How do you decide how unwell small children are?

[Saltdoughmuncher]

DS has just turned 3. He started with a temperature yesterday morning, slept most of the day and then was sick twice in the evening. Temperature kept spiking overnight but was coming down with calpol.

Today he has been a lot better. Not 100% but playing with toys and eating again. However after being in bed for an hour he has woken up with a temperature of 39 and is crying and crying for me even though I’m right next to him. He can’t tell me what’s wrong and it’s heartbreaking to see.

Google tells you temperatures, sickness etc can be signs of meningitis but then are also signs of virus’ and ear infections. How do you know when to panic and get emergency help and when to let them ride it out?

At the minute he has gone back to sleep and since he was been better during the day I think I can rule out anything serious, but seeing him a half an hour ago so upset and unwell was awful.

I will try and get an emergency GP appointment tomorrow at the care centre near us to check his ears and am hoping he stays calm overnight.

he sounds quite poorly. Does he have any rashes?

No he doesn’t have a rash anywhere. I’m sleeping next to him all night so will keep a really close eye on him.

www.nhs.uk/conditions/meningitis/symptoms/

I’d want to rule out this

I check for rashes, photo sensitivity & neck stiffness (just ask them to put their chin to chest) when I have that twitch but it’s mostly about instinct I think.
I never take temps just use the kiss test & loads of skin to skin.

I agree with the above (mother of 5) look at the child not the statistics. Some children are bouncing around with a raging fever, always react if a child is listless and limp. Never be afraid to seek help to be safe.

A rash isn't necessarily the first symptom. If in doubt get small children seen. No one is going to think you are over reacting. Have you tried paracetamol and brufen? They can be taken together and quite often that combo works on high temps.

At our hospital you can only get an out of hours gp appointment through 111. I would wake him for calpol and if his temp hasn't come down after an hour I'd ring 111, they may even send paramedics out to do a check. I ended up in a and e on Thursday night with my 13month - I really can't praise the staff enough there were very clear protocols in place and they were very through and timely. Don't ignore your gut instinct x

Literally just had identical symptoms and went to a&e. Was told it was a virus, and to keep hydrated. 24 hours of loads of water and milk seems to have done the trick.

It's so bloody stressful isn't it. When your child is properly poorly, you know. When they're mildly poorly, you know. The bit in between is awful.

I have a cut off temp wise. Anything over 40, and I'm calling somewhere or taking him somewhere.

Seriously lethargic, avoiding lights, same.

But no one in health care minds seeing a poorly child. If he wakes again, like that, with a temp, call 111 or whatever you have. If he sleeps, keep an eye on him.

Hopes he's better soon.

Also agree with the ibuprofen/paracetamol combo comment, both together seems to really do the trick

Thank you. He has been much better during the day playing and eating that I wasn’t worried anymore and thought we were coming through it. It’s only as he has woken up an hour ago he seems really poorly again. I will let him sleep for a while and keep an eye on his temperature. He was touching his ears earlier so possibly an ear infection.

I’d definitely get him seen tomorrow and if he gets worse tonight I’d ring 111. When my son was confused like that, asking for me when I was in bed with him, he had flu. I think it’s the high temperature that makes them confused. I hope he improves over night.

Thank you. I managed to wrestle some calpol in him (he won’t take nurofen at all, just spits it straight back out) and his temperature has come down to 36.9 now although he still feels very warm to touch.

Fingers crossed he gets plenty of sleep and feels better in the morning.

I generally thought when DCs were little that as long as they were eating , and animated when awake (even if tired), they weren't too bad even with a minor temperature. High temp, listlessness or lack of appetite are to me signs of things being serious.

My DD 2 at the time went from tired and unwell at nursery but fine temp when they called me to high temp 30 min later when I got there. GP gave antibiotics, high temp just below 40c all night. Fine the next morning, running around outside and eating to admitted you hospital in the afternoon.

Trust your instincts. Calpol and nurofen should NOT be given together as it can mask symptoms.

Any ice lollies in the house? That will get fluid into him and help with temperature.
Fever responding to meds - even for an hour?
Any fluid intake? - no? A&E
When did he last wee?
Is he behaving normally?
Any minor injuries or walk in Centres open near where you are?
Calpol and nurofen CAN be given in alternate providing you read the Nhs website and medical professional has advised you for that new episode.

Hope your little one feels better soon! I was in hospital with my 3.5 year old recently. So horrible to see them be poorly.. Definitely give something to lower the temp and keep him hydrated. Could be kidney infection?! Best speak to doctor though

My daughter had these symptoms only she was sick constantly , she had a urine infection and needed antibiotics x

I’ve just rang 111 for him as he is really unsettled. They are ringing me back within the hour but I’m hoping to get him an out of ours appointment for the morning.

I hope he is ok OP.
One thing I have noticed in my children is that they get littles looking skin if they are very unwell - I know it’s time for more urgent action if I see that. ( thankfully only a handful of times in 15 years and 6 children!)

That should be mottled looking

Thank you. I had to wake him for the 111 assessment and he is unhappy but talking normally. Their questions are really hard to answer at night as it’s things like is he sleepy! Also can he put his chin to chest I couldn’t really test as he wouldn’t do it on demand but I made him get up and he seemed to have normal neck movement so I went with yes!

My dd is the same. She has an ear infection and is on antibiotics.

How is he today Salt?

It’s hard and even the experts can get it wrong there are so many variables.

One of my dns had meningitis as a wee one but didn’t have any “typical” symptoms just a temp that wouldn’t come down below a certain point for a few days and quite honestly my sister had a “gut feeling” he wasn’t right.

I honestly think a combination of children’s first aid and knowing what is and isn’t normal for your child are the main keys.

I had kinda the opposite - a child who spiked very high uncontrollable fevers for the slightest bloody bug! Nothing actually wrong with her except the temp which in itself caused issues as we had a couple of times it was getting worryingly high and needed emergency intervention. But I also had the issue that her baseline temp (when she isn’t unwell) tends to be higher than others anyway so there’s been times when she has been checked over by a medic and they’ve gone (this still happens actually) “her temps a bit high” and when they’ve said what it is I’ve had to say that actually that’s within her normal baseline.

The averages for things like temp, bp are just that, averages not everyone is the same there will be outliers, weirdly another dn is the opposite and tends to the cool side so my brother has had to impress upon medics that a “normal” temp is actually an increase/fever for him.

I’ve had a lot of experience caring for children, when it’s a child you know well then you usually know if they’re not “themselves”, you’ll notice if their temps higher, heartbeat a bit faster, bit sweatier than usual etc

Eg as a child when poorly I’d a tendency not to go quiet straight away but actually to get chattier first then go almost silent. To the point if I had a very chatty day mum learned that meant I was probably coming down with something and kept a closer eye on me.

I highly recommend doing a good children’s first aid course, educate yourself on typical childhood symptoms and get to know what your child/rens baseline for things like temp are, it’s good to have that baseline of how they are when we’ll as a comparison.

But definitely if in doubt, I’d say with children under 10 especially, her them checked out. No hcp worth their salt will mind.