Your guide on looking after a sick child at home

Deborah Evans, Fellow of the Royal Pharmaceutical Society and mother of four, offers her expert advice on how to keep your child comfortable when they’re home sick from school or nursery.

The decision on whether to keep your child home from nursery, school or childcare can be a tough call for a parent.

If you’ve made the decision to keep your child off school, it can sometimes be difficult to know how to comfort them, which can take its toll on you. So, I’ve created a guide to help support you when your child is unwell at home.

If your child has a fever

Keeping your child cool is important if they are developing a fever – this can be counter-intuitive when they are complaining of feeling cold, but if their temperature is rising then piling on the blankets will just make it worse. If your child has a temperature of 38 °C or above, it will more often than not be deemed a fever.[1] Avoid over or under dressing your feverish child and keep the central heating down. You may want to retake their temperature over the course of the day, checking your child in case they show signs of a more serious illness.[2]

Top tip: A child with a fever should be kept away from school or nursery. It’s a very common and normal response to illness and should last no longer than five days.

If your child isn’t eating

It’s normal for your child to lose their appetite when they’re unwell. Ensure they keep hydrated with plenty to drink but otherwise don’t worry too much about them not eating. It is best to be guided by them – and they’re likely to be eating normally again soon!

For the first day or so, don’t worry about getting them to eat unless they want to. After that, start trying to tempt them with stomach-soothing foods such as pasta, chicken soup, mashed potatoes, cereals, crackers and peanut butter sandwiches (assuming they don’t have peanut allergies). It’s best to avoid sugary foods, foods with a high fat content and anything highly spiced. Encourage them to have nutritious drinks like milk. If your child has a sore throat then dilute fruit juices and, if they are old enough, add ice cubes.

Top tip: If your child is under eight weeks old and doesn’t want to feed, seek medical advice.

If your child is vomiting

Looking after any sick child can be exhausting, and especially so if they are being sick. It can be particularly distressing for the child but also the parent.

If your child is old enough, give them a bowl so they can take control when they are being sick without having to rush to the bathroom. Stay with your child and ensure they get plenty of rest and drink lots of fluids, such as water or squash, but only taking small sips at a time.

For babies, carry on with breast or bottle feeds but try giving them smaller, more frequent feeds. Babies on formula or solid foods should also be offered small sips of water between feeds.

If your child is in discomfort, you may want to give them infant paracetamol. Be aware that ibuprofen may further irritate an empty stomach. Oral rehydration solution is suitable for children over two years old to help prevent dehydration, or if recommended by a doctor. 

If the vomiting has been caused by a bug then it’s important to be extra careful with personal hygiene, such as washing hands, to ensure the whole family doesn’t go down with it.

If your child doesn’t feel ‘themselves’

When my children were ill, I did what I could to keep them quiet and calm, encouraging them to rest. My recommendation would be to avoid over-stimulating your children. You want their immune system to be supported to enable them to get better quickly and you also don’t want staying home when ill to feel like a treat.

When your child is starting to recover but still not well enough to go to school, quiet activities such as reading together, watching a DVD, and drawing are often should be enough to keep them occupied.

When to call a doctor

Most conditions can be treated at home and will get better by themselves. Trust your instincts as you know best when something is not right but there are situations when it’s important to seek medical advice immediately. These include:

• High fever with body temperature over 38°C in children aged nought to three months or over 39°C in children aged three to six months. Seek medical advice if your baby has a high temperature but cold feet and hands, or is less than 8 weeks old
• Vomiting repeatedly or bringing up dark-green vomit
• Your child looks pale, ashen, mottled or blue
• Your child doesn’t respond normally, wakes only with difficulty, is less active, doesn’t smile, appears ill or cries in an unusual way, appears disorientated or confused
• Your child is breathing unusually or with difficulty, for example breathing much faster than usual or panting
• Your child is crying constantly, and you cannot console or distract them, or the cry does not sound like their normal cry
• You notice a new rash that doesn’t fade on pressure (press a tumbler against the rash to see if it goes)
• Your child has any other unusual symptoms and signs you can’t explain.

If your child has a fever for more than five days, it is advisable to seek advice from your GP or Health Visitor. Alternatively, you could call 111.[3]

Call 999 for an ambulance if your child:

• stops breathing or won’t wake up
• is under eight weeks old and you’re very worried about them
• has a fit for the first time, even if they seem to recover
• has a severe allergic reaction (anaphylaxis)
• if you think someone may have seriously injured your baby

Deborah Evans is considered a national pharmacy leader and is an elected member of the English Pharmacy Board and Fellow of the Royal Pharmaceutical Society. Deborah does not endorse any medicine brands or products.