Knowing when to call the doctor out of hours is always a tough call for any parent. Nobody wants to be a timewaster, on the other hand, babies and young children can go downhill rapidly if they’re not attended to fast. When it comes to making that decision, ultimately the best person to be the judge of whether your child needs a doctor fast is you.
If you feel it is a potentially serious situation where your child needs emergency medical treatment call an ambulance.
If you don't feel the situation warrants an ambulance, but you wish to get further advice, you can call 111, or try your NHS GP.
Alternatively, you can get medical advice fast with an out of hours private GP who can give you advice over the phone or make a home visit.
The following is a guide to help inform your decision.
My child’s face is swollen
Has your child’s face suddenly swollen? Has your child’s tongue swollen? Are her eyes itchy? This could be the sign of an allergic reaction, and you need to phone 999 or head to your nearest A & E as soon as possible.
If you have an EpiPen to had, administer it, or if possible, give antihistamines which may help reduce the swelling.
If the reaction is less severe, and you feel your child is not in immediate danger, call your GP, or 111, and seek advice there.
My child has a fever
Any temperature which rises above 37.5C (99.5F) in a child is classed as a fever, but in reality most children’s temperature varies. You’ll know what is normal for your child.
Of course, fevers are common in children, and in most cases, a little bit of TLC and appropriate home treatment is usually enough to nurse a child back to health.
You will need to get medical advice if your child is under three months old and has a temperature of 38C (101F) or above, or is between and six months old and has a temperature of 39C (102F). Contact your GP or call 111.
In older children, if a high temperature is accompanied by other symptoms, such as blotchy skin or rapid breathing, again seek medical help.
You will also need to get medical advice if the high temperature is accompanied by a fit for the first time.
If your child has previously had them, your doctor will have advised you what action to take, as they can be common in young children.
Ultimately it is of course for parents to trust their gut instincts. If you feel your child is very unwell, do seek help and advice.flu%281%29.jpg" />
My child’s temperature isn’t going down
If you have treated your child’s fever with Calpol and ibuprofen, and the temperature still remains high, contact your GP.
Your child’s body may be struggling to deal with the infection, and you’ll need to get a doctor to investigate further.
For most children, fevers clear up in a few days. However, if your child still has a temperature after five days, you will need to seek medical advice from your GP.
It’s a sign that the condition isn’t caused by a virus which can be fought off by your child’s immune system, but may have a bacterial cause, which requires antibiotic treatment.
My child has a high temperature and a stiff neck/ headache
If your child has a fever and feels very unwell with a headache or stiff neck, this is warning flag for meningitis, and you will need to seek urgent hospital medical care.
Other things to watch out for is if your child appears vacant and unresponsive, and is uncomfortable with bright lights.
There may also be a rash. This will look blotchy, often with small red dots. It’s different from other rashes as it won’t fade when a glass is rolled over it. This does not always develop.
If you think your child – or anyone in your family - has meningitis you should call 999 or head straight your nearest A & E.
My child has an injury that won’t stop bleeding
If your child has had a fall, and there is bleeding that you can’t stem after ten minutes of applying pressure, your child will need further medical attention.
Although many cuts can be treated with first aid, your child may need stitches.
It will depend on how severe the injury is – you may need to dial 999, or get to A & E. Alternatively head to your nearest Minor Injury Unit (MIUs) and urgent care centre (UCC), although do check that they have the capacity to treat young children, as not all do.
My child has fallen and vomited
Children are often tumbling, and usually, for children over six months old, if it’s a short fall (less than their height), and they don’t land on any sharp objects, they are fine.
However, if a fall is accompanied by vomiting, loss of consciousness, or your child seems confused or disorientated, you will need to head for A & E.
For babies still under six months old, it’s important they always get checked by a doctor after a fall.
My child has a sudden stomach ache
Tummy aches are pretty frequent in children, sometimes real or imagined. However, as a parent, you can usually get an idea of when a tummy ache is real.
You do need to sit up and take notice of stomach pain that develops on the lower right side. This is because it may be appendicitis
If there are sudden cramps which come and go on either side, you also need to be alert, as appendicitis can start around the tummy button and move to the right.
With a tummy bug, there is a temperature, then vomiting, then cramps, and after that diarrhoea.
With appendicitis, the order is more likely to be diarrhoea. tummy pain, then vomiting, then pain, then fever.
If you suspect appendicitis, do contact your GP or call 111. If the pain is very severe or sudden, call 999.
My child is suffering cramping with bloody poo
In a young child under four, and your child has a sudden stomach pain which causes him to be doubled up over in agony one minute, but fine the next, you need to get medical assistance, as he may have intussusception.
Each episode tends to last two to three minutes and happens every hour and will become more frequent as the condition progresses.
Your child will look also look very pale and listless.
Intussusception is a condition where the bowel walls press on one another, blocking the bowel.
This can lead to reduced blood flow to that part of the bowel.
Vomiting, high temperature and a swollen stomach can also accompany the pain, and your child’s poo may contain blood and mucous.
Seek medical attention as soon as possible – and head straight to A & E if you see blood in your child’s poo.
My child has a headache with vomiting
If your child wakes up early in the morning or in the middle of the night with a headache and vomits, you should seek medical attention.
Although the chances are, it’s not serious and is simply a migraine, there is a small chance it’s something more serious, such as epilepsy and it will definitely need to be checked out.
You could call an out of hours GP for advice, or alternatively call 111 to see if you require an ambulance.
My child has breathing problems
If your child’s rib cage and stomach sucks in as he struggles to breathe, or there is whistling sound when breathing you need to seek medical help.
These symptoms may also be accompanied by blue-tinged lips. The problem may be croup or bronchiolitis. There may be other underlying causes such as allergy or asthma.
If you’re unsure of what counts as normal breathing for a child, try counting each breath taken in for 30 seconds and then multiply by two.
A normal rate is less than 60 for newborns; less than 40 for babies under a year old; less than 30 for children aged one to three; and less than 24 for children aged four to ten years old.
If your child is having breathing problems, you need to call 999, or get to an A & E immediately.
My child is dehydrated
How do you know whether your child is suffering from dehydration? In a younger child a lack of wet nappies will be obvious, for those who are potty trained, you’ll have noted less trips to the loo.
Other concerning symptoms include a flattened fontanelle, skin that’s dry and doesn’t ping back when pinched and if your child has had vomiting or diarrhoea.
If these symptoms occur, your child is dehydrated, and you need to seek medical attention. If you can’t see your GP immediately, call 999 or get to A & E.
If you need an Emergency Out of Hours GP, please call 020 3883 9525. Wait and listen to the options offered. Press 1 and you will be diverted directly to an out of hours GP. Simply quote ‘25’ and you can access to the highest quality GP service in London.