It's often hard to decide when you should worry about an infection in your child. A good rule is that if the child is playing normally and has a good appetite, they are unlikely to have a significant illness.
When a child shows some of the following signs, an infection should be suspected:
- Fretful, listless, drowsy, or irritable;
- Cries easily and won't stop;
- No interest in playing or in food;
- Feels hot to touch and looks flushed or pale;
- Complains of feeling cold;
- Has signs which give a clue to some particular infection, such as sore throat, earache, rash, cough, vomiting, diarrhoea, or localised pain.
You should know something about each of the most important signs of infection.
The normal body temperature is 37°C and it varies between 36.5°C and 37.2°C. A raised body temperature is called a fever and the most common cause of fever is infection. Since most fevers in children are caused by minor infections like the common cold, a raised temperature isn't usually a cause for alarm. Fevers in children are common and seldom require special attention.
You should worry about a child with a fever when:
- The baby is less than six months of age;
- The temperature is over 39°C;
- The temperature stays high for more than six hours at a time;
- The fever keeps recurring over one or two days;
- The fever does not respond to paracetamol;
- It is associated with other significant symptoms such as persistent vomiting, diarrhoea, unusual drowsiness, severe headache, stiff neck, convulsions, rapid breathing or cough.
In babies under six months of age, all fevers should be taken seriously.
Fevers are usually associated with a feeling of being unwell, loss of appetite, and mild headache. As the temperature rises, the skin may become hot, flushed and dry. Your child may complain of hot and cold feelings, and sometimes shivering followed by sweating as their temperature drops.
What to do about a fever
If your child has a fever but is generally well and happy, all you need to do is make sure they have plenty to drink and that they their clothes or bed coverings are not too thick.
In the case of a high fever, you can lower the temperature by removing clothing, fanning, tepid sponging (sponging with lukewarm water) and giving paracetamol (for example, Panadol or Dymadon paediatric suspension).
Contact your doctor if the temperature remains high. A child with a high temperature needs extra fluids to drink. Always use paracetamol instead of aspirin in children under the age of 12 years because aspirin occasionally causes severe reactions in certain childhood infections.
If your child has a convulsion
Children with a high fever sometimes have convulsions (fits). These are called febrile convulsions. It is quite frightening to see a child having a convulsion, but normally it causes no harm and there is no need to panic. Convulsions usually last only a few seconds.
- Lie the child on the side so saliva runs out of the mouth;
- Make sure there is no vomit in the mouth. Gently clean it out with your finger if there is;
- Do not try to force spoons or other objects into the mouth to stop the tongue from pushing back;
- Make sure that the child is not close to furniture or other objects that might cause injury during a convulsion;
- If necessary, you can remove any tight clothing
When the convulsion is finished, give some paracetamol and take other steps to lower the fever and then take your child to see a doctor. If the convulsion persists for four or five minutes, take the child immediately to the nearest doctor or hospital. Do not attempt to drive a car by yourself with a child who's having convulsions get your partner, a neighbour or a friend to drive while you look after your child.
Vomiting may be associated with gastroenteritis. However, vomiting for no obvious medical reason is common in babies. Vomiting should be taken seriously when it is accompanied by other signs of infection such as fever and diarrhoea.
Repeated passing of watery stools is always a matter for concern in babies because a large proportion of their body fluid can be lost quickly. In cases of gastroenteritis it is rarely the infection itself that is life threatening it's the loss of fluid that is the major risk.
Sore throat and earache
Sore throat and earache often go together in children because throat infections can spread to the middle ear more easily than in adults. Sore throats are usually due to mild viral infections but occasionally children get a severe tonsillitis from streptococcal bacteria. Streptococcal tonsillitis usually produces a high fever and the tonsils are bright red and speckled with small white patches. Streptococcal tonsillitis needs prompt treatment with penicillin or a similar antibiotic.
Rashes are very common in children. They are mostly caused by viral infectious diseases like chicken pox or glandular fever but are sometimes caused by allergy to a medicine or food.
If cough is persistent or only occurs at night or is brought on by exercise, the child should be taken to see a doctor. A wheezing child should always be checked by a doctor because of the possibility of bronchitis or asthma. Respiratory infections may trigger attacks of asthma in susceptible children.