Which signs in a child mean seeking help immediately?
Call 998 for severe breathing difficulty, blue or grey lips, a child who is hard to wake or not responding normally, a first seizure, a stiff neck or a non-fading rash. A baby under 3 months with 38°C or higher, or suspected fever, needs prompt medical assessment; so does a baby aged 3 to 6 months with 39°C or higher, or suspected fever. Do not wait until morning or for a home visit.
- Working hard to breathe: fast breathing, grunting, flaring nostrils, or skin pulling in between the ribs
- Floppy, unusually drowsy, or difficult to wake
- A rash that does not fade when pressed with a clear glass
- A seizure, or any first seizure
- Refusing all fluids, or no wet nappy for many hours
- Under 3 months: 38°C or higher, or suspected fever; age 3 to 6 months: 39°C or higher, or suspected fever — prompt medical assessment, not waiting for morning or a home visit
- A parent's sense that this child is different from any previous illness
Sources: NHS — fever in children: infant thresholds and warning signs
What should you actually watch overnight?
Check drinking, breathing, alertness and wet nappies or trips to the toilet alongside age and temperature. Check regularly, including at night. If the child becomes hard to wake, struggles to breathe or is not responding normally, call 998 rather than continuing to monitor.
Drinking
Small, frequent sips count. Persistent refusal of all fluid matters more than a missed meal.
Breathing
Look at the chest, not just listen. Effort and speed matter more than a cough's sound.
Alertness
Does the child respond, make eye contact, and settle again after being unsettled?
Output
Wet nappies or normal trips to the toilet are a practical measure of hydration.
Clinic or home visit for a child at night?
A home visit can suit a stable child with a non-emergency problem when travel is difficult. A clinic is better when tests or a longer examination may be needed. Emergency care is for any of the warning signs above.
Common questions
Answers connected to this guide.
My child has a fever but is playing normally. Do I need to do anything tonight?
Playing does not rule out serious illness. A baby under 3 months with a temperature of 38°C or higher, or suspected fever, needs prompt medical assessment; a baby aged 3 to 6 months with 39°C or higher, or suspected fever, also needs prompt medical assessment. Do not wait until morning or for a home visit. Call 998 for severe breathing difficulty, blue or grey lips, a child who is hard to wake or not responding normally, a first seizure, a stiff neck or a non-fading rash. In an older child without these concerns, offer fluids and check regularly, including at night; seek medical advice if worried or if the child worsens.
How do I check a rash?
Press the side of a clear glass firmly against the rash. If it does not fade, call 998 immediately; do not wait for a home visit or keep repeating the test. Absence of a rash does not rule out serious illness — severe breathing difficulty or a child who is hard to wake also means calling 998.
Can I give my child medicine left over from a previous illness?
No. Doses change as children grow, leftover antibiotic courses are incomplete by definition, and the previous illness may have been something different.