As a parent, deciding when your child needs to see a doctor can be stressful. Children get sick frequently - the average child has 6–8 colds per year - and most illnesses resolve on their own. However, some symptoms require prompt medical attention.
Fever in Children
Fever is one of the most common reasons parents seek medical advice. A fever is the body's natural response to infection and is not always cause for alarm.
When Fever Requires Medical Attention
According to NICE guideline NG143 (Fever in under 5s), seek medical advice if:
- Under 3 months: Any temperature of 38°C (100.4°F) or higher - see a doctor urgently
- 3–6 months: Temperature of 39°C (102.2°F) or higher
- Over 6 months: Fever that lasts more than 5 days, or is accompanied by other concerning symptoms
Red Flags With Fever
- Non-blanching rash (does not fade when pressed with a glass) - this may indicate meningococcal infection and requires emergency medical care
- Difficulty breathing
- Drowsiness, difficulty waking, or unusual lethargy
- Poor feeding in infants
- Seizures (febrile convulsions)
- High-pitched or continuous crying
Managing Fever at Home
- Keep your child comfortable and lightly dressed
- Offer frequent fluids
- Paracetamol or ibuprofen can be given as directed for age/weight (not aspirin - aspirin is contraindicated in children under 16 due to the risk of Reye's syndrome)
- Do not sponge with cold water (NICE advises against tepid sponging)
Common Childhood Illnesses
Coughs and Colds
Most coughs and colds are caused by viruses and resolve within 7–10 days. See a doctor if:
- Cough lasts more than 3 weeks
- Your child is wheezing or has difficulty breathing
- Breathing is rapid (see respiratory rate thresholds below)
- Coughing up blood
- High fever accompanies the cough
Vomiting and Diarrhoea (Gastroenteritis)
- The primary risk is dehydration, especially in young children
- Offer small, frequent sips of oral rehydration solution (ORS)
- Continue breastfeeding if applicable
See a doctor if:
- Your child has signs of dehydration: dry mouth, no tears when crying, sunken eyes, reduced urine output (fewer wet nappies)
- Vomiting lasts more than 24 hours in children under 2
- Diarrhoea lasts more than 7 days
- Blood in stool or vomit
- Child is unusually drowsy or irritable
Ear Infections
- Common in children aged 6 months to 3 years
- Symptoms: ear pain, pulling at the ear, fever, irritability, difficulty sleeping
- Many ear infections resolve without antibiotics. NICE recommends a watchful waiting approach for 48–72 hours before considering antibiotics for mild cases
- See a doctor if symptoms are severe, persist beyond 48 hours, or affect both ears (in children under 2)
Rashes
Most childhood rashes are harmless (viral rashes, eczema, heat rash). Seek urgent attention for:
- Non-blanching rash (the glass test): Press a clear glass against the rash - if it does not fade, seek emergency care immediately
- Rash accompanied by high fever and illness
- Rapidly spreading rash with swelling
- Blistering rash
Respiratory Rate Thresholds
Know the normal breathing rates for your child's age (based on standard paediatric references; NICE NG143 covers under-5s):
| Age | Normal Breaths Per Minute |
|---|---|
| Under 1 year | 30–40 |
| 1–2 years | 25–35 |
| 2–5 years | 25–30 |
| 5–12 years | 20–25 |
| Over 12 years | 15–20 |
Breathing rates consistently above these ranges warrant medical assessment.
When to Call Emergency Services
Call emergency services (998 in the UAE) or go to the nearest emergency department if your child:
- Has severe difficulty breathing (struggling, using neck or rib muscles)
- Is unresponsive or very difficult to wake
- Has a seizure (especially if it is the first one)
- Has a non-blanching rash with fever
- Shows signs of severe dehydration and cannot keep fluids down
- Has a serious injury or burn
- Has swallowed a harmful substance
- Has an allergic reaction with swelling of the face, lips, or throat (anaphylaxis)
Practical Tips for Parents
- Keep a thermometer at home: Digital thermometers are most reliable for children
- Know your child's normal: Trust your instincts. You know your child best. If they seem unusually unwell, seek medical advice
- Maintain vaccination schedules: Vaccines prevent many serious childhood illnesses
- Keep a basic first aid kit: Paracetamol/ibuprofen (appropriate for your child's age), plasters, antiseptic, oral rehydration salts, thermometer
This article is for informational purposes only and does not replace professional medical advice. Always consult your doctor for personalised guidance.