When your child is sick

It is a major concern to parents when their young children are sick. It is especially important to be able to tell the difference between a serious illness and a minor one. Parents also need to learn how to pick up the signs of illness early so that treatment and care can begin as soon as possible. This is especially important for very young babies and children, as their condition can deteriorate more quickly than older children.

Signs of sickness include

• fever
• reduced appetite
• no interest in playing
• unhappiness
• low energy
• drowsiness
• 'floppiness'
• breathing difficulties
• a change in skin colour
• infrequent wee or change in poo.

If your child has a fever

• get them to rest
• dress them lightly
• offer regular small drinks of clear fluid
• paracetemol can be given if your child's temperature is above 38.5C
• If you are concerned, see a doctor.

Signs of sickness

Most, but not all, illnesses in young children will be accompanied by a fever, and not all children with fever will be sick. You will need to look at your child and ask yourself:

• Is my baby not feeding? or
• Is my child happy, eating and playing? or
• Is my child lying around, not interested in surroundings?

Other signs to watch out for if your child is unwell

It is important, especially with babies and young children, to watch out for other important signs if they are unwell.

• Drowsiness and loss of interest in playing and interacting with you - the baby or young child may be less alert than usual and not interested in what is going on around them. The child may prefer to just be cuddled and may be 'floppy'.
• Breathing difficulty - breathing may be noisy, rapid and/or shallow, or the child may take long pauses between breaths. The baby may make a grunting sound, or the ribs or breastbone may be sucked in with each breath.
• Poor feeding or loss of appetite - the baby or child may suck less vigorously, for shorter periods or refuse feeds all together. This needs to be taken seriously in an infant. Taking less than half the normal amount of feed in a 24 hour period is of concern.
• Poor urine output - less than four wet nappies in a 24-hour period is a concern. This may be difficult to assess if the child has diarrhoea. For an older child, their urine will be reduced in amount and it may be concentrated (a brown to orange colour).
• Change in skin colour - the baby or child may be very pale, have mottled skin or cold hands and feet.
• Change in poo - very loose poos, absent poos or change in colour of poos may occur.

Fevers

A fever is where there is a rise in the body's temperature. Fevers are the body's natural response to fighting infection. The infection responsible for producing the fever can be a virus or bacteria. It is sometimes difficult to distinguish which is the cause. There are some important guidelines you should follow if your child has a fever.

• Keep the child at rest and comfortable.
• Remove excess blankets and clothing and keep the child lightly dressed.
• Do not allow them to shiver as this contributes to a rise in temperature. If they do shiver, wrap them in a light blanket until the shivering stops and treat the fever with paracetamol or ibuprofen.
• Give frequent small drinks of clear fluid (including water or diluted fruit juice - one part juice to four parts water).
• A child with a fever will be thirsty and, if they're not vomiting, can drink as much fluid as they desire. If your child is under six months of age, give them extra cooled boiled water, breastfeeds or bottles.
• Regularly check your child's temperature with a thermometer - mercury and digital thermometers are the most accurate. Plastic tape thermometers used on the forehead are not reliable.

Giving medication to reduce fever

If your child seems generally well and happy, there is no need to treat a fever with medication. However, paracetamol or ibuprofen can be given in the correct dose to treat a fever above 38.5C or if the child is irritable or in pain.

Read the bottle carefully before giving your child a dose, and talk to your pharmacist if you have any concerns. If there are two or more carers (eg. mum and dad) make sure your child doesn't mistakenly get two doses. Do not use paracetamol or ibuprofen for more than 48 hours without talking to your doctor. Do not give aspirin to children without first seeking medical advice.

• Paracetamol
  The correct dose of paracetamol is 15mg per kg of bodyweight every four hours - but do not exceed 60mg per kg a day, or more than four doses in 24 hours. Different brands of paracetamol have different strengths (ie. mg per ml).
• Ibuprofen (for example, Nurofen)
  Ibuprofen is an alternative medicine, which can be used to treat pain or fever in children over three months of age. The recommended dose is 5-10mg per kg of bodyweight every four to six hours. Give with food to reduce the risk of stomach upsets.

When to see the doctor

Seek medical attention - such as your local hospital or medical centre - as soon as you can if: you observe any of the signs of sickness mentioned in this fact sheet, especially if a number of these occur together you have a very young baby who you suspect is unwell you are concerned about your child. It is also important to seek help if your child:

• develops a rash
• has a convulsion or fit
• has a fever greater than 39C
• vomits persistently for hours or vomits green fluid or blood
• has pain that is not relieved by paracetamol or ibuprofen
• develops a lump or swelling - especially in the groin
• stops breathing for more than 15 seconds
• has a severe headache, neck stiffness or light hurts their eyes.
• Further advice can be obtained by calling 13HEALTH (13 43 25 84)

Remember

Ill children need extra care and attention when they are sick. Keeping them at rest and at home can be important to recovery and will minimise the risk of transferring infection to other children. Young children have no idea why they feel the way they do when they are sick, and will be irritable and upset. Your presence and reassurance is vital to their recovery.

Acknowledgement

This fact sheet is the result of input and effort from many health professionals in Queensland. Their help with the content is greatly appreciated. This fact sheet draws on information from:

• The Centre for Community Child Health, 1996, Fever: A Guide for Parents and Carers, Royal Children's Hospital, Melbourne.
• Women's and Children's health network, Using Paracetamol.
• Better Health Channel, Children who are Sick – When to See the Doctor.
• The Royal Children's Hospital and Health Service District, Paediatric Fever Management.
• The Mater Misericordiae Children's Hospital, Department of Paediatric Emergency Medicine, Parent Information About Children with High Temperatures.

This information is provided as general information only and should not be relied upon as professional or medical advice. Professional and medical advice should be sought for particular health concerns or manifestations. Best efforts have been used to develop this information which is considered correct and current in accordance with accepted best practice in Queensland as at the date of production. The State of Queensland (Queensland Health) does not accept liability to any person for the information provided in this fact sheet nor does it warrant that the information will remain correct and current. The State of Queensland (Queensland Health) does not promote, endorse or create any association with any third party by publication or use of any references or terminology in this fact sheet.