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20 Nov 2020

When should I take my baby to hospital during the pandemic?

Knowing when to seek medical help can be difficult - especially during the coronavirus pandemic. Here's straightforward guidance on what to do.

There's been a large drop in the number of babies and children being taken to emergency departments and paediatric assessment units in the UK since mid-April, according to a report published in the British Medical Journal.

As a result doctors are worried parents may not be getting help early enough when their little ones are unwell.

New traffic light information has been published to help remove some of the confusion for new parents. It's been written by the Royal College of Paediatrics and Child Health (RCPCH), the British Association of Perinatal Medicine, the Royal College of General Practitioners and the Institute of Health Visiting.

Consultant paediatrician Dr Yiannis Ioannou goes through the advice and explains what action you should take if you suspect your baby or child is unwell.

RED: You need urgent emergency help

If your baby has any of the following signs:

  • Pale, mottled (blotchy) skin which feels unusually cold.
  • Is stiff or rigid for a long time or makes repeated, jerky movement of arms or legs that doesn't stop when you hold them (a fit or seizure).
  • Is difficult to wake.
  • Has a rash that does not disappear when a glass is gently pressed against the skin.
  • Has a hot chest, face or back and is sweaty or clammy (a temperature of 38°C / 100.4°F or higher) unless this is within two days of vaccinations and there are no other signs from this section or the AMBER section below.
  • Is too breathless to feed, has pauses in their breathing lasting more than 10 seconds and is grunting or going blue.
  • Green vomit (like the colour of spinach or green washing up liquid).

Action needed:

Dr Yiannis says: 'You need to seek urgent help if these symptoms present themselves. Don't hesitate to go to your nearest A&E department or call 999.'

Always seek help urgently if you are frightened because your baby looks very unwell.

What rash is this? Take a look at the photos in this Which? guide to help you

AMBER: Contact your GP or dial 111

If your baby has any of the following signs:

  • Difficulty breathing; including breathing fast all the time, widening their nostrils or pulling in the muscles below the ribs when breathing.
  • Not interested in feeding and/or looks dehydrated (dry mouth, sunken eyes, no tears, or no wet nappies in the last 8 hours).
  • Is increasingly sleepy or irritable (crying continuously and won't calm down).
  • Has yellow skin or whites of their eyes, which is quickly becoming worse.
  • Blood in the poo.
  • Very pale (white or grey) poo - keep a sample to show the doctor.
  • Shivering.
  • Keeps being sick.

Action needed:

Dr Yiannis says: 'You should contact your GP immediately to make an appointment for your baby to be seen that day, or call NHS 111.'

What to do if this doesn't work:

During the current pandemic, it may be more difficult to get advice.

Dr Yiannis says: 'If, after four hours or more, your baby hasn't improved or their condition worsened and you haven't been able to speak to either someone from your GP practice or NHS 111, you may need to take them to the nearest A&E department.'

How to take a baby or child's temperature

GREEN: Look after your child at home

If your baby DOESN'T have any signs from the RED or AMBER sections, the following are normal:

  • Your baby is less than two weeks old (or three weeks old and breastfed) and looks slightly yellow, mainly on the face. (This may slowly increase over a day or two but will then start to fade).
  • Has four to six wet nappies a day.
  • Has green, brown, orange, yellow or black poo. (The poo of breastfed babies is usually yellow and can often look 'seedy' - it's a sign your baby is healthy).
  • Continues to feed well with breast or formula milk.
  • Baby wakes up often and cries to be fed.

Action needed:

Dr Yiannis says: 'If these are the symptoms you're seeing, you can continue looking after your child at home but if you are still concerned about your baby, contact your Health Visitor or NHS 111.'

You can do this by visiting 111.nhs.uk or by dialling 111.

If your baby seems well but is still crying a lot, you can find more advice from the ICON programme.

When the dust has settled, it might be worth looking into getting first aid training to be able to initiate some care at home, such as those run by the British Red Cross.

The RCPCH has produced a printable version of this traffic light information so you can put it on your fridge or noticeboard.

Baby first aid kit essentials: what your home first aid kit should contain