27/10/2025
When should you worry about your sick child?
Winter time and winter coughs, colds, earache and sore throats are coming into season.
For children over 6 months the below information may help you.
Fever:
Fever is a normal response that may even help to fight infections.
Fever does not harm your child.
Children with a high temperature (40 C or more) are more likely to have a more serious infection (though most will not).
What can you do about it?
To make your child more comfortable, you may want to try and lower their temperature by giving them Paracetamol and / or Ibuprofen. Take off outer clothing (do not wrap your child
up if they have a fever). Sponging a child with water can sometimes
make matters worse by upsetting a child or making them shiver (which can raise their temperature more).
However, as long as it does not upset your child, bathing/sponging with luke warm water may help a little.
Temperature Fits (Febrile Seizures)
Young children can sometimes have a fit as a result of having a temperature. It can be very scary if your child has a seizure, but it is usually not serious. Treating fever with paracetamol or ibuprofen does not prevent fits.
If your child has a fit – try to stay calm. Most of these fits will not cause your child any harm and will last less than 5 minutes.
Unless your child has had previous febrile seizures and you are familiar with what to do, it is best to dial 999 immediately for an ambulance.
It is a good idea to make sure a child who is having a fit is away from things they may hurt themselves on, and to roll them on their side (recovery position).
Cough/Chesty Cough
When young children catch a cold they often develop a ‘noisy chest’ or a ‘chesty cough’. This can be worrying for parents who believe that a chesty cough is a sign of a ‘chest infection’.
Young children often get noisy chests. This is because they have smaller airways and thinner rib cages than adults.
A child with a true chest infection will generally be more ‘unwell’.
How long will it last?
1 week - only 3/10 children's coughs will have resolved.
2nd week - 7/10 children's coughs will have resolved.
Week 3 - 8/10 children's coughs will have resolved.
What can I do about it?
Coughing helps the body fight against infection and can take a while to go. Cough syrups probably do not help.
Do antibiotics help?
Most people who take antibiotics do not get better any faster than people who do not take them. Looking at adults and children with
bronchitis (chesty cough), on average, people taking antibiotics will have a cough for only half a day less than those who don’t.
Common Cold
Colds are very common. Normal, healthy children can sometimes have 8 or more colds in a year!
How long will it last?
3/10 children are likely to feel better in 4 days.
7/10 children in 7 days.
Do antibiotics help?
There is no evidence that antibiotics help with colds.
Green Phlegm/Snot
Some parents and doctors have long believed that the colour of nasal discharge (snot) gave an indication of the type (or
seriousness) of an infection.
Recent research suggests that this is not the case. Green nasal discharge can be caused by many types of infection and does
not need to be treated with antibiotics.
Sore Throat
A sore throat does not need any treatment to make it go away. It will get better by itself.
If your child seems very unwell or has a sore throat and temperature, but no cough, for more than 3 days, could triage to the doctor.
You do not need to look in your child’s throat. If you have, and you are worried about largetonsils, this is not, by itself, something to be
concerned about. However, if your child is having difficulty breathing, or seems very unwell you should consult your
doctor urgently.
5/10 children the sore throat will be gone in 4 days.
9/10 children in 1 week.
Do antibiotics help?
After one week, more than three-quarters of those with a sore throat will be better whether they take antibiotics or not. Most (13 out of 14) who take antibiotics will get better just as quickly as if they had not taken them.
Earache
There is normally no need to treat ear infections with antibiotics. Pain control with Paracetamol and / or Ibuprofen is all that is normally needed.
If your child is having hearing problems, or the ear is
draining, you can contact the GP.
7/10 Children's Earache clears up in 4 days
9/10 in 1 week.
Do antibiotics help?
After one week, more than three-quarters of children will be better whether they take antibiotics or not. Most (14 out of 15) children who take antibiotics get better just as quickly as if they had not taken them. Children under the age of two with ear infections in both ears, and those with an ear infection that is draining, are more likely to benefit from antibiotics than other children and should be seen by a doctor or nurse.
Croup can occur in children from 6 months to 12 years, but is most common in children under 3 years old. It is caused by a virus in the voice box and upper airway and causes a ‘barking’ cough (like a seal bark). It is usually worse at night.
What can I do about it?
Comfort and hold your child to keep them calm – anxiety seems to make croup worse. Give your child sips to drink to prevent dehydration. Sitting your child up may help them with the
cough. Most croup will improve with simple measures like this. If this does not settle your child or they are having difficulty breathing you should call for help.
Your child should see a doctor urgently if:
Their breathing is rapid
The tissues around the neck or below the ribs are pulled in when they breathe
They are becoming agitated, exhausted, bluish-grey or pale, or
They can not swallow, or are drooling
Do antibiotics help?
Antibiotics do not help with croup.
Not Eating/Drinking
Children often eat and drink less when they are unwell. Encourage them to drink plenty.
Most will start to drink before becoming dehydrated. However, you should watch for signs of dehydration, such as drowsiness, dry eyes / mouth, or peeing less. This is especially so or young children (under 1) and those who are vomiting.
What can I do?
A child’s immune system is very powerful, and will clear up most common
infections by itself.
You can help your child fight the infection by making sure they get plenty of rest and offering them healthy food (like fruit).
Give your child plenty to drink. This will help prevent dehydration, loosen phlegm, and lubricate the throat. Try to avoid very sugary drinks.
Pain and fever are best treated with Paracetamol and / or Ibuprofen.
Paracetamol and Ibuprofen work differently. They can be used together if one alone has not worked. Just make sure you do not give more than the maximum recommended dose of either of them.
Make sure no-one smokes around your child.
Why not take antibiotics?
There are several reasons why it is not a good idea to take antibiotics unless they are really needed.
Using antibiotics can make bacteria resistant to antibiotics. In other words, the antibiotics will no longer work against the bacteria. Someone who has recently had antibiotics is more likely to have resistant bacteria in their body. Some bacteria have become resistant to almost all antibiotics!
Most antibiotics have side effects, e.g. diarrhoea, rashes and stomach upset.
Antibiotics kill our natural bacteria that help to protect us. This can result in infections such as thrush.
Antibiotics can also cause allergic reactions. These are often just annoying rashes, but can, in some cases, be severe reactions.
When should I seek further help?
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 breath. (It sometimes looks as though the tissues between the ribs and below the ribs get sucked in each time they breath). Any child who has a lot of difficulty breathing needs to see a doctor
urgently.
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.
Symptoms related to meningitis:
- Unusually severe headache
- A stiff neck (difficulty putting chin to chest)
- Dislike of bright lights
- A rash that does not fade with pressure
