Wwyd - unwell baby

[wotsitchops]

Dd is 15 months old and has been unwell all weekend. Initially thought it was teething and a sniffle but she's gotten worse to the point where she is waking up every half an hour at night clearly in pain. I suspect ear infection or throat infection. This morning she came out in a rash all over her stomach and back. I rang the GP and have been waiting for a call back all morning. When they did call back they said there are no face to face appointments today but if I send a photo of the rash they'll decide if she needs antibiotics.

Aibu to think this is really poor? She's clearly unwell, not sleeping, not eating, obviously in a lot of pain but nobody can see her. Im now still waiting for a call back after submitting the photo an hour ago. The system is fucked. It's not an emergency (I know a rash can be bad but it's fading under a glass) but I'm tempted to go to A&E just to get her seen. I can't bear another night of her being in pain and im already giving her the max dosage of calpol and nurofen. She's so distressed. What do I do?

i Am suprised they didn’t make space to see her with her age.

but the rash probably suggests it is viral so sadly it will most likely be a case of wait it out. But obviously if your worried take her to get checked- do you have a walk in Centre?

Nope no walk in centre sadly. It really is a nightmare. And I feel like I've spent all day sat about waiting for call backs and I'm still not going to get her seen. Under the old system I could have phoned first thing and potentially had a morning appointment with a doctor. Now you have to wait for a callback to be triaged before you even stand a chance of seeing someone. By that time the bloody appointments are all gone.

I'm aware it could be viral. She is prone to ear infections and has been prescribed antibiotics several times already. Sometimes they work sometimes not. But I think there needs to be a bit more investigation and at least for someone to look at her. I feel helpless.

Chances are they won't be able to do anything for her anyway. Childhood is full of viruses that are uncomfortable for the child but not dangerous. Sniffles, waking frequently, being in discomfort doesn't sound massively alarming, nor does a rash provided you did the glass test and all was fine. How's her fever? Is she alert/ responsive?

That said, i always thought GPs saw young children out of caution as they can deteriorate so fast, so I am surprised they won't see her.

Ear infections in particular can turn nasty quite quickly. And she's had them before with very similar symptoms so I'm assuming it's that. If I could see a doctor they'd be able to look in her ear and confirm it. I'm really shocked too, she's a sick baby and in the time they've pissed about with call backs and photos they probably could have had a quick look at her. I know it's not that simple but the whole system is awful.

I'm really surprised as well, my GP practice would always prioritise a child that young for an appointment on the day. They can't diagnose a bacterial ear or throat infection based on a picture of a rash!
I'd call 111 to ask for if they have other options for her to be seen.

Has she got a fever?

Is the rash like sand paper?

My daughter had a cold then sore throat and a rash and she had Scarlet Fever.

But if not like sand paper probably viral!

Hope she's feeling better soon x

Sorry just read again.

If she's having the max doses of paracetamol and nurofen and is still in pain that's a very good sign it's more than a virus. I would give 111 a ring they may be able to get you and out of hours appointment.

If not I would be tempted to take her to A&E. You are right the system is fucked. My GP wouldn't see my son a few months ago when he was 10 months and had not eaten or drank for 3 days and was being sick...

Thankfully we have a walk in centre

Did you say that to the receptionist?

My heart sinks when I read these threads. Every doctor knows that most of the infections that small children pick up are self-limiting and, whilst unpleasant, they get better, and only symptomatic relief can be given. But ..... the one in thousands whose symptoms mask a serious cause (meningitis being top of the list) can become very very ill very quickly. No doctor should refuse to check this out to be sure they are not missing something urgent. Most doctors would want to check it out for their own peace of mind. This is certainly what my late OH did - he knew that it was likely to be fine, but no way he would take that chance - and he always said that mothers know their children and their instincts should always be trusted.

Our health system is in a bad way when this can happen.

It's not the receptionist I spoke to it's the triage nurse. She said she'd speak to the doctor, show him the photos and then get back to me. But I've been waiting over an hour for a call back. It's just constant waiting when she could have been seen first thing and treated (or not) by now.

She has a low grade fever, nothing too alarming but she's so distressed and clearly in a lot of pain.

I find this too post covid. When my first daughter was a baby, you'd call on the morning and they'd squeeze you in - you'd often have to wait around but for a baby, they'd make the time, always saying when I apologised for fretting that they'd rather see her and it be nothing than not see her and it be something.

Second daughter even when quite seriously worried it's like trying to see the pope. All this bullshit about taking a photo of the back of her throat ffs. she's a toddler, she's not just going to let me photograph her tonsils, with my low res phone camera, and produce an image you can tell anything from at all. They usually just tell me to call 111, who invariably give me a referral to an urgent care centre because I don't make a fuss about nothing as a rule.

I know the system is struggling but it does worry me so much, I know there are things with both of them I should probably get investigated that I don't because it's just so hard to get seen and you get made to feel like such a nuisance. It makes me a worse mum. Luckily it's not had a serious outcome as yet. But you're right, it sucks.

Ok, well did you tell the triage nurse about the recurrent ear infections? That sounds more relevant to being seen than the rash.

The triage nurse presumably has the child's medical record. It would not be above and beyond to expect her to review it before making the call.

No, it's not. But if it was my child I would make sure I told them the relevant information to be seen. Previous ear infections with the same symptoms and requiring antibiotics surely sounds like one of the most relevant bits of information for that.

@Nordicrain I did and I said it's all the same sort of symptoms as before although it seems worse this time. Still doesn't seem to make a difference.

I'm a Mum of 9 and don't have time for sitting unnecessarily in A&E. I would take her to A&E or your other option is wait until the surgery has closed and then ring 111 , who should, with those symptoms then be able to book you an appointment with the out of hours GP. Ive been in your situation and this is what 111 told me as they can't book out of hours GP until the surgery has closed. I chose to go to A&E and we were admitted and treated for sepsis!!

I think there's just so many people wanting children to be checked out when unwell that the system just can't cope with it and it's why we're starting to see surgeries declining to see children when as there's so many there just isn't the capacity anymore.

It's likely that you telling them he often has ear infections actually reassures them he doesn't need to be seen today. They'd more likely prioritise seeming him if there was a concern this was something other than an ear infection. If he needs a referral to ENT for recurrent infections then this is wouldn't generally be an emergency and can wait.

For what it's worth antibiotics are rarely beneficial in ear infections and should only be given to those who are systemically very unwell, have symptoms and signs of a more serious illness or condition, or have a high risk of complications. At the surgery I work in they're typically only prescribed after a perforation for prophylaxis (the perforation likely caused by a viral infection, but now there's an opening into the middle ear which increases the risk of developing a secondary bacterial infection- is how the GP explained it to me).

There's mixed opinions about just prescribing to under 2s regardless of this even knowing it won't benefit the child but does reduce further unnecessary re-presentation. In terms of what systemically unwell looks like it's more then a fever and ear pain, it's the persistent floppy, not eating barely drinking, when as a parent it's not a 'I wonder if my child is unwell I need reassurance' it's the 'something is very wrong and I'm taking them to see a Doctor right now'.

You can read through the guidelines here for what GPs should be working around: https://cks.nice.org.uk/topics/otitis-media-acute/management/acute-otitis-media-initial-presentation/#management

And there's more parent centred advice here: https://www.what0-18.nhs.uk/parentscarers/worried-your-child-unwell/earache

My DD is 5 months and recently had an ear infection.

We were seen at the doctors and because of your DD's age they should be seeing her to really.

I've taken my DC's over to A&E when 111 have sent us over there and they've always said to us if you want to bypass the GP if you can't get appts then bring them here as they're always happy to check them over. Could be different at your A&E but ours have always been quite reassuring that they would rather check them over then miss something or have a worried parent.

I think if you're concerned enough as you know her best then take her over if you feel she needs to actually see someone but I'd be more swayed at the moment by phoning 111 as they might be able to get you a doctors appt elsewhere rather than having to go to A&E. Hope she feels better soon x

She is alert but she's also lethargic and she has barely ate or drank today. She is exhausted but can't sleep due to the pain.

I came to a&e on the advice of the nurse who absolutely couldn't get us an appointment today but agreed that she needed to be seen.

I'd never usually say this but it sounds like she's over medicated. Maxed out on nurofen and calpol but only with a low grade fever? Several lots of antibiotics due to ear infections and only 15 months old. I'd wait for the doc to respond then call 111 if no response today, but I wouldn't dash to a&e. I'd focus on getting the GP to refer her to ENT - she needs to be checked out properly to explore the underlying reason. I'd also get her on probiotics like elderberry etc to boost her immune system and reset the gut a bit! Especially after all those antibiotics. For now I'd dial down the calpol and nurofen and let her body do its thing a bit until a doc can check out whats currently happening (which does sound like a virus) good luck.

She hasn't been on any antibiotics lately. The last lot was about 2 months ago. She couldn't shift the infection then and they just kept prescribing them, usually over the phone without seeing her because once again...lack of appointments. I have got her a referral now but in the short term I just need her to pick up a bit. No food and minimal water isn't good.