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Taking Care of Poorly Children and Infants

Let’s look at some of the most common conditions that babies and infants experience. This will help you to identify the conditions, how to take care of your baby or infant yourself, and when to recognise it’s time to contact your GP practice for help.

Keep all medicines locked away and out of reach from children e.g. in a locked drawer, medication box or cabinet.

1. Cold

2. Cough

3. Cradle Cap

4. Ear infection

5. Head lice

6. Infant colic

7. Nappy rash

8. Sore throat

9. Threadworms

Cold

The symptoms of a common cold are typically a blocked or runny nose, sore throat, head and muscle aches, coughs, sneezing, raised temperature, pressure in the ears and face or a loss of taste and smell.

It’s normal for a child to have multiple colds in a year because they haven’t had time to build immunity. This only happens once they catch colds, so it’s a positive part of the life cycle. As they gradually build up immunity, they will get fewer colds. Most colds get better in 5 to 7 days but can take up to 2 weeks in small children.

Here are some suggestions for how to ease the symptoms in your child:

  • Make sure your child drinks plenty of fluids.
  • Saline nose drops can help loosen dried snot and relieve a stuffy nose. Ask your pharmacist for further help if needed.
  • Encourage the whole family to wash their hands regularly to stop the cold spreading.
  • If your child has a fever, pain or discomfort, children’s paracetamol or ibuprofen can help. Children with asthma may not be able to take ibuprofen, so check with a pharmacist or health visitor first. Always read the instructions on the manufacturer’s leaflet for over- the-counter medications.

Word of caution

Children under 6 should not have over-the-counter cough and cold remedies, including decongestants (medicines to clear a blocked nose), unless it has been advised by a GP or pharmacist.

Babies under the age of two months old should not be given any sort of children’s paracetamol unless it has been advised by a GP or pharmacist.

Children can take paracetamol as:

  • Liquid syrup – from the age of two months.
  • Suppositories – from the age of two months.
  • Tablets (including soluble tablets) – from the age of six years old.
  • Fast Melts – from the age of six years old.

Always read the instruction leaflet before giving your baby or infant medicine.

Find out about key facts and dosage of paracetamol for children here: https://www.nhs.uk/medicines/paracetamol-for-children/

Children's sore throats

Sore, dry throats are often caused by viral illnesses such as colds or flu and might arrive a day or two before a cold actually starts. You can give them children’s paracetamol (available as tablets or syrup) or ibuprofen to reduce the pain.

Children can take paracetamol as:

  • Liquid syrup – from the age of two months.
  • Suppositories – from the age of two months.
  • Tablets (including soluble tablets) – from the age of six years old.
  • Calpol Fast Melts – from the age of six years old.

Always read the instruction leaflet before giving your baby or infant medicine.

Most sore throats get better on their own after a few days.

If your child’s sore throat lasts more than four days, has a high temperature and is generally unwell, contact your GP practice to arrange a consultation.

If they’re unable to swallow fluids or saliva or they have difficulty breathing, go to A&E or call 999 immediately and explain your child’s symptoms.

Find your nearest A&E department

Children's coughs

A cough is often caused by mucus trickling down the back of the throat when we have colds.

If your child is feeding, drinking, eating and breathing normally and there’s no wheezing, a cough is not usually anything to worry about.

It may be upsetting to hear your child cough, but coughing helps clear away phlegm from the chest or mucus from the throat.

If your child is over the age of 1, they can try drinking a warm drink of lemon and honey.

Hot Lemon With Honey

  • Squeeze half a lemon into a mug of nearly boiled water.

  • Add 1 to 2 teaspoons of honey.

  • Drink while still warm – remembering not to give hot drinks directly to small children to hold.

If your child’s temperature is very high, or they feel hot and shivery, they may have a chest infection. You should take them to a GP, or you can call 111.

If a cough continues for a long time, especially if it’s worse at night or is brought on by your child running about, it could be a sign of asthma. Take them to a GP, who will be able to check if your child has asthma.

If your child is finding it hard to breathe, go to A&E or call 999 immediately as they’ll need urgent treatment in hospital.

Find your nearest A&E department

Children's ear infections

Common in babies and small children, ear infections often follow a cold and sometimes cause a high temperature. Most ear infections are caused by viruses, which can’t be treated with antibiotics. They’ll just get better by themselves, usually within about three days.

A baby or toddler may pull or rub at an ear. Other possible symptoms include fever, irritability, crying, difficulty feeding, restlessness at night, and a cough.

If your child has ear ache, with or without fever, you can give them children’s paracetamol or ibuprofen at the recommended dose. Don’t give children paracetamol and ibuprofen at the same time, unless advised by a healthcare professional.

Medicine information

  • Find out about key facts and dosage of paracetamol for children here: https://www.nhs.uk/medicines/paracetamol-for-children/
  • Try one medicine first and, if it doesn’t work, you can try giving the other one.
  • Do not put any oil, ear drops or cotton buds into your child’s ear, unless your GP advises you to do so.

Cradle cap

It’s a very common and harmless skin condition in babies that usually clears up on its own, but there are things you can try to help it get better.

It may look like it should hurt your baby but it isn’t itchy or painful, and it can’t be caught from another baby nor passed on.

Do these things to make it better…

Do not do these things – they don’t help…

  • Wash your baby’s hair regularly with mild, unperfumed baby shampoo and gently loosen flakes with a soft brush.
  • Gently rub on baby oil or vegetable oil to help soften the crusts.
  • Use baby oil, vegetable oil or petroleum jelly overnight and wash with baby shampoo in the morning.
  • Don’t use olive oil – recent research has found it may not be suitable for use on skin.
  • Don’t use peanut oil (because of the allergy risk).
  • Don’t use soap.
  • Do not use adult shampoos.
  • Don’t pick at your baby’s cradle cap crusts – this can cause an infection.

Word of caution

If the following is relevant to your baby’s cradle cap, contact your GP practice to make an appointment…

  • The cradle cap is all over your baby’s body.
  • The crusts leak fluid or bleed.
  • The affected areas look swollen.
  • You have seen no improvement even though you’ve treated it for a few weeks.

The above could be signs of an infection, or another condition like eczema or scabies.

The NHS page for cradle cap can be found here: https://www.nhs.uk/conditions/cradle-cap/

Infant colic

Colic is when a baby cries a lot but there’s no obvious cause. It’s a common problem that should get better on its own. But call NHS 111 or see a GP if you’re worried.

Baby colic

It’s natural for your baby to cry but if your baby cries for more than three hours a day, three days a week for at least one week, your baby may have colic. You may also find they cry more often in the afternoon and evening.

It can start when a baby is a few weeks old. It usually stops by the time they’re 6 months old.

These are other signs it could be colic…

  • It’s hard to soothe or settle your baby.
  • They clench their fists.
  • They go red in the face.
  • They bring their knees up to their tummy or arch their back.
  • Their tummy rumbles or they’re very windy.

Because colics in babies is so normal, you don’t usually need to see a doctor but if you remain concerned after the timings referenced above, speak to your health visitor for advice and support. Alternatively, drop into your local pharmacy and speak to a pharmacist who will be happy to help.

Health visitors and doctors will usually advise you to:

  • Hold or cuddle your baby when they’re crying a lot.
  • Sit or hold your baby upright during feeding to stop them swallowing air.
  • Wind your baby after feeds.
  • Gently rock your baby over your shoulder.
  • Gently rock your baby in their Moses basket or crib, or push them in their pram.
  • Bath your baby in a warm bath.
  • Put some gentle or soothing background noise or music on the radio or TV to distract them.
  • Keep feeding your baby as usual.

Although there’s very little evidence the following things work, you could speak to your health visitor for further advice in case you want to try something else…

  • Anti-colic drops and herbal and probiotic supplements.
  • Changes to your diet if you’re breastfeeding.
  • Applying gentle pressure to your baby’s spine (spinal manipulation) or skull (cranial osteopathy).

Word of caution

Contact your GP practice so they can look into your baby’s ongoing colic if any of the following is relevant to you and your baby…

  • You’re worried about your baby.
  • Nothing seems to be working.
  • You’re finding it hard to cope.
  • Your baby is older than 4 months and still seems to have symptoms of colic.

Head lice and nits

It’s very common for young children and their families to get head lice and nits. It’s nothing to do with dirty hair and they are simply picked up by head-to-head contact.

How do you spot head lice when they’re only about 3mm in size?

  • Itchy head.
  • Something moving in the hair.

Finding live lice is the only way to be sure. You can do this by combing their hair with a special, fine-toothed comb (detection comb), which you can buy online or at pharmacies.

Getting rid of head lice can be done at home without consulting a GP but treat them as soon as you spot them. There’s no need to keep your child off school if they have head lice, nor to wash laundry on a hot wash.

How do you get rid of head lice?

First try ‘wet combing’ with the comb we just described…

  • Wash hair with ordinary shampoo.
  • Apply lots of conditioner (any conditioner will do).
  • Comb the whole head of hair, from the roots to the ends.

This usually takes about 10 minutes to comb short hair, and 20 to 30 minutes for long, frizzy or curly hair.

Do wet combing on days 1, 5, 9 and 13 to catch any newly hatched head lice. Check again that everyone’s hair is free of lice on day 17.

If wet combing hasn't worked, try medicated lotions and sprays

Ask a pharmacist for advice if you have tried wet combing for 17 days, but your child still has live head lice.

They may recommend using medicated lotions and sprays which kill head lice in all types of hair. You can buy them from pharmacies, supermarkets or online.

Head lice should die within a day. Some lotions and sprays come with a comb to remove dead lice and eggs.

Some treatments need to be repeated after a week to kill any newly hatched lice.

Check the pack to see if they’re okay for you or your child, and how to use them. If lotions or sprays don’/t work, speak to a pharmacist about other treatments

Word of caution

The list below are examples of treatments, which are not recommended because they’re unlikely to work.

  • Products containing permethrin.
  • Head lice “repellents”.
  • Electric combs for head lice.
  • Tree and plant oil treatments, such as tea tree oil, eucalyptus oil and lavender oil herbal remedies.

This video about wet combing for head lice by the charity Community Hygiene Concern might be useful.

Nappy rash

It doesn’t usually develop in newborns, but all babies can get nappy rash and up to a third of all our babies and toddlers have nappy rash at any one time.

Nappy rash can be caused by…

  • Your baby’s skin being in contact with wee or poo for a long time.
  • The nappy rubbing against your baby’s skin.
  • Not cleaning the nappy area or changing the nappy often enough.
  • Soap, detergent or bubble bath.
  • Alcohol-based baby wipes.
  • Your baby recently taking antibiotics.

What does nappy rash look like?

  • There may be red patches on your baby’s bottom, or the whole area may be red.

  • Their skin may look sore and feel hot to touch.

  • There may be spots, pimples or blisters.

Most babies with mild nappy rash don’t feel sore, but if the rash is severe your baby may feel uncomfortable and be distressed.

How to prevent nappy rash

The simple steps below will help prevent – and clear up – nappy rash. You can usually treat their skin yourself. If the rash isn’t upsetting your baby, apply a thin layer of a barrier cream to protect their skin at each nappy change. Ask your health visitor or pharmacist to recommend one. Nappy rash usually clears up after about three days if you follow these hygiene tips.

  • Change wet or dirty nappies as soon as possible.
  • Clean the whole nappy area gently but thoroughly, wiping from front to back. Use water or fragrance-free and alcohol-free baby wipes. Read more about how to clean your baby.
  • Bath your baby daily – but avoid bathing them more than twice a day as that may dry out their skin.
  • Dry your baby gently after washing them – avoid vigorous rubbing.
  • Lie your baby on a towel and leave their nappy off for as long and as often as you can to let fresh air get to their skin.
  • Do not use soap, bubble bath, or lotions.
  • Do not use talcum powder as it contains ingredients that could irritate your baby’s skin.

If the rash is causing your baby discomfort, your health visitor or pharmacist can recommend a nappy rash cream to treat it. You should apply the cream first and wait a few minutes before you apply the barrier cream.

Other rashes in the nappy area

It’s normal for babies to develop skin rashes, but it’s important to know the difference between a minor irritation and a condition that requires attention. If the rash doesn’t go away or your baby develops a persistent bright red, moist rash with white or red pimples that spreads into the folds of their skin, they may have an infection.

Ask your pharmacist or health visitor for advice. The pharmacist may recommend a cream for you to use.

If the rash is severe, take your baby to the GP who may prescribe cream or medicine. Follow your GP’s instructions on whether and when to apply barrier cream as well as the prescribed cream.

Find other information about caring for a newborn baby here: https://www.nhs.uk/conditions/baby/caring-for-a-newborn/nappy-rash/

Threadworms

As their name suggests, threadworms (pinworms) are tiny worms and you an actually spot them in your poo – they look like pieces of white thread. Threadworms (or ‘worms’), are common in children and spread easily but you can treat them without seeing a GP.

Identifying them

You might also see them around your child’s bottom (anus). The worms usually come out at night while your child is sleeping.

See what threadworms look like in poo

Common symptoms can include…

Less common signs of worms include:

  • Extreme itching around the anus or vagina, particularly at night.
  • Irritability and waking up during the night.
  • Weight loss.
  • Wetting the bed.
  • Irritated skin around the anus.

A pharmacist can advise you about threadworms. You can buy medicine (mebendazole), which is usually a chewable tablet or liquid you swallow. Tell the pharmacist if you need to treat a child under two, or if you’re pregnant or breastfeeding. Treatment might not be suitable and you may need to speak to a GP.

Treat everyone in your household, even if they do not have symptoms.

Word of caution

Although the medicine kills the threadworms, it doesn’t kill the eggs, which can live for up to two weeks outside the body, so there are things you can do to stop becoming infected again.

  • Wash hands and scrub under fingernails – particularly before eating, after using the toilet or changing nappies.
  • Encourage children to wash hands regularly.
  • Bathe or shower every morning.
  • Rinse toothbrushes before using them.
  • Keep fingernails short.
  • Wash sleepwear, sheets, towels and soft toys at a hot temperature.
  • Disinfect kitchen and bathroom surfaces.
  • Vacuum and dust with a damp cloth.
  • Make sure children wear underwear at night – change it in the morning.

Don’t

  • Do not shake clothing or bedding, to prevent eggs landing on other surfaces.
  • Do not share towels or flannels.
  • Do not bite nails or suck thumbs and fingers.

Note: If you or your child has threadworms there’s no need to stay off nursery, school or work.

Find more information about threadworms here: https://www.nhs.uk/conditions/threadworms/

Further reading:

https://www.nhs.uk/conditions/

https://www.nhs.uk/conditions/social-care-and-support-guide/

https://www.selfcareforum.org/fact-sheets/