1609-Southend CCI.qxp 6521-Cornwall · 2017. 6. 19. · Alison Clare, Interim Director, A Better Start Southend 1609-Southend CCI.qxp_6521-Cornwall 26/09/2016 11:22 Page 3. Health

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If a child in your care is ill or injured, choose 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

Severe painWorsening health conditionsChokingLoss of consciousnessFitting/convulsionsBroken bones

Self Care

NHS 111For 24 hour health adviceand information.

PharmacistFor advice on commonillnesses, injuries andmedication.

GPFor the treatment of illnessesand injuries that will not goaway.

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

A&E or 999For serious and life-threatening emergencies.

You can treat minor illnesses and injuries at homeby using the recommended medicines andmaking sure they get plenty of rest www.nhs.uk.

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

To find your local pharmacy and its contact details visit: www.nhs.uk/chemist

Write your GP’s (family doctor) telephone numberhere:

Use NHS 111 out-of-hours service

The accident and emergency departmentprovides assessment, diagnosis and treatment for patients with emergency conditions, seriousinjuries or illnesses.Southend University Hospital NHS FoundationTrust, Prittlewell Chase, Westcliff-on-Sea,Essex SS0 0RY.

High temperatureHead injuries not involving loss of consciousnessPersistent coughWorsening health conditions(inside GP hours)Minor bumps, cuts and possible fracturesDehydratedHeadacheAbdominal pain

Concern Service What to do? A Parent’s GuideCommonchildhood illnesses &well-being

Children aged 0-4

1609-Southend CCI.qxp_6521-Cornwall 26/09/2016 11:22 Page 1

Welcome Contents

3

Who can help?A guide to services 4

Know the basics 6

Children’s medicines 7

The first monthsFeeding your baby 8

Being sick & reflux 10

Crying & colic 12

Nappy rash & cradle cap 14

Sleeping 16

Sticky eyes & eye care 18

Immunisations 20

Baby blues 22

Bonding and attachment 23

Childhood illnessesFever 24

Coughs, colds & flu 26

Allergies 28

Wheezing & breathing difficulties 30

Constipation 32

Diarrhoea & vomiting 34

Earache & tonsillitis 36

More serious illnessesMeningitis & sepsis 38

Chickenpox & measles 40

Asthma 42

General welfareA Better Start Southend 44

A healthy lifestyle 46

Household accidents 48

Your child's learning & development 50

Useful contacts 51

To view the latest version of this booklet online visit www.southendchildhealth.co.uk

This book has been created by A Better Start Southend in partnership with Public Health and NHS Southend Clinical Commissioning Group.

A Better Start Southend is a ten-year research programme aiming to make Southendthe best place in the country to be a child - and a parent.

Every parent or carer wants what is best for their growing baby and to give them thebest start in life. Children will achieve well because:• Their parents are ready for parenthood.• They have a positive parent/child relationship.• They are ready for school.• They and their families receive effective and consistent professional support.• There is improved health at individual, family and community level.

You can use this handbook to help you know what to do when your baby/child is ill.Learn how to care for your child at home, when to seek advice from a health visitor,call a doctor and when to contact emergency services.

Most issues are an everyday part of growing up, often helped by a chat with yourmidwife or health visitor. Almost all babies, toddlers and children will get commonchildhood illnesses like chickenpox, colds, sore throats and ear infections. Whilethese are not very nice at the time they are easily treated at home with support fromyour GP or health visitor rather than going to A&E. If you are worried you must getfurther advice - you know your child best - trust your instincts.

Alison Clare, Interim Director, A Better Start Southend


Health visitorHealth visitors are there tosupport you until your baby isfive years old. They will visit youat home for a new birth visitwhen the baby is about 10-14days old and then may see youin a baby clinic. They will helpwith advice about feeding andweaning, or any other worries,and can direct you to where toget extra help if you need it.

Family Nurse Partnership (FNP)The FNP intensive, structured home visitingprogramme is delivered by specially trained nursesworking with young families from early pregnancyuntil the child is two years old. The service isoffered to first time mothers, aged 19 years orunder, who are pregnant with their first child.

A&E & 999For serious and life-threatening emergencies.A&E and 999 are emergency services that should only be usedwhen babies and children are badly injured or show symptoms ofcritical illness. These include choking or breathing difficulties,unconscious or unaware of surroundings, taken poison or tablets,severe abdominal pain, fewer wet nappies suggesting dehydration.

Children’s CentresFamily friendly environmentswhich provide support andadvice for your child’s healthand development up until theystart school. Activities includestay and play sessions, infantfeeding support groups andparenting sessions.Find your nearest centre atwww.southendinformationpoint.org

GP (Doctor)You will need to registerwith a local GP. Your GPcan advise, give you themedicines you needand point you in theright direction if youneed other specialistservices. You will usuallyneed to make anappointment. All GPswill see a child quickly ifyou are worried.After 6.30pm weekdays,at weekends and publicholidays you can call theGP out-of-hours serviceon NHS 111.

If you think you need help urgentlyduring the day or night you should callNHS 111 before you go to any other

health service. NHS 111 is available 24 hours a day,365 days a year and is free to call, including from amobile. You will be directed straight away to the localservice that can help you best. 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 minor injuries and illnesses can be besttreated in your home by using over-the-countermedicine from your pharmacist and getting plenty ofrest. If you are still worried call NHS 111 or your GP.

Self careDentist

Discuss registeringyour child early onwith your dentist andtake them with you toappointments.Visit www.nhs.uk tofind your nearestdentist. For out-of-hours dentistinformation callNHS 111.

PharmacistYour local pharmacist can provideadvice on most common healthissues and can suggest anddispense medicines. There areoften pharmacists in supermarketsand many are open late.

Visit www.nhs.uk to find thepharmacy nearest to you.

Some local pharmacies operate afree minor ailments scheme (Careat the Chemist), or they can directyou to one that does. See yourlocal pharmacist for a confidentialconsultation about coughs, colds,sore throats, pain and temperature,minor eye infections, head lice andlots more. This NHS scheme isavailable from age one and anymedicine dispensed is free if youdo not pay for your prescriptions.

We have a wide range of healthcare and children and familyservices. See which service or professional is best to help you.

Your midwife assessesyours and your baby'shealth and well-being atvarious stages throughoutyour pregnancy andsupports you both in thetwo weeks after the babyis born.They will also supportyou if you choose ahome birth.

Midwife

A guide to services

4 5


Being prepared and knowing the signs

Know the basics

Paracetamol and ibuprofenConsider using either sugar-free paracetamol or ibuprofen for children withfever who appear distressed (as a general rule a temperature of over 38°C100.4°F), as these can help to reduce fever and distress. Often a fever can beleft to run its course unless there are other signs of serious illness. Ensure theyare drinking enough and appear otherwise well. 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 signs 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.

Make sure you’ve got the right strength of medicine for the age of yourchild, always follow instructions carefully and check use by dates. Read the labelcarefully. 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.

6 7

Children's medicinesNot always needed for childhood illnesses

Antibiotics for childrenIf you’re offered a prescription for anantibiotic, talk to your GP about why it isneeded and how it will help. Ask aboutany possible side effects for example,whether it could make your child sleepy orirritable and other side effects likesickness and diarrhoea.

Repeated use and misuse of antibioticsare some of the main causes of theincrease in resistant bacteria. Antibioticsare now no longer routinely used to treatchest infections, ear infections inchildren and sore throats.

If your child is prescribed antibioticsalways finish the whole course to makesure all the bacteria are killed off. Yourchild may seem better after two or threedays, but if the course is five days, theymust carry on taking the medicine. Theillness is more likely to return if your childdoes not finish all the antibiotics.

Most illnesses get better by themselves and make your childstronger and able to resist similar illnesses in the future.

Paracetamol and ibuprofen are often used to relieve the discomfortcaused by a high temperature. Some children, for example those withasthma, may not be able to take ibuprofen, so check with yourpharmacist, GP or health visitor.

Don't give aspirin to children under 16, and if you're breastfeeding,ask your health visitor, midwife or GP for advice before takingaspirin yourself.

Children don’t often need antibiotics. Most childhood infections are causedby viruses. Antibiotics are medicines which kill bacteria. They work onlyagainst bacteria, not the viruses that cause the majority of sore throats,colds, sinus infections and bronchitis. For bacterial infections however,antibiotics work quickly and symptoms usually improve within 24-48 hours.Often children can feel completely better shortly after beginning the antibioticcourse. To beat the bacterial infection, it is important that your child finishesthe entire course as prescribed, even if your child seems better.

Thermometer

Plasters

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

Barrier cream

Pharmacist saysKeep a small supply ofuseful medicines in a lockedcabinet or somewhere uphigh where a child cannotreach them. Include things like:

Antihistamine

321Antibiotics aren'talways the answerwhen your child isunwell.

My child has a bad coldand I want to get someantibiotics from my GP.

Do not expect your GPto automatically giveyou antibiotics (or anyother medicine).


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.

Tongue-tie can sometimes affect feeding, making it hard toattach properly to the breast. Speak to your health visitor.

8

The best start in life

9

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 breast2-3cm 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

3

2

1

Source: DoH, www.lullabytrust.org.uk

At birth, giving your baby a long cuddle - skin to skin contact for up to one hour,calms both mum and baby, it regulates baby’s heart rate and temperature, andstimulates mothering hormones which helps to form a close bond and increasebreast milk supply. Baby’s immediate needs are to feel safe and secure, and to beable to feed whenever hungry. Holding your baby close to feed, and responding toall of baby’s needs encourages healthy brain connections. Most of this developmentwill occur within the first two years. Responsive parenting will enable your baby toreach its full potential, to help them form good relationships and communicate well,giving them the best start in life.

Sterilising and bottle hygiene• All the equipment you use for bottle feeding your baby needs to be washed in

hot soapy water, rinsed and sterilised.• The cleaning and sterilising instructions are the same, whether you are using

expressed breast milk or infant formula milk.• You need to keep sterilising your feeding equipment until your baby is at least

six months old.• Infections (like gastroenteritis) are rare, but if they do occur, can be very serious.

Feeding tipsHow to tell your baby is havinglots of milk:• Lots of wet heavy nappies -

around six in 24 hours.• Dirty nappies, two to three

soft stools daily until four tosix weeks, after which two tothree per week.

• Baby is content and settledduring and after each feed.

• During a feed, you can hearbaby swallowing.

• Weight gain - checked byyour health visitor at the localbaby clinic.

Remember, your milk fulfils all ofyour baby’s needs for around sixmonths. It also reduces theincidence of sudden infant deathsyndrome (SIDS). Ordinarysupermarket cow’s milk shouldnot be offered until your babyreaches one year, although it issuitable to use from six monthsin breakfast cereals.

Feeding your baby

321Go to your local breastfeedingsupport group, usually held at achildren’s centre. Other mumsand peer supporters will be thereto give you lots of tips.

Are your nipplessore? If yes, pleaseask for help as soonas possible.

Have you been shownhow to hand express?This is a really usefulskill, and it’s free!


10

Health visitor saysPossetting (vomiting a smallamount of milk) is normalduring or after a feed. If thiscarries on at other times,between feeds it may be atummy bug. It is important forbabies to have plenty of fluidsto stop any dehydration.

A problem likely to get better on its own

It is common for babies to be sick in the early weeks as they get used tofeeding and their bodies develop. Bringing up small amounts of milk is knownas possetting. When your baby vomits there will be a much larger amount. Itcan be frightening for your baby, so they are likely to cry. Lots of things cancause your baby to be sick.

Make sure your baby is positioned correctly when breast or bottle feeding.Incorrect positioning can cause a baby to be sick. Your midwife or healthvisitor can help with this.

Being sick often or with large amounts may be due to ‘gastric reflux’ whereacid from the tummy can come up again. Babies can be grumpy and it cansometimes lead to poor feeding. If your baby is feeding well but doesn't seemthemselves, you may just need to change the baby's position during and aftera feed to make them more upright. Feeding smaller amounts and more oftenmay also help.

11

GP saysAfter the first few months, if yourbaby is suddenly sick it is morelikely to be caused by a stomachvirus rather than possetting.Gastroenteritis is an infectionwhich can come with diarrhoea(runny poo).

This is more serious in babies thanolder children because babieseasily lose too much fluid fromtheir bodies. If they becomedehydrated they may not passenough urine, lose their appetiteand have cold hands and feet.

If your baby is unwell, or if vomitinghas green bile stained fluid or haslasted more than a day get yourGP’s advice straight away.

Being sick & reflux

321As babies develop it willstop naturally. Talk to yourhealth visitor.

I have a new baby. I have just given mybaby a feed.

They always seem tobring up small amountsof milk. This is known as‘possetting’.


12

Never shake yourbaby

No matter how frustrated youfeel, you must never shakeyour baby. Shaking moves theirhead violently, and can causebleeding and brain damage.Source: NHS Choices

Health visitor saysKnow your baby. Try tounderstand what it is they need.Things to check first are:

P Does their nappy needchanging?

P Could they be hungry?

P Could they be too hot?

P Could they be too cold?

P Does their cry sounddifferent?

P Could they be teething?

P Do they want a cuddle?

P Are they tired and need asleep?

These are all things which couldbe causing your baby to cry.

Crying & colicUnderstanding why

13

All babies cry, especially in the first few weeks after birth. Crying is their way ofletting you know they need something or are uncomfortable. They may needchanging, they may be hungry or just need a cuddle.

If your baby cries suddenly and often, but they otherwise appear to be happy andhealthy, they may have colic. Colic is common and although uncomfortable it is notserious and usually affects babies only in the first few months of their lives.

The most common symptoms of colic are:• Continuous crying, which typically occurs in the late afternoon or evening. • A flushed appearance.• Drawing their legs to their chest.• Clenching fists.• Passing wind.• Having trouble sleeping.

When a baby cries, it can be upsetting, it can be easy to get frustrated and youmay not be getting much sleep. It is very important to stay calm and don’t be afraidto ask for help. If your baby's crying seems different in any way (such as a veryhigh-pitched cry or a whimper), then seek medical advice. Crying can sometimesbe a sign that your baby is unwell. Trust your instincts - you know your baby best.

321If you are still worried,speak to your healthvisitor, or contact your GP.

My baby is crying morethan usual.

What is your baby trying totell you? It may besomething really simple.


14

This is the name given to the greasy yellow-brown scalesand crusting affecting the scalp in newborn babies.Do not pick the scales as this may increase the risk of infection. It is not a serious condition and is not contagious. It is not usuallyitchy and will usually clear up within a few months.

Talk to your health visitor if the rash spreads or there is anyinfection or oozing.

Gently wash the baby’s hair and scalp with a babyshampoo. Use a soft brush or cloth to loosen andremove the loose skin flakes.

Soften the scales with natural oil such as coconut oil(not olive oil) overnight. After softening the scales usea soft brush or cloth and gently remove any loosescales and wash the hair with a baby shampoo. Ifany hair comes out with the scales it will grow back.

Health visitor’s cradle cap tips

Source: NICE CKS 2013

A common problem that’s easy to treat

15

Health visitor’s nappy rash tips

Nappy rash & cradle capNappy rashNappy rash is very common and can affect lots of babies. It is usually caused whenyour baby's skin comes into contact with wetness that collects in their nappy. A nappyrash causes your baby's skin to become sore. The skin in this area may be covered inred spots or blotches. You should change their nappy more often.

Most nappy rashes can be treated with a simple skincare routine and by using acream you can get from the pharmacist. Talk to your pharmacist about creams thatyou can buy over the counter. There are two types of nappy cream available. One is abarrier cream to keep wetness away from your baby's skin. The other is a medicatedcream, that is good for clearing up any soreness but should only be used whenadvised by a health professional. With a mild nappy rash, your baby won't normallyfeel too much discomfort.

EczemaEczema is common in babies and they normally grow out of the condition, it oftenstarts between the ages of two and four months. The symptoms are patches of red,dry and itchy skin. If you think your child has eczema, speak to your GP or healthvisitor. In all cases of eczema, frequent unperfumed emollients (moisturisers) help.

Leave your baby in awarm, safe placewith no clothes ornappy on, to let theair get to their skin.

Use a barrier cream.

Remember tochange and checktheir nappy often.

321Change nappies often.Speak to your healthvisitor and if you arestill worried, your GP.

There is a red, sore rasharound the nappy area.Baby is uncomfortableand cries a lot.

Has baby been in a dirty nappy fora long time? Have you followedadvice from your health visitor, orspoken to your pharmacist?


16

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 should 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 reducethe 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 number BS-1877-10:1997.

12 These apply to day time and night timesleeps.

Source: www.lullabytrust.org.uk

Bed-sharing with your babyis never completely safe. It is particularly dangerousfor your baby to sleep inyour bed if you (or yourpartner):• Are a smoker (even if you

never smoke in bed or athome).

• Have been drinking alcoholor taken any drugs.

• Have taken any medicationthat makes you drowsy.

• If your baby was premature(born before 37 weeks).

• If your baby was low birthweight (less than 2.5kg).

• If you or your partner areoverweight.

It is very dangerous to fallasleep together on a sofa,armchair or settee and it is alsorisky to allow a baby to sleepalone in an adult bed.

SleepingPatience, praise and peaceThere are many different reasons why babies do not sleep. It is normal for a babyat six weeks old not to sleep through the night. Feel confident in yourself to knowwhether your child is really distressed or just restless. Trust your instincts.

Try to establish a regular sleep routine early on by putting them to bed at a regulartime (day and night). Place your newborn baby on their back to sleep, in a cot inyour bedroom for the first six months. Prepare a warm, comfortable place forthem to relax in. Try to avoid always rocking your baby or ‘feeding them’ to sleepas this can become a habit. Adult beds are not designed for babies and toddlersand do not conform to safety standards. Only breastfeeding babies should everbe fed in bed and should be positioned on the outside of the bed and returned tothe cot after the feed.

You can help your baby to sleep safe and sound by keeping the temperature intheir room between 16-20°C. A basic room thermometer will help you to keep aneye on the temperature.

Reading to your child at bedtime helps them to unwind, and gives you somespecial time together. If your child is scared of the dark, try keeping a night light on.

17

321Put your baby tosleep on their backand let them play ontheir tummy.

Flat head syndromehappens when the back orone side of the baby's headis squashed against a firmmattress for a long time.

The solution is not tochange your baby'ssleeping position from lyingon their back at night.


18

Health visitor saysSome babies have watering eyes.Massaging the tear ducts helps todislodge tears that have collectedin the upper part of your baby’stear duct, as well as encouragingthe tear duct to develop. This canbe done by applying light pressurewith your clean, index finger andmassaging from the outer corner ofyour baby’s eye towards their nose.Repeat several times a day for acouple of months. If this persistspast one year, your baby should bereferred to an eye specialist fortreatment.Source NHS Choices

Protect your baby’s eyes

19

ConjunctivitisThe signs of ‘sticky eyes’ cansometimes be confused with aninfection called ‘conjunctivitis’.With conjunctivitis the white ofthe eyes become red and thereis more yellow or green stickygoo which comes back regularly.If you notice this and it continuesfor more than 24 hours, contactyour health visitor or GP. Thiscan be passed on easily, sowash your hands and use aseparate towel for your baby.

Sticky eyes & eye care‘Sticky eyes’ are common in newborn babies and young children while their tearducts are developing. You may see some sticky stuff in the corner of the eyes ortheir eyelashes may be stuck together.

It normally clears up on its own, but you may have to clean your baby's eyesregularly with damp cotton wool. Use clean, cooled boiled water.

Wipe each eye from the corner by the nose outwards. Use a clean piece of cottonwool for each wipe. Remember to wash your hands before and afterwards andavoid sharing towels to prevent spreading infection.

Eye tests and checksIt is important to look out for any signs of problems with your baby’s eyes. Routineeye tests are offered to newborn babies and children to identify any problemsearly on in their development. It's quite normal for the eyes of newborn babies to‘cross’ occasionally, particularly when they're tired. However, speak to your GP ifyou notice this happening to your child after three months of age. Left untreated,‘lazy eye’ can develop.

Although serious vision problems during childhood are rare, early testing ensuresthat any problems are picked up and managed as early as possible.

321Use cooled boiledwater on a cleanpiece of cotton woolfor each wipe.

Is there discharge in thecorner of your baby’s eye anddo their eyelashes appear tobe stuck together?

Sticky eyes is a commoncondition that affectsmost babies, speak toyour health visitor.


ImmunisationsProtect your child now and in the future

21

Immunisations, also known as vaccinations are usually given by injection. Children inthe UK are offered vaccinations against a variety of diseases as part of the HealthyChild Programme. A record is kept in the Parent Held Child Health Record (RedBook), which is a book you keep containing information on your child’s health.

Immunisations are mainly given during the first five years. It’s important to havevaccinations at the right age to keep the risk of disease as low as possible. Don’thesitate to ask your health visitor or GP for advice - that’s what they are there for!Childhood immunisations are free and most are given at your GP’s surgery.

Some immunisations are given more than once to make sure the protectioncontinues. This is known as a booster, so make sure your child gets it.

If you are pregnant, you will be offered the whooping cough vaccine at your GP’ssurgery. The ideal time is 28 to 32 weeks of pregnancy so that your baby will beborn protected against whooping cough infection. You will also be offered theinactivated flu vaccine to protect against flu.

Babies should have a dose of liquid paracetamol following meningococcal groupB disease vaccination to reduce the risk of fever.

321Immunisations don’t justprotect your child duringchildhood, they protectthem for life.

Immunisation begins attwo months, whenbaby's natural immunityto illness, begins to drop.

The protection immunisationsoffer to your child againstserious diseases are worththe small amount of pain.

When to immunise

8 weeks

12 weeks

16 weeks

Between 12 and 13months old - within a 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 Rotavirus diphtheria, tetanus,acellular pertussis (whooping cough), inactivated poliovaccine, haemophilus influenzae b (Hib) vaccine androtavirus 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 vaccine (Booster)MMR Measles, mumps and rubella

Influenza (flu) - nasal spray vaccine in autumn each year

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

Source: N

HS

Imm

unisation Information.

20See the link for video information:

www.nhs.uk/video/Pages/vaccines-and-your-childs-immune-system.aspx

Image ©

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GP saysImmunisations are used toprotect children from diseaseswhich can be very seriouscausing long-term complicationsand even death.

The protection immunisationsoffer to your child are worth thesmall amount of pain.

Check with your health visitor,practice nurse or GP for furtherinformation, updates and futureimmunisations or if your child hasa chronic medical condition.


Our children’s health is closely linked

As parents whether you are a single parent, a mum, dad or carer we allwant to do what’s best to keep our children safe, fit and well. However, it can be easy to forget about our own health and well-being. If as parents wehave a positive attitude, a good social outlook and a healthy lifestyle it is often thecase that our children will too. You should have your postnatal check about sixweeks after your baby’s birth to make sure that you feel well and are recoveringproperly and to discuss contraception etc.

Family life plays an important role in the well-being of both children and parents.Doing active and creative things together can really boost happiness levels allround. Children’s centres can be great places for you to socialise and meet otherparents as well as giving your child the opportunity to meet friends. Sometimes itcan be a bit daunting when meeting a group of complete strangers, but it can bean easy way to meet new people and make friends, after all, you all havesomething in common - your children!

We are often our children’s first teachers and they not only learn about practicalthings from us, but pick up on attitudes that can last a lifetime. It is important to takecare of your own physical and mental health in order to be able to ‘parent’ well.

Baby blues

23

Helping children thrive

The bond (attachment, connection) is the unique emotional relationshipbetween you and your baby. If a parent or carer is responsive to a baby’ssignals or cues and communicates with them from birth onwards, a babywill develop a secure attachment. Communication is the foundation ofrelationships and bonding, and is essential for learning, play and socialinteraction.

Language (including body language) is how we get to know and bond withone another and build relationships. In talking and listening, we help ourchild develop and learn as well as make close connections.

When communicating with your baby hold them close and make eyecontact. Smile and copy their facial expressions. This may turn into a goodgame! Copy the noises your baby makes. Sometimes you may find they‘answer’ you! Sing songs to your baby. Older babies might enjoy games like‘peekaboo’ and ‘round and round the garden’. Talk to your baby about thethings you are doing together.

Contact your health visitor and local children’s centre for information aboutthe activities they provide or if your child seems to be having difficulties.

Bonding & attachment

Look out for signs of emotionalattachment delays, including:• They do not like to be touched or

hugged.• They are indiscriminately affectionate

with strangers.• They resist social interaction.• They seem to want to be alone.• They display intense anger.• They can be destructive or aggressive.

If you suspect a child may haveattachment difficulties they will require aspecialist assessment. Talk to yourhealth visitor, nursery nurse or GP.

22

Postnatal depressionSome women experiencedepression after having a baby andthis is more common than manypeople realise. It can developwithin the first few weeks aftergiving birth, or may not occur untilaround six months after the birth.Some women feel they are unableto look after their baby or they feeltoo anxious to leave the house orkeep in touch with friends.Treatment will benefit both yourhealth and the healthydevelopment of your baby, as wellas your relationship with yourpartner, family and friends. Seekinghelp for postnatal depression doesnot mean you are a bad mother orunable to cope. Talk to your healthvisitor or GP about how you feel.

321It is important to have ahealthy family lifestyle andtreat your own health asimportantly as your child’s.

I often overlook my ownwell-being as I want to dothe best for my child.

Your child’s well-being islinked to your health.

321Speak to your healthvisitor for further adviceand support.

My six month old baby isquiet, withdrawn anddifficult to engage with.

Make eye contact andtalk to your baby.


24

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 drinkas 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).

Fever

25

A child with a significant fever will have a body temperature above 38˚C. Yourchild may also feel tired, look pale, have a poor appetite, be irritable, have aheadache or other aches and pains and feel generally unwell. Take thetemperature from the armpit, using an electronic thermometer (don’t use in themouth of under 5s) or use an ear thermometer. Remember that measurementsfrom under the arm are less accurate as the armpit is slightly cooler.

A fever is part of the body’s natural response to fight infection and can often beleft to run its course provided your child is drinking enough and is otherwise well.If your child is having trouble drinking, trying to reduce their temperature may helpwith this. This is important to prevent your child from becoming dehydrated,which can cause kidney problems. Your child’s urine should be pale yellow - if it isdarker, your child needs to drink more fluids.

Fevers are common in young children. They are usually caused by viralinfections and clear up without treatment. However, a fever can occasionally bea sign of a more serious illness such as a severe bacterial infection of the blood(septicaemia), urinary tract infection, pneumonia or meningitis.

You should also contact your GP if fever symptoms are not improvingafter 48 hours. Check your child during the night.

Always seek medical advice if your child develops a fever soon after anoperation, or soon after travelling abroad.

GP saysWhen looking after a feverishchild at home you should:• Get the child to drink more

(where a baby or child isbreastfed the most appropriatefluid is breast milk).

• Look for signs of dehydration -reduced wet nappies, drymouth, sunken eyes, no tears,poor overall appearance, sunkensoft spot on baby’s head.

• It is not advisable to giveibuprofen if your child isdehydrated.

• Know how to identify ameningitis rash (see page 38).

• Check child during the night.

Source: NICE, Feverish illness in children/2013

Part of the body’s natural response

321If their temperatureremains over 38˚C anddoesn’t come down,contact your GP.

My toddler is hotand grumpy.

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


26

Don't pass it on:Catch it Germs spread easily. Always carry tissues anduse them to catch coughs or sneezes.Bin it Germs can live for several hours on tissues.Dispose of your tissue as soon as possible.Kill it Hands can pass on germs to everything youtouch. Wash your hands with soap as soon as you can.

You will probably find when your child starts mixing with other children they get lots ofcoughs, colds and sniffles. There are some good things about this though as it helpsthe body build up a natural immune system.

Flu can be more serious than a cold and leave your child feeling quite unwell. Flutends to come on more suddenly and severely than a cold. Your child may haveaching limbs and feel uncomfortable, and be ill for a week or more.

Most viruses will run their course without doing any real harm because they will get betteron their own. An annual nasal spray flu vaccine is available from the age of two as part ofthe NHS Childhood Vaccination Programme. Ask your GP or pharmacist for details.

Things you can do at home to help:

P Give your child lots to drink.

P Try sugar-free paracetamol or ibuprofen (not aspirin) (see page 6).

P Keep them away from smoke and anyone who smokes.

P Talk to your pharmacist but remember that coughing is the body’s way ofkeeping the lungs clear.

P Make sure they get plenty of sleep/rest.

Contact your GP if:

P Your baby has a persistent temperature of 38˚C or more.

P They have a fever with a rash.

P They are drowsy and less interactive.

P Your child is finding it hard to breathe.

P Persistent temperature does not respond to medicine (see page 24, fever).

Not usually serious

Source: 2013 NICE Guidance.27

Pharmacist saysChildren can be treatedusing over the countermedicines to bring down araised temperature if it iscausing distress. Sugar-free paracetamol oribuprofen liquid can helpand can be given from theage of about three months.Check the label carefully. If indoubt, check with thepharmacist and tell themhow old your child is. Flu symptoms are moresevere and you may need tosee your GP.

Coughs, colds & flu

3

2

1

If symptoms last for morethan 10 days or your childis coughing up yellow ‘goo’they may have a bacterialinfection. Contact your GP.

My child keeps coughingand sneezing, has a mildtemperature and seemsgenerally unwell.

Have they recently startednursery? Catching colds isvery common. Have youspoken to your pharmacistabout sugar-free paracetamoland cough medicines?


28 Source: Allergy UK/2014

EyesItchy eyes, watery eyes, pricklyeyes, swollen eyes, ‘allergicshiners’ - dark areas under theeyes due to blocked sinuses.

Allergy UK01322 619 898 www.allergyuk.org

Spotting symptomsMany of these symptoms can develop as aresult of other common childhood illnesses.With an allergy, symptoms often appearmore quickly or suddenly.

Nose, throat and earsHay fever symptoms - runny/blocked/itchy nose, sneezing, pain in sinuses,headaches, post-nasal drip (mucusdrips down the throat from behind thenose), loss of smell and taste, sorethroat, swollen larynx (voice box), itchymouth and/or throat, blocked/glue ear.

SkinUrticaria - Wheals or hives, bumpy,itchy raised areas, rashes.Eczema - Cracked, dry or weepy,broken skin.

DigestionSwollen lips/tongue, stomach ache,feeling sick, vomiting, constipation,diarrhoea, bleeding from the bottom,reflux, poor growth.

AirwaysWheezy breathing, difficulty in breathing,coughing (especially at night time),shortness of breath.Antihistamines

Antihistamines are anti-allergymedicines, and most are readilyavailable from a pharmacywithout prescription. While olderantihistamines have a reputationfor making people drowsy, moremodern antihistamines onlyoccasionally have those sideeffects. Source: www.allergyuk.org

AllergiesManaging and understanding your child’s allergy

Source: NICE - Testing for food allergy in children and young people29

Anaphylactic shockAnaphylaxis is a dangerous typeof allergic reaction which is mostlikely to be caused by particularfoods, insect bites or medicines.Early signs of allergic reaction:• Swelling and itching; the face

may be flushed and wheals orhives may erupt on the skin.

• Lip or facial swelling. • Acute vomiting/abdominal pain.

Anaphylaxis or severereactions:• Difficulty breathing, coughing

and/or wheezing. • Loss of colour; cold and clammy.• Loss of consciousness (may

appear asleep). Call 999 and tell the operator youthink the child has anaphylaxis.

If available, an adrenaline injectionshould be given as soon as aserious reaction is suspected. Ifyou already have an EpiPen orinjection device, make sure youknow the correct way to use it inadvance of an emergency.

50% of children in the UK have allergies. For parents it is a learning curve inunderstanding what to avoid and how to control and manage the allergy. Find outas much as you can. There are many types of allergies.

An allergy is when the body has a reaction to a protein such as foods or milk,insect stings, pollens, house dust mite or medicines such as antibiotics. Somefamilies seem to include more individuals with allergies than other families.

Allergic symptoms can be mild, moderate or severe. When a child first showssigns of an allergy it is not always clear what has caused the symptoms, or even ifthey have had an allergic reaction, since some allergic symptoms can be similar toother common childhood illnesses. Urticaria (wheals or hives) can be one of thefirst symptoms of an allergic reaction. If the reaction is severe, or if the symptomscontinue to re-occur, it is important that you contact your GP.

Most food allergies occur during early infancy and cow’s milk protein allergy is one ofthe most common although many children grow out of this allergy by five years old.

321Children are mostcommonly allergic to cow’smilk, hen’s eggs, peanutsand other nuts, such ashazelnuts and cashew.

Food allergies occurwhen the body’s immunesystem reacts negativelyto a particular food orfood substance.

Allergens can cause skinreactions, digestive problemsand hay fever-like symptoms.


30

BronchiolitisBronchiolitis is a common respiratorytract infection that affects babies andyoung children under a year old. Theearly symptoms are similar to thoseof a common cold and include arunny nose and cough.

As it develops, the symptoms ofbronchiolitis can include a persistentcough, noisy breathing and difficultyfeeding.

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

Source:www.nhs.uk/conditions/Bronchiolitis/

CroupCroup causes a distinctivebarking cough with a harshsound, when the childbreathes 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, paracetamolcan be given from the ageof three months and willease discomfort. If symptoms get worsecontact your GP.


Look at the signs

31

Any kind of breathing difficulty your infant or child experiences can be scary forparents. It is often nothing to worry about and illnesses like bronchiolitis, mild croupand a cough can often be treated at home.

Use your instincts with newborns and babies:• Rapid breathing or panting is common. If there is no other sign of illness, it

comes and goes and your baby is breathing comfortably most of the time,there’s normally no need to worry.

• Breathing may sound a bit rattly. Try holding your baby upright.• Occasional coughing or choking may occur when a baby takes in milk too

quickly with feeds. Try to slow things down a bit. Check feeding position.• A cold or mild cough. Keep an eye on them at this stage and use your instincts.

If you are worried talk to your health visitor.

In older babies and toddlers you may notice:• Coughing, runny nose, mild temperature - (see page 26, coughs, colds & flu).• Croup (hoarse voice, barking cough) needs to be assessed by your GP and may

need treating with steroids.• Child appears pale.• Wheezing is fairly common in the under 5s associated with colds. It is not

usually suggestive of asthma unless symptoms occur between viral infections.

Wheezing & breathing difficulties

GP’s tipsGet help and contact your GPnow if your child:

P Seems to find breathinghard work and they aresucking in their ribs andtummy.

P They can’t complete a full sentence withoutstopping to take a breath.

Get help and call 999 ortake them to A&E now if:

P Their chest looks like it is‘caving in.’

P They appear pale or evenslightly blue-ish.


32

Breastfed babiesConstipation is very rare in babieswho are solely breastfed, but notuncommon in babies who haveformula milk, or who have solidfoods. Make sure you are makingup the formula powder with thecorrect amount of water.

If your baby is already on solid foodsthen the juice or the fruit itselfshould be fine for providing relief.Fruits, such as apples, pears andprunes, contain sorbitol which is anatural laxative, helping the lowerbowel retain water, which in turnhelps the poo stay soft and easy topass. For younger babies, checkwith your health visitor before youstart giving anything other than milk.Source: www.NCT.org.uk

ConstipationRare in babies who are solely breastfed

Constipation is a very common problem in children. Many children normallypass stools (faeces/poo) as far apart as every few days. Regardless, youshould treat hard stools that are difficult to pass as constipation.

Breastfed infants will generally have more stools per day but occasionally canpass normal soft stools only once a week. Their stools vary more in frequencywhen compared to bottle-fed infants. For example, breastfed infants produceanywhere from 5 to 40 bowel movements per week whereas formula-fedinfants have 5 to 28 bowel movements per week. Switching the type of milk orformula can also cause constipation.

Many things contribute to constipation but infants and children who get well-balanced meals typically are not constipated.

Ask your health visitor for advice. In rare cases, constipation can be due to anunderlying illness, so if the problem doesn’t go away in a few days, it’simportant to talk to your GP.

33

Health visitor saysTo avoid constipation and helpstop it coming back make sureyour child has a balanced dietincluding plenty of fibre such asfruit, vegetables, baked beansand wholegrain breakfastcereals. We do not recommendunprocessed bran (an ingredientin some foods), which cancause bloating, flatulence (wind)and reduce the absorption ofmicronutrients. Ensure theydrink plenty of fluids.

321If the problem persists speakto your health visitor or GP.

My bottle-fed babygets constipated.

Try cooled, boiled waterbetween feeds.


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

P Give them regular drinks - try smallamounts of boiled cooled water ifbottle fed.

P Breastfeed on demand ifbreastfeeding.

P Being extra careful with handhygiene (use soap and water orantibacterial hand gel and dryhands well with a clean towel).

P Rehydrating solutions come inpre-measured sachets to mix withboiled cooled water. It helps withdehydration.

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

34

Health visitor saysIf you are breastfeedingcontinue to do so and keepdrinking plenty of fluids.

Source: www.nhs.uk/conditions 2015

Diarrhoea & vomitingNot nice for you or your baby

Sickness and diarrhoea bugs are caught easily and are often passed on in placeswhere there are lots of children.

Feeling sick and suddenly being sick are normally the first signs. Diarrhoea canfollow afterwards. If your child is not vomiting frequently, is reasonably comfortablein between and you are able to give them frequent small amounts of water, theyare less likely to become dehydrated and probably don't need to see a doctor.Speak to your GP if they are unwell for longer than 24 hours or sooner ifthey are newborn or if you notice signs of dehydration.

If you're breastfeeding, keep on doing so even more frequently. Offer olderchildren plenty of water, or an ice-lolly for them to suck. If they want to eat, givethem plain foods like pasta or boiled rice (nothing too rich or salty).

Keep them away from others, especially children, who may pick up an infection.Be extra careful with everyone’s handwashing.

_Signs of

dehydration

P Less wet nappies.

P More sleepy than usual.

P Dry mouth.

P Sunken fontanelle (thesoft spot on the top ofthe head that is moredipped in than usual).

Try a rehydrating solutionfrom your pharmacist.

35

321Speak to your GP if symptomsshow no sign of improvementafter 24 hours or straight awayif they are newborn.

My baby hasdiarrhoea and isbeing sick.

Have you given them lots ofwater? This will help preventthem becoming dehydrated if itis a tummy bug. Speak to yourpharmacist and ask about arehydrating solution.


36

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.


Earache & tonsillitisA baby’s ears need to be treated with care

37

Looking after yourbaby’s ears

• A baby’s ears need to betreated with care.

• Never use a cotton bud insideyour child’s ear.

• If they have a temperaturewax may ooze out.

• Use different, clean dampcotton wool on each ear togently clean around the outerarea.

• Avoid smoky environments.• Do not use ear drops or oil

unless prescribed by your GP.• If your child is still not hearing

six weeks after infection, yourGP/health visitor can referthem to audiology for ahearing test.

Ear infections are common in babies and toddlers following a cold. A child maypull at their ear, but babies often cannot tell where their pain is coming from, sothey just cry and seem generally uncomfortable.

Babies have some natural protection against infections in the first few weeks - thisis boosted by breastfeeding. In babies and toddlers, bacteria pass from the noseto the ears more easily. Earache can be painful and your child may just need extracuddles and painkillers (such as sugar-free paracetamol or ibuprofen) from thepharmacist.

Tonsillitis - Earache can also sometimes be caused by tonsillitis (inflammation ofthe tonsils). It is a common type of infection in children. Other symptoms include asore throat, coughing and a high temperature. Your child may have swollenglands in the neck - this is the body’s way of fighting infection.

It is not a serious illness and you only need to see your GP if symptoms lastlonger than four days or become more serious with severe pain, difficultyswallowing, a very high temperature or breathing difficulties.

321Most ear infections get better bythemselves. Speak to your GP ifsymptoms show no sign ofimprovement after 24 hours, yourchild seems in a lot of pain or younotice fluid coming from the ear.

My toddler hasearache or a sorethroat but seemsotherwise well.

Have you tried sugar-freeparacetamol or ibuprofenfrom your pharmacist?(See page 6).


38

The glass testThe glass test is a really useful way of spotting suspected meningitis. If yourchild has a cluster of red or purple spots, press the side of a clear drinkingglass firmly against the rash.

In this example the spots are stillvisible through the glass. This is calleda non-blanching rash - it does notfade. Contact a doctor immediately(e.g. your own surgery or Walk-in/Urgent Care Centre). If you cannot gethelp straight away go to A&E.

In this example the spots under theglass have virtually disappeared. It isunlikely to be meningitis but if you are still worried call NHS 111, contactyour GP or go to A&E.

Find out more from www.meningitisnow.org

Go straight to the Accident and Emergency Department

Not common but serious

39

Fever, cold hands and feet

Floppy andunresponsive

Drowsy anddifficult to wake

Spots/rash.Do the glass test

Rapid breathing or grunting

Fretful, dislikesbeing handled

Unusual cry or moaning

GP saysIf any of the signs below are

present contact a doctor.

_

Meningitis & sepsisBabies and toddlers are most vulnerable as they cannot easily fight infectionbecause their immune system is not yet fully developed. They can’t tell you howthey are feeling and can get a lot worse very quickly. Keep checking them.

Meningitis is a swelling around the brain. It is a very serious, contagious illness,but if it is treated early most children make a full recovery.

Sepsis (often called septicaemia or blood poisoning) is a life-threatening conditiontriggered by an infection. The skin may also develop pinprick bruises or largepurple areas, which do not change colour if you roll a glass tumbler over them.This is a common sign of meningococcal septicaemia, a type of blood poisoningcaused by the meningococcus bacteria, which can also cause meningitis.

You should always treat any case of suspected meningitis or septicaemia asan emergency.

Early signs may be like having a cold or flu. Children with meningitis can become seriously ill very fast, so make sure you can spot the signs. Your childmay have a cluster of red or purple spots. Do the glass test. This rash can beharder to see on darker skin, so check for spots over your baby or child’s wholebody as it can start anywhere (check lightest areas first). However, the rash isnot always present - be aware of all the signs/symptoms.

The presence of fever and any other of the above symptoms should be takenextremely seriously. Not all children will show all the signs listed on the right.


40

PainkillersIf your child is in pain or has a hightemperature (fever), you can give themparacetamol. Do not 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 saysDo not forget to keep up-to-date withimmunisations 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 saysIf 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.

ChickenpoxChickenpox is a mild and common childhood illness. Itcauses a rash of red, itchy spots that turn into fluid-filledblisters, which then crust over to form scabs, whicheventually drop off. Some children have only a few spots,while others can have spots covering their entire body. Theseare most likely to appear on the face, ears and scalp, underthe arms, on the chest, tummy and on the arms and legs.

Chickenpox is caused by a virus. It is infectious from one totwo days before the rash starts, until all the blisters havecrusted over. To prevent spreading the infection, PublicHealth England advises to keep children off nursery/schooluntil five days after the onset of the rash.

Your child will probably feel pretty miserable and irritablewhile they have it. They may have a fever for the first fewdays and the spots can be incredibly itchy.

Paracetamol can help relieve fever and calamine lotion orcooling gels help ease itching.

Chickenpox usually gets better on its own. However, somechildren can become more seriously ill and need to see adoctor.

Contact your GP straight away if:• Blisters become infected. • Chest pain or difficulty breathing.

MeaslesMeasles is a very infectious, viral illness which, in rarecases, can be fatal. One in five children with measlesexperience complications such as ear infections, diarrhoeaand vomiting, pneumonia, meningitis and eye disorders.There is no treatment for measles. Vaccination is the onlyway of preventing it, so make sure your child has theirMMR vaccination. Speak to your health visitor.

Symptoms develop around 10 days after you areinfected and can include:• Cold-like symptoms. • Red eyes and sensitivity to light. • A fever. • Greyish white spots in the mouth and throat.

After a few days, a red-brown spotty rash appears. Startingbehind the ears it then spreads around the head and neckbefore spreading to the rest of the body. If there are nocomplications symptoms usually disappear within 7-10 days.

Contact your GP if you suspect that you or your childmay have measles.

Help to make your child comfortable:• Close the curtains/dim lights to help reduce light sensitivity.• Use damp cotton wool to clean eyes. • Give sugar-free paracetamol or ibuprofen. • Ensure they drink lots.

Chickenpox & measles

41Source: www.nhs.uk


42

Symptoms of severe asthmaSymptoms 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 saysThe most important part ofmanaging asthma is for youand your child to know aboutasthma and what triggers anattack. Make sure your child’sasthma action plan is kept upto date.Our practice Asthma Clinicsoffer advice and treatment. Ask about whether your childneeds the flu vaccine.


AsthmaKnow the symptoms

43

GP saysYour GP will normally be able todiagnose asthma by asking aboutyour child’s symptoms, examiningtheir chest and listening to theirbreathing. A peak flow test may beuseful if your child is old enough.Parents should regularly attend theirpractice’s Asthma Clinic to getsupport on better management oftheir child’s asthma at home, as thiswill save unnecessary trips tohospital. Ask your GP or practicenurse to give you an asthma actionplan for your child.All children over six months withasthma who require continuous orrepeated use of a steroid preventerinhaler or oral steroid tablets shouldhave the seasonal flu vaccine.

Asthma has many causes and is a common long-term condition that can bewell controlled in most children. The severity of asthma symptoms variesbetween children, from very mild to more severe. Asthma is more than justwheezing. Other symptoms can be coughing, difficulty breathing and a tight,sore feeling in the chest. Asthma is difficult to diagnose in children under theage of two years as nearly one third of children will wheeze at some point.

The two most common triggers of asthma in children are colds and allergies.In older children allergies become particularly important, so avoiding thetriggers to which your child is allergic may help improve their asthma. Don’t getany pets if your child has asthma and make sure no-one in the house smokes.

A sudden, severe onset of symptoms is known as an asthma attack, it can belife threatening and may require immediate hospital treatment. Make sure youknow how to use your child’s inhaler properly and attend the yearly review withyour GP.

Asthma often runs in families and parents should avoid smoking indoors ornear to their children.

Asthma UK0300 222 5800 www.asthma.org.uk

321Has your child got a personal asthma action plan? See yourpractice’s asthma nurse or GP forregular reviews (read more atwww.asthma.org.uk). If your child hasa serious asthma attack call 999.

My child seems towheeze and cough a lotand it seems to getworse at night. Is there afamily history of asthma?See your GP for advice.

Do you smoke?Try to stop. Donot smoke in thehouse or nearchildren.


44 45

A Better Start Southend is a ten-year research programmeaiming to make Southend the best place in the country tobe a child - and a parent. We want to bring parents, carersand professionals together to develop services for youngchildren and their families, because we believe we will onlybe successful if we work with the people who understandSouthend’s children best.

Southend’s programme combines funding from the BigLottery Fund, Southend–on-Sea Borough Council’s EarlyYears budget and other sources. It is being delivered inpartnership with the Council and the Pre-School LearningAlliance, the largest early years membership organisation in England.

Our key focus is on the following children’s developmentalareas:• Communication and language• Diet and nutrition• Social and emotional

If you’re a parent or carer of a child under four years-old, ifyou’re expecting a baby, or if you work with youngchildren, please take a look at our plans for the future atwww.abetterstartsouthend.co.uk or like us onFacebook www.facebook.com/abetterstartsouthend


46

A healthy lifestyleIt’s never too early

What happens to children before they are born and in their early years can affecttheir health and life opportunities later on. For example, babies that are breastfedhave less chance of getting infections or of becoming obese and thereforedeveloping type 2 diabetes and other illnesses as they get older. Those whogrow up in a caring and safe environment and have a healthy relationship withtheir parents are more likely to do better as they go through life.

If we know how to prevent illness, and encourage healthy behaviour frompregnancy onwards, our children stand a great chance of having a healthy life.

Vitamins are essential nutrients that your body needs in small amounts so that itcan work properly. Even though you can get lots of vitamins from a healthybalanced diet, you still might not get everything you need at certain times in yourlife - such as when you’re pregnant, a new mum or a small child. Ask your healthvisitor about the free Healthy Start vitamin vouchers (see box on opposite page).

If you don’t already live a healthy lifestyle, now is a great time to start.

47

Healthy Start is a government scheme for pregnant women orwomen with children between the ages of 1-4. Women receivevouchers every week to support a healthy diet if they are receivingincome support or other related benefits. The value of thevouchers depends on the number and age of the children. Thevouchers can be used to purchase, plain cow’s milk, fresh orfrozen fruit and vegetables (with no added ingredients), whole orchopped, packaged or loose.Healthy Start vitamin drops can be obtained from the health visitorsat the health centres or children’s centres during child health clinics.All women can purchase vitamins at subsidised prices. Ask your health visitor or GP for details or visitwww.healthystart.nhs.uk

As well as giving your baby a healthy start, you can help supportthem in early experiences and discovering the world around them.During the early months, babies explore and learn using their feetas well as their hands to feel textures and form. Leave their socksoff when you can.

It's also important to spend one-to-one time, giving them yourcomplete attention, without any distractions like the TV or mobilephone.

A healthy weightMany parents are unaware of theserious health implications ofchildren being overweight (orobese) with a greater risk of long-term health problems, includingcardiovascular problems and type 2diabetes. Overweight babies andtoddlers are more than five times aslikely to be overweight as childrenand adults. Good eating andexercise habits need to bedeveloped early in life. Talk to yourhealth visitor about healthy mealideas for all the family.

Being overweight is rarely to dowith a medical problem, and issimply due to an unhealthy diet andnot enough exercise. It is better toprevent your child becomingoverweight in the first place. Goodsleep patterns, a healthy varied dietand regular exercise will all helpkeep your child to a healthy weight.

free fruit,vegetables andvitamins

Start4Life Healthy tipswww.nhs.uk/start4life

321It's much easier to getyour baby on the righttrack now than to tryand change what theyeat later.

Should I give mybaby sweet things toeat and drink, sheloves fruit squash?

Drinks with added sugar areparticularly bad for babies’ teeth -it’s like giving a baby a lolly to suckon all day. Giving your baby a‘sweet tooth’ also means that theyare more likely to keep pesteringand crying for sugary things.


• Limb can appear to be disjointed.• Swelling and bruising.WHAT TO DO:• Don’t let them eat or drink in case they need an

anaesthetic.• Hold an ice pack (frozen peas) wrapped in a tea towel

gently onto the area.• Stabilise a broken arm using a towel as a sling.• Support the limb, especially when in a car, so ask

someone else to drive if possible.• Go to A&E.

FallsFor babies the biggest danger is rolling off the edge of abed, or changing surface. For toddlers it is more aboutfalling from furniture or down stairs.PREVENTION:• Ensure baby cannot roll off any surfaces (use pillows). • Do not put a bouncing cradle or car seat on a surface

where they could wriggle off.• Use stairgates once your child is mobile. Make sure

balconies are locked and fit window safety locks.WHAT TO DO:If your child has a serious fall call 999.

ChokingBabies and toddlers can easily swallow, inhale or chokeon small items like balloons, batteries, peanuts, buttons,plastic toy pieces, strings or cords.

PREVENTION:• Check on the floor and under furniture for small items.• Check that toys are age appropriate and in good

condition. • Find out more about CPR (a first aid technique that is a

combination of rescue breaths and chest compressions.Sometimes called the kiss of life).

WHAT TO DO:If your child is choking act immediately and calmly. Makesure you do not push the object further down the throat.Encourage your child to cough. Use back blows, if theybecome unconscious call for help (do not leave your childalone) and start CPR.

Head injuryOne of the signs of a severe head injury is being unusuallysleepy, this does not mean you cannot let your child sleep.You need to get medical attention if:• They are vomiting persistently (more than three times).• They are complaining it hurts.• They are less responsive to you.• Pain is not relieved by paracetamol or ibuprofen.

If they are tired from what’s happened, or from crying,then it is fine to let them sleep. If you are worried in anyway about their drowsiness, then you should wake yourchild an hour after they go to sleep.WHAT TO DO:Check that they are okay, and that they are respondingnormally throughout the night.

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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 grille

on 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.

PoisoningPoisoning from medicines, household products andcosmetics are common.PREVENTION:Lock all chemicals, medicines, alcohol, batteries andcleaning products away.

WHAT TO DO:Find out what your child has swallowed and take it withyou when you go to A&E.

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. • Do not place a child's cot, bed or highchair near a

window. • Do not hang toys or objects on the cot or bed.• Do not hang drawstring bags where a small child could

get their head through the loop of the drawstring.• Find out more about CPR. WHAT TO DO:Untangle child, call 999 and start CPR.

FracturesA fracture is a broken or cracked bone. PREVENTION:Supervise play, use correct safety equipment (helmet, kneeand elbow pads) for scooters, skateboards and bikes.How do I know if it's broken?• Sometimes it’s obvious and you can see the bone

through the skin.• They are in pain and sometimes shock.

Household accidents

Household accidents

Source: RoSPAFor advice on CPR and dealing with other injuries www.redcrossfirstaidtraining.co.uk


Child Accident Prevention Trust020 7608 3828 www.capt.org.ukCry-sis08451 228 669 www.cry-sis.org.uk

Diabetes UKwww.diabetes.org.ukFamily Lives0808 800 2222 www.familylives.org.ukForeign and Commonwealth OfficeIf you are at risk of FGM. 020 7008 1500La Leche League GB0845 120 2918 available 24 hours7 days a week. www.laleche.org.uk

National Breastfeeding Network Helpline0300 100 0212, 9.30am-9.30pmwww.breastfeedingnetwork.org.uk

National Childbirth Trust0300 330 0700 8am-midnight 7 days a week. www.nct.org.uk

National Domestic Violence Helpline0808 2000 247www.nationaldomesticviolencehelpline.org.uk

NetmumsParenting advice and information. www.netmums.com

NHS Information Service for Parentswww.nhs.uk/start4life

NATIONAL CONTACTS LOCAL CONTACTS

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Southend Information PointFor a range of local family supportnetworks, health providers andsocial activities in Southend. 01702 215007www.southendinfopoint.org

A Better Start SouthendA Better Start Southend aims toimprove the lives of babies andchildren by providing families withopportunities to help their childdevelop, ensure they are ready forschool and have the best start in life. [email protected]

Breastfeeding SupportThere are infant feeding supportgroups throughout Southend.Speak to your midwife, healthvisitor or children’s centre for moreinformation.www.southendinfopoint.org

Child Health ClinicsAsk your GP or contact your localChildren’s Centre to find out aboutbaby clinics.www.southendinfopoint.org

Children’s CentresIf you need parenting support,social support, job centre advice,food bank or baby bank, pop intoyour local Children’s Centre - theyprovide you with support or pointyou in the right direction of localservices to help you.To find your nearest children’scentre visitwww.southendinfopoint.org

Healthwatch SouthendMake sure your views on localhealth and social care are heard.01702 356066info@healthwatchsouthend.co.ukwww.healthwatchsouthend.co.uk

Free Two Year Old EducationSome two-year-olds in Southendcan get up to 15 hours a week offree early education and childcare.Your child will get to make newfriends, try different activities, learnthrough play and have fun. To findout if you are eligible and to apply,visit www.southend.gov.uk

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Everyone agrees that the earliest years in a child’s life are important asthey provide the foundation for everything else that follows.

We know that you want to encourage and support your child to achievetheir potential as curious, confident and secure individuals. Learning isalso about your child being social, aware of the world around them andhaving the language in which to express themselves.

There are a wide range of services in Southend that can work inpartnership with you and your family to achieve this including early yearsproviders (for instance childcare, childminders and children’s centres).

How can I help my child learn?There are a wide range of ways you can help your child learn. If your childis with an early years provider, they will work in partnership with you tosupport you in this (for example through the Early Years Foundation StageFramework). Depending on the age of your child some of the ways thatyou can help are by:• Encouraging them to explore new places and to meet new people;• By getting them into a regular routine at bedtime;• Encouraging them, if they are able, to go to the toilet independently; and• Reading stories together and looking at and talking about picture books.

Developmental AssessmentThere are a range of ways in which youcan support your child’s learning. One ofthese ways is through the Ages andStages Questionnaires offered throughyour health visiting team. In Southend youmay also be offered (or can request) otherassessments such as communicationsand language. These are family friendly,and can be used from when your child isone month, all the way up to 5½ yearsdepending on the assessment.

The benefits for you are as follows:• They will highlight your child’s strengths;• They will support your understanding of

your child’s development;• They will indicate any potential

additional support that you might needto help your child’s learning; and

• They can be done in a variety of settings depending on your preference;

• They will not take up much of your time.

Your child’s learning& development

All factual content has been sourced from Department of Health, NHS Choices, British Association of Dermatologists,Meningitis Now and NICE guidelines. This information cannot replace specialist care.


Documents

1609-Southend CCI.qxp 6521-Cornwall · 2017. 6. 19. · Alison Clare, Interim Director, A Better Start Southend 1609-Southend CCI.qxp_6521-Cornwall 26/09/2016 11:22 Page 3. Health