5.1 Identify signs and symptoms of ill health in babies and children

This guide will help you answer 5.1 Identify signs and symptoms of ill health in babies and children.

Being able to identify signs and symptoms of ill health in babies and children is a key responsibility in early years care. By recognising early signs of illness, childcare workers can act quickly to ensure children receive the right care and treatment. Early identification can also prevent illnesses from spreading to others in the setting.

Recognising signs of illness involves observing changes in a child’s behaviour, body, and overall mood. Young children, especially babies, cannot always communicate when they are feeling unwell, so you must be attentive to visual and behavioural cues.

Common Signs of Ill Health

Signs of ill health can affect different parts of the body and can range from mild to severe. Below are some common examples to watch out for:

Fever

• A fever is a body temperature higher than 38°C (measured with a thermometer).
• Babies and children with fever may have hot, flushed skin and sweat more.
• They may also feel irritable, tired, or less responsive than usual.

Fever often indicates an infection but can also result from teething or overheating.

Vomiting and Diarrhoea

• Recurrent vomiting or loose stools (diarrhoea) can be a sign of illness like gastroenteritis or food poisoning.
• Babies may refuse feeds or show poor weight gain if they have ongoing vomiting issues.
• Diarrhoea can lead to dehydration, which may cause dry lips, reduced urine output, or lethargy.

Hydration is key; watch for signs of dehydration in these cases.

Respiratory Issues

• Wheezing, coughing, or difficulty breathing could indicate respiratory infections or asthma.
• Babies may breathe quickly or struggle to feed if they are congested.
• Severe symptoms like bluish lips or skin should be treated as emergencies.

Pay attention to noisy breathing or unusual chest movements.

Skin Changes

• Rashes, hives, or changes in skin colour often provide clues about illnesses like chickenpox, measles, or scarlet fever.
• Children with pale, cold skin may have low blood pressure or poor circulation.
• A purplish, spot-like rash that does not fade under a glass can be a sign of meningitis.

Monitor for any skin signs that seem unusual or sudden.

Pain

• A child displaying signs of discomfort, such as crying excessively, pulling at their ears, or holding their stomach, may have pain.
• Ear infections, teething, or urinary infections are common causes.
• For verbal children, they might complain of a headache or body aches.

Take all pain seriously, even if no physical injury is obvious.

Behavioural Signs of Ill Health

In addition to physical symptoms, changes in behaviour are a frequent indicator of illness in children. Different children express illness in different ways, so familiarity with typical behaviour patterns is helpful.

Lethargy and Fatigue

• A child who is unusually tired or less active may not be feeling well.
• For babies, a lack of interest in feeding or little movement might indicate illness.

Be cautious if a child is hard to wake or keeps falling asleep unexpectedly.

Irritability

• Sick children may be fussier than normal or cry more often.
• Separation anxiety can worsen if a child feels unwell.

Irritability should be monitored alongside other signs like fever.

Loss of Appetite

• A drop in feeding or eating habits might mean the child has a sore throat or tummy ache.
• Babies may refuse breastfeeds or bottles.

Track what the child consumes and report prolonged appetite loss.

Unusual Behaviour

• Children with mild illnesses might seem withdrawn or clingier than usual.
• A child skipping playtime or avoiding favourite activities can be another clue.

Alert parents/carers if behavioural changes persist.

Illnesses Related to Specific Age Groups

Babies and children of different age groups show symptoms in varying ways. Identifying these correctly involves understanding developmental stages.

Babies

• Babies under six months might show more subtle symptoms. They may cry differently, become very floppy or stiff, or feel excessively hot to touch.
• They are prone to conditions such as bronchiolitis or colic.

Monitor feeding and nappies; changes in wet or dirty nappies may indicate a concern.

Toddlers

• In toddlers, symptoms such as constant rubbing of an ear or repeated coughing could indicate health problems.
• They are more prone to illnesses like chickenpox and hand, foot and mouth disease.

Keep on the lookout for oral ulcers or itchy skin blisters.

Preschoolers

• Early years children may verbalise feeling sick but might struggle to describe specific symptoms like nausea.
• Watch for weight loss, persistent high fevers, or limb pain.

Children in this age group often catch colds and respiratory infections due to shared play areas.

Context-Specific Observations

Ill health can look different depending on the setting or activity. Be aware of how symptoms may appear during routine tasks.

During Playtime

• A child disengaging from play or avoiding physical activity altogether may be unwell.
• Breathing difficulties often become noticeable during active play.

Keep an eye on children who isolate themselves.

Nap Time

• A child who cannot sleep due to coughing, vomiting, or restlessness might have an underlying illness.
• Sweating excessively during sleep can indicate a fever.

Pay attention to temperature changes as ill children may feel chilled even under blankets.

Mealtime

• Refusal to eat or difficulty swallowing can indicate a sore throat or an ear infection.
• Vomiting after meals may be connected to dairy intolerance or gastroenteritis.

Make a note of choking, spitting up food, or if meals take much longer than usual.

Infectious Illnesses to Watch For

Some illnesses spread easily in childcare settings. Knowing their symptoms helps you manage them effectively.

Chickenpox

• Small red, itchy spots that develop into fluid-filled blisters.
• Mild fever and tiredness may accompany the rash.

Hand, Foot, and Mouth Disease

• Blisters on hands, feet, and inside the mouth.
• Symptoms can include fever, sore throat, and a lack of appetite.

Measles

• High fever with red, blotchy skin rash that begins on the face before spreading.
• Accompanied by a cough, runny nose, and red, watery eyes.

Conjunctivitis (Pink Eye)

• Redness and swelling around the eyes with itchy, watery discharge.
• Children may rub their face constantly.

When you suspect an infectious illness, notify parents and take measures to prevent the spread.

Responding to Suspected Ill Health

When a child shows signs of illness, act quickly and in line with your setting’s policies.

• Report symptoms to a senior staff member or manager.
• Inform parents/carers as early as possible.
• Provide immediate care, such as offering water, a cool compress, or ensuring the child is resting.

If symptoms worsen or there is a risk to health, seek medical advice promptly.

When to Seek Emergency Help

Some symptoms require an urgent medical response. Call 999 or take the child to A&E if you observe:

• Seizures or fits.
• Unresponsive behaviour or the child becoming very drowsy.
• A rash that does not fade when pressed with a glass.
• Difficulty breathing, choking, or bluish lips.

Always stay calm and reassure the child as you manage emergencies.

Conclusion

Identifying signs and symptoms of ill health in babies and children is a vital skill in early years settings. By observing their physical, emotional, and behavioural changes, you can act responsibly and ensure they receive the care they need. Maintain communication with colleagues and families to ensure the best support for each child. Regular training and staying informed about children’s health will strengthen your ability day to day.