illness

  • Your child is drowsy or irritable. (Although children with a temperature are often more sleepy, irritable and lacking interest than usual, they usually improve after treatment with paracetamol and/or ibuprofen. If they do not improve, or if they are very drowsy indeed, they should see a doctor urgently).
  • Your child has problems breathing – including rapid breathing and being short of breath or ’working hard’ to breathe. Any child who has a lot of difficulty breathing needs to see a doctor urgently.
  • Unusually cold or discoloured hands or feet with a warm body.
  • Severe arm and/or leg pains (for no obvious reason).
  • Unusual skin colour (pale, blue or dusky around lips).
  • High temperature (40°C or higher) (not necessarily a sign of serious infection, but if the temperature does not come down with treatment or your child has other features on this list then you should seek help).
  • An infant who is not feeding or any child that is showing signs of dehydration. A dehydrated child may be drowsy, have very dry lips, or sunken eyes. In babies there may be a reduction in wet nappies.

Symptoms related to meningitis and sepsis

  • A fever (temperature of 38°C or higher).
  • A rash that does not fade with pressure.
  • Dislike of bright lights.
  • Cold hands and feet.
  • Reduced or altered responsiveness.
  • Unexplained irritability.
  • Unusually severe headache.
  • A still neck (difficulty putting chin to chest). This may not be easily seen in toddlers.

If your child is unwell with a fever and any of the other symptoms above seek urgent medical attention.

Other symptoms that should be assessed by a GP

  • A cough lasting more than three weeks (or sooner if becoming breathless more easily or there is a family history of asthma).
  • A fever for 24 hours or more with no other sign of infection (such as cough, runny nose, earache).
  • Your child loses weight and does not regain it within two weeks in an under five-year old or within four weeks in an older child.

Most common infections do not get better quicker with antibiotics.

Most children with a cold, cough, sore throat or earache, who see their GP, will still be ill four days later. This does not mean that they need treatment or need to be seen again.

One third of children who have seen their GP with a cough will still be coughing two weeks later. This does not mean that they need treatment.

Only children with signs of more serious illness generally need to be seen by a doctor or nurse.

These signs include

  • Excessive drowsiness
  • Difficulty breathing or rapid breathing
  • Cold or discoloured hands and/or feet with warm body
  • Abnormal pains in arms and/or legs
  • Abnormal colour (pale or blue).

Always call the doctor or dial 111 for NHS24 out of hours if your child:

  • cries constantly and can’t be comforted
  • seems drowsy and floppy and won’t wake up
  • has a fever that lasts for more than three days
  • is not getting better after an operation or course of treatment for an illness
  • has been vomiting for more than 24 hours
  • has a headache or stiff neck
  • seems to be dehydrated.

CALL 999 if you feel your child is seriously ill.

Last updated: 15 April 2019