As parents we hope we'll never have to meet any of the following conditions, but it's always good to know what to do, just in case.

Anaphylactic shock

What it is

A life-threatening allergic reaction possibly to certain foods, such as peanuts, or to a bee or wasp sting.

Signs and symptoms

Sudden dramatic swelling of your newborn baby’s face. Your baby will have difficulty breathing, turn pale, feel clammy and cold and may lose consciousness.

What your doctor can do

Give the baby an injection to reverse the shock.

What you can do

Take your baby immediately to your doctor or to an A&E.

Breathing difficulties

What it is

Usually, it is due to an inflammation of the airways or lungs caused by an infection such as pneumonia (due to a bacteria or a virus), bronchiolitis (often caused by RSV – respiratory syncytial virus) or croup (usually due to a virus). It could be an obstruction in the airways caused by your baby having placed a small object into her mouth, which she has then inhaled into her lungs.

Signs and symptoms

Your baby will wheeze, look bluish, and suck her ribs in with each breath.

What your doctor can do

Diagnose the problem and treat accordingly.

What you can do

Take your baby immediately to your doctor or an A&E.

Febrile convulsions

What it is

Involuntary contractions of the muscles often associated with a high temperature. A few babies will have a fit or convulsion as a result of running a high temperature; this is alarming, but not usually dangerous.

Signs and symptoms

If your baby has a convulsion, she will go rigid, her arms and legs will jerk, her eyes will roll and she will lose consciousness.

What your doctor can do

Stop the fit quickly by giving your baby an injection. Advise you on how to minimise the risk of your baby having another fit.

What you can do

If your baby has a fit, you can protect him during the fit (see box right) and then seek help from your doctor or an A&E. If this is the first time your baby has had a fit, or the fit lasts more than five minutes go straight to A&E. Almost all children who have febrile convulsions grow out of them by the time they are five.

Coping with a febrile convulsion Febrile convulsions or fever fits are often caused by high temperatures:

• they can be frightening to see but last only a few seconds or minutes, and do not usually cause any lasting harm
• try not to panic. You can help him by staying calm
• lay him in the recovery position, on the side with head titled back slightly so that the airway is clear
• move any things that may harm him out of the way
• don’t try to insert anything into his mouth. Biting the tongue is rare and you may break teeth
• if he is sick, clear his mouth with your finger
• open a window to cool him down and gently remove his outer clothes if you can
• when he comes around he may be confused and need your reassurance
• offer him some water, and let him rest.

Meningitis

What it is

Inflammation of the lining of the brain and spinal cord; infection can be viral or bacterial.

Signs and symptoms

Your baby will have a high fever, may be irritable with a highpitched, moaning cry; vomit or lose her appetite, have pale or blotchy skin, a tense or bulging fontanelle, fast/shallow breathing and/or very cold hands and feet. A rash may develop with purple/red bruiselike spots that do not fade when under pressure.

Don’t wait for a rash to appear before seeking medical advice. This only happens in the type known as ‘meningococcal meningitis.’

What your doctor can do

Refer baby to hospital immediately for antibiotic treatment and intensive care.

What you can do

See your doctor or go to A&E immediately if your baby has these symptoms.

Meningitis vaccinations

There are vaccinations for Meningitis C and HiB (Haemophilus influenzae type B) infection, which can cause meningitis, and pneumococcal infection, a very dangerous illness causing blood poisoning, meningitis and pneumonia. Having these immunisations will reduce the risk to your baby of developing meningitis and serious breathing problems (epiglottitis). However, there are other forms of meningitis for which there are no vaccinations so you should still be on the look out for the signs and symptoms of this serious condition, see previous page.

Meningitis

• meningitis is always a medical emergency needing urgent attention. Call your doctor or go to A&E if your baby has signs of meningitis.
• a rash does not appear in all forms of meningitis. it occurs in the type known as 'meningococcal meningitis' only.
• don't wait for the rash to appear before seeking medical advice.
• immunisation cannot protect against all forms of meningitis; if your baby shows signs of miningitis seek medical advice straight away.
• don't worry about it being a false alarm. Every doctor would prefer to see a baby who doesn't have meningitis , than miss one who does!

Diseases for which there are vaccinations

You are unlikely to meet these if your child has been vaccinated, but this is what to watch out for.

Diptheria

What it is

A serious illness, caused by diptheria toxin, affecting the airways and making breathing difficult.

Signs and symptoms

High temperature with severe difficulty in breathing because of a membrane covering the airway. The condition is serious and can be fatal. it is rare in this country because of the effectiveness of the vaccine. This disease will return unless we keep up a high vaccination rate amongst children.

Measles

What it is

A highly infectious and potentially fatal illness caused by the measles virus.

Signs and symptoms

Your baby will probably have a runny nose, a cough, a fever, red, watery eyes and a blotchy red rash, which starts behind the ears and spreads to the rest of the face and body. There are white spots on the inside of the cheeks on the third or fourth day. There will sometimes be vomiting and diarrhoea. Complications include breathing difficulties, ear infections and brain damage.

Incubation time

8–14 days. The illness is infectious from when the child develops the first signs (see above) until 4 days after the start of the rash.

What your doctor can do

Prescribe an antibiotic to prevent complications if a bacterial infection develops.

What you can do

If you think your baby has measles, call your doctor as it is a serious illness. Keep your child cool (see ‘Nursing a poorly baby’) and bathe sore eyes with cooled boiled water. If your child worsens, call your doctor again.

Mumps

What it is

An illness caused by a virus, which affects the salivary glands.

Signs and symptoms

Your baby may have a fever, dry mouth, and difficulty swallowing.

A swelling will appear below the ears and around the jaws, on one or both sides of your baby’s face.

Incubation time

14-21 days. The infectious period starts a few days before, and continues until about 5 days after, the swellings appear.

What your doctor can do

Prescribe antibiotics for any secondary infections.

What you can do

Call your doctor if you think your baby has mumps. Give your baby plenty of drinks, and soft foods. Keep your baby cool (see ‘Nursing a poorly baby’) while she has a temperature. Give the correct dose of liquid medicine if your baby is in pain. Keep an eye on your baby; she may need further treatment if complications develop. If your child becomes drowsy and will not take fluids, or if you feel that she has worsened in any way, then call your doctor again.

Polio

What it is

A viral infection, poliomyelitis, which affects the central nervous system.

Signs and symptoms

Sore throat, fever, stiffness and muscle pains. Polio can cause limbs to become paralysed and sometimes affects the breathing muscles. It can lead to meningitis and can be fatal. Polio has become almost unknown in the UK since most babies are vaccinated against it, but it can be caught abroad, which is why it is so important that your baby is protected from this disease.

Rubella (German measles)

What it is

A virus that causes swollen glands and a rash.

Signs and symptoms

The symptoms are usually mild in children and can include swollen glands behind the ears and a bright pink rash on the face and body. Rubella is only a serious illness if a mum-to-be catches it in the first three or four months of pregnancy; then there is a serious risk that her baby will be born with birth defects. It is for this reason that the Department of Health advises you to vaccinate your baby against rubella.

Incubation time

14–21 days. The infectious period starts roughly one week before, and lasts until 4 days after, the rash appears.

What your doctor can do

Treatment is not usually necessary.

What you can do

Give your baby drinks and plenty of rest.

Tetanus

What it is

A serious, often fatal, illness caused by tetanus toxin which affects the nervous system. Tetanus spores are present in soil and may get into the body through small wounds or scratches.

Signs and symptoms

Muscles become stiff, often starting in the jaw (lockjaw) before spreading. There are often painful muscular spasms. Tetanus spores in the soil can never be eradicated. Immunisation is very effective and it vital to prevent this serious disease. Tetanus is rare in this country because of the effective vaccine.

Whooping cough

What it is

A bacterial disease, which affects the respiratory system, and can be very dangerous.

Signs and symptoms

Whooping cough starts with a cold, fever and cough. The cough changes to an unmistakeable pattern of violent coughing bouts ending in a ‘whoop’ as your baby draws air back into her lungs. Some babies may turn blue and stop breathing instead of making the whooping noise. Vomiting sometimes follows the bouts of coughing and can lead to dehydration. Complications can include ear infections, convulsions, pneumonia, hernias and sometimes brain damage.

Incubation time

7–10 days. The infectious period starts 7 days after the child has been exposed to whooping cough and lasts for 3 weeks after the start of the symptoms. The child is most infectious during the initial stages when there is usually a rather irritating cough, and before the onset of the typical whoop.

What your doctor can do

Prescribe antibiotics to help reduce the severity of the illness.

What you can do

Call your doctor. Offer drinks and soft food after each coughing attack so that your baby stays nourished. Give rehydration fluids (available from the pharmacist or on prescription), if your baby isn’t keeping much down.