FINAL Childhood Illness 01.02.16

8/16/2019 FINAL Childhood Illness 01.02.16

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If a child in your care is ill or injured, choose well from the following services available:

NHS 111 is free to call from any landline or contract mobile phone. Pay-as-you-go mobile phones require 1 pence credit to make a call.

Grazed kneeSore throatCoughs and colds

As a parent if you are:UnsureConfusedNeed help

Mild diarrhoeaMild skin irritations (includingspots/rash)Mild fever

High temperatureHead injuries not involvingloss of consciousness

Persistent coughWorsening health conditions(inside GP hrs)

Minor bumps, cuts andpossible fractures (during 9-5)DehydratedHeadacheTummy pain

Unexpected and sudden sicknessSevere painWorsening health conditions(outside GP hrs)

ChokingLoss of consciousnessFittingBroken bones

Self Care

NHS 111For 24 hour health adviceand information.

PharmacistFor advice on commonillnesses, injuries andmedication.

Doctor/GPFor the treatment of illnesses

and injuries that will not goaway.

Minor Injuries UnitFor treatment of minorillnesses and injurieswithout an appointment.

Urgent CareWhen you need healthcarein a hurry 24 hours a day.

A&E or 999For very severe or lifethreatening conditions whenit is safe to move your child.

You can treat minor illnesses and injuries at homeby using the r ecommended medicines andmaking sure they get p lenty of rest www.nhs.uk.

Ring NHS 111 when it is less urgent than 999Tel: 111www.nhs.uk/111

To find your local pharmacy and its contactdetails visit:www.nhs.uk/chemist OR text ‘pharmacy’ to64746 for your nearest 3 pharmacist details.

Write your GP (family doctor) telephone numberhere:

Minor Injuries Unit or Walk-in Centre

A&E

A&E


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Welcome The first years of a child’s life are crucial to their healthy development andwill have a big influence on their well-being. Parents, carers and otherfamily members are often children’s prime carers and educators.

During the early years we can start t o lay the foundations for positive long-term development. The time before school starts is also the perfect time forfamilies to adopt a positive attitude to their health and well-being. If parentsare confident they are doing all they can to make sure their children aresafe, well-nourished, play and learn actively and create opportunities whichbuild social and emotional confidence, they can rest assured that they aredoing all they can to lay the path for a happy and positive future.

As well as general well-being, this handbook will help you to understandwhen is the right time to call NHS 111, visit your GP, chat to your healthvisitor or take a visit to your local pharmacy.

Every parent wants to know what to do if their child is unwell and how torecognise the signs. Trust your instincts, you know your child best, so if youare worried get further advice.

Visit www.cheshirewestandchester.gov.uk/fisor

www.valeroyalccg.nhs.ukor www.southcheshireccg.nhs.ukor

www.westcheshireccg.nhs.uk

to view this booklet online.

All factual content has been sourced from Depa rtment of Health, NHS Choices, British

Association of Dermatologists, Meningitis Now, NICE guidelines.

To view this booklet via

the app, search

cheshire child health


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GP (Doctor)

You will need to registerwith a local GP. Your GPcan advise, give you themedicines you need andpoint you in the rightdirection if you needother specialist services.

You will usually need tomake an appointment. AllGPs will see a childquickly if you are worried. After 6.30pm weekdays,at weekends and publicholidays you can call theGP out-of-hours serviceon NHS 111.

A guide to services

If you think you need help urgently duringthe day or night you should call NHS 111before you go to any other health service.

By calling NHS 111 you will be directed straight awayto the local service that can help you best. It is available24 hours a day, 365 days a year and is free to call,including from a mobile. You should call NHS 111:• When you need help fast but it’s not life threatening.• When you think you need to go to A&E or another

NHS urgent care service.• When it’s outside of your GP’s surgery hours.• When you do not know who to call for medical help.• If you do not have a local GP to call.

111

Many illnesses can be treated in your home by usingover the counter medicine from your pharmacist andgetting plenty of rest. Self care is the best choice totreat very minor illnesses and injuries. If you are stillworried call NHS 111 or your GP.

Self care

There are a wide range of healthcare and children and family services.

See which service or professional is best to help you.

Pharmacist Your local pharmacistcan provide advice onmost common healthissues and can suggestand dispensemedicines. There areoften pharmacists insupermarkets and manyare open late.

Visit www.nhs.uk to findthe pharmacy nearestto you.


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Being prepared and knowing the signs

Know the basics

Thermometer

Plasters

Liquid painkillers(e.g. sugar-free paracetamolor ibuprofen)

Barrier cream

Pharmacist saysKeep a small supply of usefulitems. Include things like:

Paracetamol and ibuprofenConsider using either sugar-free paracetamol or ibuprofen for children withfever who appear distressed (as a general rule a temperature of over 37.5°C99.5°F), as these can help to reduce fever and distress. Treat them with eitherparacetamol OR ibuprofen in the first instance. It can take up to an hour foreither of them to work. Paracetamol and ibuprofen should NOT be giventogether at the same time. However, if your child remains distressed before thenext dose is due, then you may want to try a dose of the other medicine. Aspirin should not be given to children under 16 years of age.

Parents are usually good at noticing when something is wrong. However, it isnormal to worry that you won't recognise the s igns that your baby is unwell. Trustyour instincts, you know your baby best.

Learn how to spot the signs of serious illness and how to cope if an accidenthappens. If you know the basics and you are prepared, you will find it easier to cope.

Keep a small supply of useful medicines in a locked cabinet or somewhereup high where a child cannot reach them. See box on the right, for things to haveat home just in case. Make sure you’ve got the right s trength of medicine forthe age of your child, always follow instructions carefully and check use by dates.Read the label carefully. Do not give aspirin to children under 16.

Find out about CPR (resuscitation) before a possible emergency, visitwww.redcrossfirstaidtraining.co.ukIf your baby seems to have a serious illness get medical help straight away.

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There are lots of different positions for breastfeeding. You justneed to check the following:• Are your baby’s head and body in a straight line?

If not, your baby might not be able to swallow easily.• Are you holding your baby close to you?

Support their neck, shoulders and back. They should beable to tilt their head back easily.

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Hold your baby’s whole body close withtheir nose level with your nipple to helpthem attach correctly.

Let your baby’s head tip back a little sothat their top lip can brush against yournipple. This should help your baby tomake a wide open mouth.

When your baby’s mouth opens wide,their chin is able to touch your breastfirst, with their head tilted, so that theirlower lip can make contact with the breast

2-3cm below the nipple.

With their chin firmly touching and theirnose clear, their mouth is wide open andthere will be much more of the darker skinvisible above your baby’s top lip thanbelow their bottom lip. Your baby’s cheekswill look full and rounded as they feed.4

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Source: DoH, www.lullabytrust.org.uk


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Health visitor says

You will know your baby bestof all. Try to understand what itis they need. Finding out whyyour baby is crying is often amatter of going through all thepossible options.

Things to check first are:

Does their nappy needchanging? Could they be hungry? Could they be too hot? Could they be too cold? Does their cry sounddifferent?

These are simple things whichcould be causing your babyto cry.


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Health visitor says

It can help to give your babysomething hard to chew on,such as a teething ring.

Teething rings give your babysomething to safely chew on,which may help to ease theirdiscomfort or pain. Someteething rings can be cooledfirst in the fridge.

All sorts of things are put downto teething - rashes, crying,bad temper, runny noses, extradirty nappies. Be careful not toexplain away what might be thesigns of illness by assuming it’s‘just teething’.

Dentist’s tooth care tips:

1. Clean teeth twice a day, for two minutes, especially at night.2. Reduce sugars to meal times only.3. Visit the dentist every six months.4. Don't give juice drinks in a bottle. Your baby may still like using a

bottle as a comforter and suck away on it for hours, giving sugarand acid plenty of time to damage teeth.

5. Offer your child water or milk to drink rather than juice or squash.For help accessing an NHS dentist call NHS 111 or visit www.nhs.uk


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This is the name given to the large greasyyellow or brown scales that appear on yourbaby’s scalp. Sometimes t hey may flake andthe skin may be red. It should not cause yourbaby any discomfort and should settle overtime. It is important not to pick at the scalesas this may cause infection.

If this does not s ettle, the redness spreads oryour baby is itchy then seek medical advice.

Gently wash the scalp and use asoft baby brush or cloth and g entlyremove any loose scales.

Massaging baby oil or natural oil -such as almond or olive oil - intotheir scalp at night can help loosenthe crust.

Health visitor’s cradle cap tips

Leave your baby in awarm, safe place withno clothes or a nappyon, to let the air getto their skin.

Use a barrier cream.(see Pharmacist says

box opposite).

Remember tochange and check their nappy often.

Health visitor’snappy rash tips


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Health visitor says

Some babies have watering eyes.

Massaging the tear ducts may helpto dislodge tears that have collectedin the upper part of your baby’s tearduct, as well as encouraging thetear duct to develop. This can bedone by applying light pressure withyour clean, index finger andmassaging from the outer corner of your baby’s eye towards their nose.Repeat several times a day for acouple of months. If this persistspast one year, your baby may bereferred to an eye clinic fortreatment.Source: NHS choices


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Call 0300 123 1044 or visitwww.nhs.uk/smokefree

A safe sleeping environment

1 Place your baby in the ‘feet to foot’ positioni.e. baby’s feet at the foot of the cot.

2 Newborn babies sleep in a cot inparent’s bedroom or room where youare during the day.

3 Make sure baby is not too hot nor too cold.

4 Put baby to sleep on their back to reduce

the risk of cot death.

5 Keep baby’s head uncovered.

6 Do not smoke and keep the housesmokefree.

7 No pillow, stuffed animals, toys orbumper pad.

8 No heavy or loose blankets.

9 If a blanket is used, it must be tucked inand only as high as the baby’s chest.

10 Crib sheets must fit tightly over mattress.

11 Use a clean, firm, well-fitting mattress.Mattresses should carry the BSI numberBS-1877-10:1997.

12 These apply to day time and night timesleeps.

Source: www.lullabytrust.org.uk


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A variety of factors may causelanguage and speech delays,including:• Lack of communication from

parents or carer.• Lack of emotional bonding.

• A learning disability.• Hearing loss, which may occur in

children who have severe middle earinfections or occur as a result of certain medications, trauma, orgenetic disorders.

• Autistic spectrum disorders (ASD) agroup of neurological disorders thatmay involve impaired communicationas well as impaired social interactionand cognitive skills.

It helps to talk to your child andencourage sounds and speech froman early age.


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Young babies: Always contact your GP or NHS 111 if your child:• Is under three months of age and has a

temperature of 38 ̊C or above.• Is between three and six months of age and

has a temperature of 39 ̊C or above.• Is over six months and shows other signs of

being unwell - for example, they are floppy anddrowsy or you are concerned about them.

Older children: A little fever isn’t usually a worry. Contact yourGP if your child seems unusually ill, or has ahigh temperature which doesn’t come down.It’s important to encourage your child to drink

as much fluid as possible. Water is best.

To help reduce temperature:• Undress to nappy/pants.• Keep room at comfortable temp (18 ̊C).• Encourage your child to drink more

(even little amounts often).• Give sugar-free paracetamol or

ibuprofen in the correct recommendeddose for your child (see packaging).

1 2 3My toddler is hotand grumpy.

Have you tried infantparacetamol? Have youmade sure they aredrinking lots of fluids?

If their temperatureremains over 38˚C anddoesn’t come down,contact your GP.


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Bronchiolitis

Bronchiolitis is a common respiratorytract infection that affects babiesunder a year old. The earlysymptoms are similar to those of acommon cold and include a runnynose and cough.

As it develops, the symptoms of bronchiolitis can include:

A persistent cough, noisy breathingand difficulty feeding.

Symptoms usually improve afterthree days and in most cases theillness isn’t serious. However,contact your GP or health visitor if your child is only able to feed half the normal amount or is strugglingto breathe, or if you are generallyworried about them.

Source:

www.nhs.uk/conditions/Bronchiolitis/

CroupCroup has a distinctivebarking cough and makesa harsh sound, when theybreathe in.Comforting your child isimportant as symptomsmay worsen if they areagitated or crying. Mildcases of croup can bemanaged at home. If yourchild has a fever and isdistressed, sugar-freeparacetamol can be givenfrom the age of three

months and will help bringdown a raised temperatureand ease discomfort.If symptoms get worsecontact your GP.



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What are the signsof an ear infection?

The signs are a raisedtemperature, general irritabilityand pain or discomfort. The earsmay be red and your baby maypull them because they areuncomfortable. They may evenhave a pus-like discharge, whichcan also be associated with ablocked feeling in the ear orhearing loss. Although most earinfections settle down withoutany serious effects, there can bemild hearing loss for a short time(two to three weeks).

Newborn hearingscreening

All newborn babies should beoffered a hearing test. If yourbaby's hearing is not screenedin hospital, ask your midwife orhealth visitor to arrange anappointment.



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Symptoms of severe asthma

Symptoms include repeated coughing andwheezing, shortness of breath and bringing upphlegm. Symptoms often get worse at night.Call 999 to seek immediate medicalassistance if your child has severesymptoms of asthma.

Asthma nurse says

The most important part of managing asthma is for youand your child to know aboutasthma and what triggers an

attack.GP Asthma Clinics offer adviceand treatment. Ask about theseasonal flu vaccine.



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Painkillers

If your child is in pain o r has a hightemperature (fever), you can give themparacetamol. Do no give ibuprofen tochildren with chickenpox because itmay increase the risk of skin infection. Aspirin should not be given tochildren under the age of 16.

Health visitor says

Do not forget to keep up-to-date with

immunisations to protect your childfrom measles (MMR vaccination). It isnever too late for your children (oryourself) to ‘catch up’ with the MMRvaccination if they missed it earlier.

Midwife says

If you are pregnant and have hadchickenpox in the past it is likely thatyou are immune to chickenpox.However, please contact your GP ormidwife for advice.


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There are lots of ways you can care foryour child at home. Things to try are:

Give them regular drinks - try smallamounts of cold water. Breastfeedon demand if breastfeeding.

Being extra careful with handhygiene (use soap and water or aliquid soap and dry hands wellwith a clean towel).

Rehydrating solutions come inpre-measured sachets to mix withwater. It helps with dehydration.

If your child is unwell for more than 24hours speak to your GP. If your baby isnewborn or very unwell contact yourGP straight away.

Pharmacist says

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Health visitor says

If you are breastfeedingcontinue to do so and keepdrinking plenty of fluids.

Source: www.nhs.uk/conditions 2015


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Breastfed babies

Constipation is very rare in babies whoare solely breastfed, but not uncommonin babies who have formula milk, orwho have solid foods. Ask your healthvisitor or pharmacist for advice ontreatment. Make sure you are makingup the formula powder with the correctamount of water. Some formulas arespecially targeted at babies who haveminor constipation - your health visitorcan discuss your options.

If your baby is already on solid foods

then the juice or the fruit itself should befine for providing relief. Fruits, such asapples, pears and prunes, containsorbitol which is a natural laxative,helping the lower bowel retain water,which in turn helps the poo stay softand easy to pass. For younger babies,check with your health visitor before youstart giving anything other than milk.Source: www.NCT.org.uk


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Tips which may help

• Eat well and eat together, wheneveryou can.

• Limit snacking between meals.• Give lots of praise and

encouragement for good eating.• Stick to a routine for mealtimes.• Limit the options at mealtimes offer a

meal that includes at least one thingyou know they like.

• Introduce new foods gently andoffer just one new food at a time.• Keep an eye on milky and

sweetened drinks and sugary snacks which may fill them upresulting in poor appetite at mealtimes.

• Consider your toddler's sensitivepalate, they may not like the texture,colour, or taste of some foods.

• Think about a vitamin supplementspecially designed for toddlers. It maybe useful if your toddler is a fussy eater. Ask about the Healthy Start scheme.

• Get them involved in preparing andtasting food.


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When to immunise

8 weeks

12 weeks

16 weeks

Between 12 and 13months old - withina month of the firstbirthday

Two to six year olds(including children inschool years 1 and 2)

3 years 4 months

Diseases protected against

DTaP/IPV/Hib and PCV and MenB and Rotavirusdiphtheria, tetanus, acellular pertussis (whoopingcough), inactivated polio vaccine, haemophilusinfluenzae b (Hib) vaccine and pneumococcal vaccineand meningococcal B vaccine and rotavirus vaccine

DTaP/IPV/Hib and MenC and Rotavirus diphtheria,tetanus, acellular pertussis (whooping cough), inactivatedpolio vaccine, haemophilus influenzae b (Hib) vaccine andmeningococcal C vaccine and rotavirus vaccine

DTaP/IPV/Hib and PCV and MenB diphtheria,tetanus, acellular pertussis (whooping cough),inactivated polio vaccine, haemophilus influenzae b (Hib)

vaccine and meningococcal B vaccine

Hib/MenC haemophilus influenzae b (Hib) vaccine andmeningococcal C vaccinePCV pneumococcal conjugate vaccineMenB meningococcal B vaccineMMR Measles, mumps and rubella

Influenza(flu) - nasal spray vaccine in autumneach year

DTaP/IPV/Hib diphtheria or low dose diphtheria,tetanus, acellular pertussis, inactivated polio vaccine,(Pre-School Booster)MMR Measles, mumps and rubella

S o ur c e : N H S I mm uni s a t i onI nf or m a t i on.

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Basic skills like toilet training, communications skills, being able tounderstand and follow simple tasks, taking turns and having some socialskills all prepare a child to be ready for learning. Teachers and classroomassistants are then freed up to teach rather than spend time toileting,feeding children and helping them with the most basic social skills.

How can I get my child school ready?• Make sure they are toilet trained• Help them understand how to follow simple tasks• Help them to answer to their name• Encourage them to share and understand turn-taking


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Safe around electricity

RoSPA* recommends that allelectrical equipment is stored safelyaway when not in use and childrenare supervised and warned to keepaway from plug socket outlets. 13-amp power sockets made to BS1363 incorporate a shuttermechanism, which stops access (of little fingers) to the live connectors.If your child has had a shock t urnoff the power before approachingyour child. If this isn’t possible, pushthe child away from the source of the electricity with a material thatdoes not conduct electricity, suchas a wooden stick or a woodenchair. Try tapping their feet orstroking their neck and shouting"hello." If you get no response fromyour child, start CPR and call 999immediately. Get medical attentionfor any electrical burn or shock.

*RoSPA: The Royal Society for the

Prevention of Accidents

A burn is damage to the skin caused by direct contact with something hot.Burns can also be caused by certain chemicals, electricity and friction. A scald

is a burn that is caused by a hot liquid or st eam. Scalds are treated in the sameway as burns.

Treat any burn or scald straight after the accident but always take yourchild to hospital for anything more than a very small burn or scald. A baby’s skin is very delicate and can be scarred without the right treatment. Treatany electrical or chemical burn as serious, call 999 or go to A&E.

Cool the burnt area by placing under cool running water for at least 20 minutes(making sure the child does not get too cold). When the burn has cooled, coverit with a sterile dressing, food quality cling film or a plastic bag. Don’t wrap it tootightly. Don’t apply fatty substances like butter or ointment. Give paracetamol oribuprofen (see page 6 for advice on usage). Take your child to hospital.

Babies/toddlers pull up on everything when learning to stand and walk. Keep hotdrinks out of reach and not on tablecloths that they may pull onto themselves.

50If you are still worried call NHS 111. If you cannot get help straight away, go toA&E.

Knowing what to do

Burns, scalds & shocks

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CutsGlass, knives and sharp objects can cause serious cuts.PREVENTION:Do not leave drinking glasses on the floor. Make sure glassbottles are kept up high. Hide kitchen knives.WHAT TO DO:• If the cut is not serious bathe the area, make sure there

is no glass left and cover with a clean non-fluffy cloth.• If the cut is serious, is bleeding a lot or has a piece of

glass under the skin go to A&E.

DrowningMany children drown, often in very shallow water. Ithappens in the bath, in garden ponds, paddling poolsand water butts.

PREVENTION:• Supervise children near water at all times. Use a grilleon ponds or fill in to use as a sand pit.

• Make sure your child learns to swim.WHAT TO DO:Get your child out of the water. Try to get them to coughup any water. If they are not responding call 999.

Insect bites and stingsMost insect bites and stings cause small reactions thatare confined to the area of the bite (localised reactions).

They can usually be treated at home.PREVENTION:

Avoid swarms, use a net over a pram or pushchair if outside.

WHAT TO DO:Most insect bites and stings cause itching and swellingthat usually clears up within several hours. Minor bitesand stings can be treated by:• Washing the affected area with soap and water.• Placing a cold compress or ice pack (frozen peas

wrapped in a towel) over the affected area to reduceswelling.

• Avoid scratching the area as it can become infected.• If painful give paracetamol or ibuprofen (children under

16 years of age shouldn't be given aspirin).• Use a spray or cream that contains lo cal anaesthetic,

antihistamine or mild hydrocortisone (1%) to preventitching and swelling.

• Take an antihistamine tablet to help reduce swelling

(ask your pharmacist).Call 999 if there is swelling or itching anywhere else on thebody after being bitten or stung, or if they are wheezing orhave difficulty swallowing. See your GP if the redness anditching gets worse or doesn't clear up after a few days.

StrangulationWindow blind cords and chains can pose a risk of injuryor strangulation.PREVENTION:• Install blinds that do not have a cord.• Pull cords should be kept short and out of reach.• Tie up the cords or use one of the many cleats, cord

tidies, clips or ties that are available.

H o u s e h ol d

a c c i d e n t s

S k f h


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Protecting your child’s health

Secondhand smoke is made up of two types of smoke: mainstream (breathed inand out by smokers) and sidestream (smoke from the burning tip of a cigarette).Secondhand smoke is dangerous for children as they are growing up because:• Smoking near children is a cause of serious respiratory illnesses, such as

bronchitis and pneumonia.• Exposure to secondhand smoke increases the risk of children developing

asthma and can cause asthma attacks.• Younger children who are exposed to secondhand smoke are much more likely

to contract a serious respiratory infection that requires hospitalisation.

• There is an increased risk of meningitis for children who are exposed tosecondhand smoke.

• Children exposed to secondhand smoke are more likely to get coughs andcolds, as well as middle ear disease, which can cause deafness.

Take 7 steps outside your home to ensure it does not affect your children. Also,have a smokefree car at all times as exposure to the chemicals in secondhandsmoke is increased in a confined space even with the windows open!

Source: www.take7stepsout.co.uk

Make your homesmokefree

• Tell everyone in your house,and any visitors, that yourhome is now smokefree.

• Keep a pair of slip-on shoesand other all-weather bits byyour back door, so you cango out anytime.

• Keep an ashtray 7 stepsfrom your back door as areminder. It’ll help keep the

garden tidy too.• Can’t make it outside?Nicotine replacementmethods like patches andgum can help.

• If you smoke, or are exposedto secondhand smoke duringpregnancy, it means thatyour baby shares chemicalsfrom the smoke you breathe.1 2 3

Does it really affect mychild if I smoke withthe car window open?

Yes, and it is now illegalto smoke in a vehiclecarrying anyone agedunder 18.

It is also illegal not tostop any passengerssmoking. There is afine for both offences.

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Smokefree homes

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FINAL Childhood Illness 01.02.16