1553-West Leicester CCI:6521-Cornwall

1553-West Leicester CCI:6521-Cornwall
1553-West Leicester CCI:6521-Cornwall
Page 1
A Guide
This handbook has been produced by:
West Leicestershire Clinical Commissioning Group,
NHS East Leicestershire and Rutland Clinical Commissioning Group
NHS Leicester City Clinical Commissioning Group
This booklet is available online and in other languages visit:
Every effort has been made to keep the information in this booklet up-to-date and accurate. However, we cannot guarantee
that inaccuracies won’t occur. West Leicestershire Clinical Commissioning Group, East Leicestershire and Rutland Clinical
Commissioning Group, Leicester City Clinical Commissioning Group their employees or partner agencies won’t be held responsible
for any loss, damage or inconvenience caused as a result of reliance on such information.
Sense Interactive Ltd, Maidstone. © 2014 All Rights Reserved. Tel: 01622 752160 www.sensecds.com
FOR PARENTS AND CARERS of children aged birth-5 years
health and
1553-West Leicester CCI:6521-Cornwall
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If a child in your care is ill or injured, choose from the following services available:
Grazed knee,
sore throat,
coughs and colds
Self Care
You can treat minor illnesses and injuries at home
by using the recommended medicines and
making sure they get plenty of rest www.nhs.uk.
As a parent if you are:
need help
NHS 111
For 24 hour health advice
and information.
Ring NHS 111 when it is less urgent than 999
Tel: 111
Mild diarrhoea, mild skin
irritations (including spots/rash),
mild fever
For advice on common
illnesses, injuries and
To find your local pharmacy and its contact
details visit: www.nhs.uk/chemist
Teething problems, tooth brushing
and dental care, preventing
dental decay
For advice, prevention and
treatment of dental decay.
To find your local NHS dentist: visit NHS Choices
website at www.nhs.uk/dentists or call your local
Healthwatch on 0116 2574 999
High temperature, head injuries
not involving loss of
consciousness, persistent cough,
worsening health conditions,
minor bumps, cuts and possible
fractures, dehydrated, headache,
tummy pain
Doctor or
Walk-in Centre (when
your surgery is closed)
For the treatment of illnesses
and injuries that will not go
Unexpected and sudden sickness,
severe pain, worsening health
conditions (outside GP hrs)
Urgent Care
When you need healthcare
in a hurry 24 hours a day.
Choking, loss of consciousness,
fitting, broken bones
A&E or 999
For very severe or life
threatening conditions.
Doctor/Walk-in Centre
Write your Doctor’s (family doctor) telephone
number here:
Who can help?
A guide to services
Know the basics
The first months
Feeding your baby
Being sick
Nappy rash & dry skin
Sticky eyes & conjunctivitis
Teething trouble
A&E/Urgent Care Centre
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.
General welfare
Common childhood illnesses
Rashes & chickenpox
Coughs, colds & flu
Wheezing & breathing difficulties
Upset tummy
Household accidents
How to resuscitate a child
Bumps & bruises
Burns & scalds
Domestic abuse
Children in shape
School readiness
Sleeping difficulties
Smokefree homes
Good oral health
Sun safety
Useful contacts
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A guide to services
Many illnesses can be treated in your home by using
over the counter medicine from your Pharmacist and
getting plenty of rest. Self-care is the best choice to
treat very minor illnesses and injuries. If you are still
worried contact NHS 111 or your Doctor.
If you think you need help urgently
during the day or night you should call
111 before you go to any other health
service. By calling 111 you will be directed straight
away to the local service that can help you best. It is
available 24 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 Doctor’s surgery hours.
• When you do not know who to call for medical help.
• If you do not have a local Doctor to call.
Doctor or GP
You will need to register with a
local GP practice. The surgery
will have a range of services;
find out about them from:
• Surgery reception
• Leaflets in the surgery
• Surgery website
You will usually need to make
an appointment but you can
get initial telephone advice from
a Doctor or Nurse.
Out of hours (6.30pm-8.00am)
cover is provided by the GP
out-of-hours service. Ring the
usual surgery number and
follow the instructions or
telephone 0845 0450 411.
Your local Pharmacist
knows about most
everyday health issues.
They can suggest the
best medicine to help.
There are often
pharmacies in
supermarkets and
many are open late.
Your Midwife can also
give you help. They
will support you
during pregnancy and
up to 14 days after
the birth. Your Health
Visitor will then take
over your care.
Health Visitor
Children’s Centres
Your Health Visitor will
know you and your baby
well. They are there to
support you when you
need them. They will visit
you at home or see you
in a clinic and can offer
support and advice and
can tell you where to get
extra help if you need it.
They are part of a team
of Nurses and Nursery
Contact No:
Children's Centres are for
families with children under five.
Together the centres offer a wide
range of services including:
• Health Visitors
• Midwifery services
• Play sessions for children
• Parenting support (including
support for teenage parents)
• Services for disabled children
• Speech and language support
Many centres also provide high
quality early learning and
Urgent Care
If your GP practice is
closed and you have a
minor injury or require
urgent care you can visit
an Urgent Care Centre or
Walk-in Centre.
They provide convenient
access to a range of
treatments for minor
illnesses and injuries that
don’t need an
appointment or a trip to
A&E and the 999
ambulance service are
only for critical or life
threatening situations.
This includes things like
major head injuries,
severe bleeding, burns,
broken bones, breathing
difficulties, severe allergic
reactions or if you are
really worried. You do
not need an
appointment but may
need to wait. Some
hospitals have separate
A&E facilities for children.
NHS dental care is FREE until the age of 18. NHS dental care is also FREE for
ALL pregnanct mothers AND for 12 months after birth. Take children to see
the Dentist AS SOON AS the first baby tooth shows in the mouth. Take your
child to the Dentist REGULARLY, not just when in pain.
1553-West Leicester CCI:6521-Cornwall
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Know the basics
Being prepared and knowing the signs
Types of thermometer
As a general rule, in children, a temperature
of over 37.5°C (99.5°F) is a fever.
Digital thermometers are quick to use,
accurate and can be used under the arm (always
use the thermometer under the arm with children
under five years old). Hold your child’s arm
against their body and leave the thermometer in
place for the time stated in the instructions.
Ear thermometers are put in the child’s ear.
They take the temperature in a few seconds and
do not disturb the child, but they can be expensive
to purchase. Ear thermometers may give low
readings when not correctly placed in the ear.
Read the instructions carefully.
We do not advise using strip or mercury
Source: www.nhs.uk
Parents are usually good at noticing when something is wrong with their
baby/child from quite early on. It is normal to worry that you won't recognise the
signs that your baby is unwell. Trust your instincts, you know your baby best.
Learn how to spot the signs of serious illness and how to cope if an accident
happens. If you know the basics and you are well prepared, you will find it easier
to cope - and less scary. Keep a small supply of useful medicines in a locked
cabinet or somewhere up high where a child cannot reach them. There is a useful
list in the box on the right, of things to have at home just in case. Make sure
you’ve got the right strength of medicine for the age of your child, always follow
instructions carefully and check use by dates. Read the label carefully.
If your baby seems to have a serious illness it is important to get medical attention
as soon as possible.
Pharmacist says
Keep a small supply of useful
medicines. Include things like:
Liquid painkillers
(e.g. paracetamol or
Barrier cream
My baby is crying
more than usual
and seems to be
irritable and hot.
Source: NHS choices
Is there a fever, have you
checked their temperature? Look
at ‘normal temperature level’ on
left. Have you tried paracetamol?
Remember to check the label to
give the right dose.
If you have tried this and it
has not worked see your
Pharmacist. If temperature
is 38˚C or above coupled
with a rash, contact your
Doctor immediately.
Natural oils
like olive oil or almond oil
(for dry skin)
1553-West Leicester CCI:6521-Cornwall
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Hold your baby’s whole body
close with their nose level
with your nipple to help them
attach correctly.
There are lots of different positions for breastfeeding. You just need
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 be able to
tilt their head back easily.
Source: County
Health Partnerships
Let your baby’s head tip back
a little so that their top lip can
brush against your nipple.
This should help your baby to
make a wide open mouth.
When your baby’s mouth
opens wide, their chin is able
to touch your breast first,
with their head tilted, so that
their lower lip can make
contact with the breast 2-3cm
below the nipple.
With their chin firmly touching
and their nose clear, their
mouth is wide open and
there will be much more of
the darker skin visible above
your baby’s top lip than
below their bottom lip. Your
baby’s cheeks will look full
and rounded as they feed.
Feeding your baby
The best start in life
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, and
stimulates mothering hormones which helps to form a close bond. Baby’s immediate
needs are to feel safe and secure, and to be able to feed whenever hungry. Holding
your baby close to feed, and responding to all of baby’s needs encourages healthy
brain connections. Most of this development will occur within the first two years.
Responsive parenting will enable your baby to reach its full potential, to be able to
form good relationships and communicate well, giving them the best start in life.
Sterilising and bottle hygiene
• The cleaning and sterilising instructions are the same, whether you are using
expressed breastmilk or infant formula milk.
• All the equipment you use for bottle feeding your baby needs to be washed in
hot soapy water, rinsed and sterilised.
• 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.
Are your nipples
sore? If yes, please
ask for help as
soon as possible.
Have you been shown
how to hand express?
This is a really useful
skill, and it’s free!
Source: UNICEF UK Baby Friendly Initiative 2010
Go to your local Breastfeeding Support
Group, usually held at a Children’s
Centre, call 0300 3000 103 for details.
Other mums and Peer Supporters will
be there to give you lots of tips.
Midwife says
How to tell your baby is having
enough milk:
• Lots of wet heavy nappies around 6 in 24 hours.
• Soiled nappies, 2-3 soft
stools per day.
• Baby is content and settled
during and after each feed.
• During a feed, you can hear
baby swallowing.
• Weight gain - which will be
checked by your Midwife or
Health Visitor.
Remember, your milk fulfils all
of your baby’s needs for around
6 months, after which you can
start to offer food, alongside
breast milk. Cow’s milk should
not be offered until your baby
reaches its first birthday.
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Being sick
A problem likely to get better on its own
It is common for babies to be sick, often in the early weeks as they get used to
feeding and their bodies develop. Possetting is bringing up small amounts of milk,
when your baby vomits this will be a much larger amount. It can be frightening for
your baby, so they are likely to cry. Lots of things can cause your baby to be sick.
Health Visitor says
Possetting is ‘normal’ during
or after a feed. If this carries
on at other times, between
feeds it may be a tummy
bug. It is important for babies
to have plenty of fluids to
stop any dehydration.
Make sure your baby is positioned correctly when breast or bottle feeding as
incorrect positioning can cause a baby to be sick.
Being sick often or lots of it, may be due to ‘gastric reflux’ where acid from the
tummy can come up again. Babies can be grumpy and it can sometimes lead to
poor feeding. If your baby is feeding well but doesn't seem themselves, you may
just need to change the baby's position during a feed to make them more upright.
Feeding smaller amounts and more often may also help.
I have a new baby.
I have just given
my baby a feed.
They always seem to bring
up small amounts of milk.
This is known as
‘possetting’. As they
develop it will stop
naturally. Talk to your
Health Visitor or Midwife.
Doctor says
After the first few months, if
your baby is suddenly sick it is
more likely to be caused by a
stomach virus rather than
possetting. Gastroenteritis is a
tummy bug (see Upset tummy
page 34), which can come
with diarrhoea (runny poo).
This is more serious in babies
than older children because
babies easily lose too much
fluid from their bodies and
become dehydrated. If they
become dehydrated they
may not pass enough urine,
lose their appetite and have
cold hands and feet.
Get expert advice. If your
baby is unwell, or if vomiting
has lasted more than a day,
get your Doctor’s advice
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Understanding why
Health Visitor says
Know your baby. Try to
understand what it is they need.
Finding out why your baby is
crying is often a matter of going
through all the possible options.
Things to check first are:
Does their nappy need
Could they be hungry?
Could they be too hot?
Could they be too cold?
Does their cry sound
Are they uncomfortable?
These are simple things which
could be causing your baby
to cry.
All babies cry, especially in the first few weeks after birth. Crying is their way of
letting you know they need something or are uncomfortable. They may need
changing, they may be hungry or just need a cuddle. Always burp your baby after
a feed as this will help.
If your baby cries suddenly and often, but they otherwise appear to be happy and
healthy, they may have colic. Colic is common and although uncomfortable it is not
serious and usually affects babies only in the first few months of their lives. The
most common symptom of colic is continuous crying, which typically occurs in the
late afternoon or evening. Other signs include a flushed appearance, drawing their
legs to their chest, clenching fists, passing wind and trouble sleeping.
When a baby cries, it can be upsetting. It is very important to stay calm and don’t
be afraid to ask for help. Do not shake your baby.
My baby is crying more
than usual.
Have you followed the
advice given by your Health
Visitor? Have you thought
about what your baby is
trying to tell you, it may be
something really simple.
If you have tried this and it
has not worked speak to
your Health Visitor, or
contact your Doctor if you
are worried.
Doctor says
If your baby's crying seems
different in any way (such as
a very high-pitched cry or a
whimper), then seek medical
advice. Trust your instincts you know your baby best.
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Health Visitor’s
nappy rash tips
Health Visitor’s
cradle cap tips
This is the name given to the
yellowish, greasy scaly patches on
the scalp of newborns and usually
appears in the first 3 months. It can
look like a bad case of dandruff and
clears up over time without causing
your baby discomfort.
Wash scalp gently every
day using luke warm water.
Use a small amount of
natural oil (vegetable oil)
on the scalp and leave on
for 15 minutes before
washing off with luke
warm water.
It is important not to pick at the
scales as this may cause infection.
Nappy rash & dry skin
Leave your baby in a
warm, safe place with no
clothes or a nappy on, to
let the air get to their skin.
A common problem that’s easy to treat
Use a barrier cream.
A nappy rash causes your baby's skin to become sore. The skin in this area may be
covered in red spots or blotches. You might need to change their nappy more often.
(see Pharmacist says box
Remember to change and
check their nappy often.
Nappy rash is very common and can affect lots of babies. It is usually caused when
your baby's skin comes into contact with wee and poo that collects in their nappy.
Most nappy rashes can be treated with a simple skincare routine and by using a
cream you can get from the Pharmacist. With a mild nappy rash, your baby won't
normally feel too much discomfort.
Dry skin
A baby’s skin is thinner and needs extra care. Dry, flaky skin, some blemishes,
blotches and slight rashes are normal in newborns and will naturally clear up. If
your baby is otherwise well but has a rash you are worried about contact your
Midwife, Health Visitor or Pharmacist.
There is a red, sore rash
around the nappy area.
Baby is uncomfortable and
cries a lot.
Has baby been in a dirty
nappy for a long time?
Have you followed advice
from your Health Visitor, or
spoken to your Pharmacist?
Change nappy often.
Speak to your Health
Visitor and if you are
worried see your Doctor.
Pharmacist says
Call in and talk to us about
creams we can provide you
with over the counter.
There are two types of nappy
cream available. One is a
barrier cream to keep wee
away from your baby's skin.
The other is a medicated
cream, that is good for clearing
up any soreness
but should only be used when
advised by a health
professional e.g. Health Visitor
or Pharmacist.
1553-West Leicester CCI:6521-Cornwall
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Sticky eyes & conjunctivitis
Two different issues
‘Sticky eyes’ are common in newborn babies and young children while their tear
ducts are developing. You may see some sticky stuff in the corner of the eyes or
their eyelashes may be stuck together.
It normally clears up on its own, but you may have to clean your baby's eyes
regularly with damp cotton wool. Use clean, cooled boiled water.
Wipe each eye from the corner by the nose outwards. Use a clean piece of cotton
wool for each wipe. Remember to wash your hands before and afterwards and
avoid sharing towels to prevent spreading infection.
Is there discharge in the
corner of your baby’s eye
and do their eyelashes
appear to be stuck
Source: DoH 2006.
Sticky eyes is a common
condition that affects most
babies, speak to your
Health Visitor.
Use cooled boiled water on
a clean piece of cotton
wool for each wipe.
Doctor says Conjunctivitis
The signs of ‘sticky eyes’ can
sometimes be confused with an
infection called ‘conjunctivitis’.
With conjunctivitis the signs are
yellowy, green sticky goo which
comes back regularly. If you
notice this, contact your Health
Visitor or Doctor. This can be
passed on easily, so wash your
hands and use a separate towel
for your baby.
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Teething trouble
Every baby goes through it
Health Visitor says
It can help to give your baby
something hard to chew on,
such as a teething ring.
Teething rings give your baby
something to safely chew on,
which may help to ease their
discomfort or pain. Some
teething rings can be cooled
first in the fridge.
All sorts of things are put down
to teething - rashes, crying, bad
temper, runny noses, extra dirty
nappies - but be careful not to
explain away what might be the
signs of illness by saying it’s
‘just teething’.
Source: DoH Birth to five edition 2009.
The time when babies get their first primary teeth (milk teeth) varies. Very few are
born with a tooth already, whilst others have no teeth at one year. Teeth generally
start to show when a child is four to nine months old, although every baby
develops at their own pace. This is known as ‘teething’. Some babies show few
signs while others find it more uncomfortable. Some teeth grow with no pain or
discomfort at all. At other times you may notice that the gum is sore and red
where the tooth is coming through, or that one cheek is flushed. Your baby may
dribble, gnaw and chew a lot, or just be fretful.
Some people attribute a wide range of symptoms to teething, such as diarrhoea and
fever. However, there is no research to prove that these other symptoms are linked.
You know your baby best. If their behaviour seems unusual, or their symptoms
are severe or causing you concern, talk to your Health Visitor. Source: www.nhs.uk
If babies have pain or discomfort they can be treated with a painkiller that is
available from your Pharmacist. This will help ease any discomfort your child has.
Always tell your Pharmacist about other treatments you have given your baby. The
medicine will contain a small dose of paracetamol and should be sugar free.
My baby has red
cheeks and seems
a bit frustrated
and grumpy.
Have you asked your Health
Visitor about teething?
Have you discussed options
with your Pharmacist?
Source: DoH Birth to five edition 2009.
Try some of the gels or paracetamol
available. If you are worried and
things do not feel right contact your
Health Visitor or Doctor or Out-of hours helpline 0845 840 0065.
Dentist says
Talk to your Dentist about your
child’s tooth care routine. They
can show you how to brush
your baby’s teeth with a soft
baby toothbrush and a smear
of family toothpaste. Make sure
you see a Dentist regularly and
take your baby with you, too.
NHS dental care is FREE for
ALL pregnant mothers AND for
12 months after birth. NHS
dental care is also FREE until
the age of 18. Ask your Dentist
to brush on FLUORIDE
VARNISH for added protection
against tooth decay (for
children aged 3 and above) IT’S FREE!
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Rashes & chickenpox
Baby skin needs extra care
Chickenpox is a mild disease
that most children catch at
some point.
Chickenpox is easy to pass
on to someone who has not
had it before. If your child has
chickenpox keep them away
from others.
If you are pregnant and have
had chickenpox in the past it
is likely that you are immune
to chickenpox. However,
please contact your Doctor or
Midwife for advice.
A baby’s skin is thinner and needs extra care. Dry, flaky skin, some blemishes,
blotches and slight rashes are normal in newborns and will naturally clear up. If
your baby is well but has a rash you are worried about contact your Midwife or
Health Visitor. Another common rash for babies is heat rash. This mainly appears
on the head and neck as tiny red spots and is nothing to worry about. Keep them
warm but not hot and try to dress them in natural cotton clothes, with nothing that
can rub on their skin.
Your baby may also suffer from something called cradle cap. This is the name
given to the yellowish, greasy scaly patches on the scalp of newborns and usually
appears in the baby’s first three months. It can look like a bad case of dandruff
and is harmless, it doesn’t cause any irritation to your baby and usually clears up
by the time they are two years old.
Your baby’s skin may be
flaky and dry.
Dry skin is common in
newborn babies, as their
skin is 15 times thinner
than that of an adult.
Avoid soap and
using products on your
baby’s skin. Wash your
baby in clean water.
The above information cannot replace specialist treatment. If you are worried contact your Doctor.
Doctor says
Go to A&E immediately if your
baby has a rash that does not
disappear when you press a
glass to it. This may be a sign
of meningitis and needs to be
seen by a Doctor no matter
how well your baby seems.
Call 999 or go to A&E if your
baby has a rash and a high
temperature or vomiting (see
page 30 for more information
on meningitis).
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Coughs, colds & flu
My child keeps coughing and
sneezing, has a mild temperature
and seems generally unwell.
Not usually serious
Have they recently started
nursery? Catching colds is
very common. Have you
spoken to your Pharmacist
about paracetamol and
cough medicines?
You will probably find when your child goes to playgroup or nursery that they get
lots of coughs, colds and sniffles. There are some good things about this though
as it helps the body build up a natural immune system.
If symptoms last for more
than 10 days or your child
is coughing up yellow ‘goo’
they may have an infection.
Contact your Doctor.
Most bugs will run their course without doing any real harm because they will get
better on their own. An annual nasal spray flu vaccine is available for all children
aged two and three as part of the NHS Childhood Vaccination Programme. Ask
your Health Visitor.
Flu can be more serious than a cold and leave your child feeling quite unwell. Flu
tends to come on more suddenly and severely than a cold. Your child may feel
achy and uncomfortable, and be ill for a week or more.
Paracetamol - can be given to children for pain or fever.
Check you have the right product, dose and strength for your
child’s age. Read the box carefully.
Ibuprofen - can be given to babies and children of 3 months
and over who weigh more than 5kg. Read the box carefully.
Avoid if your child has asthma unless advised by your Doctor.
Do not give paracetamol and ibuprofen at the same time.
If your child is still distressed you could consider changing to
the other drug when the next dose is due.
Aspirin - do not use for children under 16.
Don't pass it on:
Catch it Germs spread easily. Always carry
tissues and use 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 you
touch. Clean your hands as soon as you can.
Things you can do at home to help:
Give your child lots to drink.
Try paracetamol (not aspirin).
Keep them away from smoke and anyone who smokes.
Talk to your Pharmacist but remember that coughing is the body’s way of
keeping the lungs clear.
See your Doctor if:
Your baby has a temperature of 38˚C or more.
They have a fever with a rash.
They are not waking up or interacting.
Your child is finding it hard to breathe.
Pharmacist says
Children can often be treated
using over the counter
medicines to help to bring
down a raised temperature
and ease discomfort.
Paracetamol and cough
medicines can help. Check the
label carefully. Some are
available as a liquid for children
and can be given from the age
of about three months. Check
with the Pharmacist and tell
them how old your child is.
Flu symptoms are more severe
and you may need to see your
1553-West Leicester CCI:6521-Cornwall
Bronchiolitis is a common
respiratory tract infection that
affects babies and young
children under a year old. The
early symptoms are similar to
those of a common cold and
include a runny nose and cough.
Page 25
My child has a distinctive
barking cough and makes a
harsh sound when they breathe
in. This is known as croup.
Comforting your child is
important as symptoms may
worsen if they are agitated or
crying. Mild cases of croup can
be managed at home. If your
child has a fever, paracetamol will
help lower their temperature and
ease discomfort from coughing.
As it develops, the symptoms
of bronchiolitis can include: A
slight fever, a persistent cough
and difficulty feeding.
Symptoms usually improve
after three days and in most
cases the illness isn’t serious.
However, contact your Doctor
or Health Visitor if your child is
only able to feed half the
normal amount or is struggling
to breathe, or if you are
generally worried about them.
Source: www.nhs.uk/conditions/
Some people have found that
allowing their child to breathe
in steam from a hot bath or
shower in a closed room has
eased symptoms. Make sure
the water isn't too hot as it
will scald the skin. If
symptoms get worse
contact your Doctor.
Wheezing &
breathing difficulties
Look at the signs
Any kind of breathing difficulty your infant or child experiences can be scary for
parents. It may be nothing to worry about and could just be normal baby ‘snuffles’.
Use your instincts with newborns and babies. It could be:
• Rapid breathing or panting, which is common. 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 which 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 22 Coughs, colds & flu).
• Croup (hoarse voice, barking cough) needs to be assessed by a Doctor and
may need treating with steroids.
• Child appears pale.
If you’re worried about your child wheezing or having breathing difficulties even
after reading this, contact your Doctor or call 999 immediately.
Source: NHS Choices - Symptoms of bronchiolitis
Doctor’s tips
Get help and contact your
Doctor now if your child:
Seems to find breathing
hard work and they are
sucking in their ribs and
They can’t complete a
full sentence without
stopping to take a breath.
Get help and call 999 or
take them to A&E now if:
Their chest looks like it is
‘caving in.’
They appear pale or even
slightly blue-ish.
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Know the symptoms
Asthma is a common long-term condition that can be well controlled in most
children. The severity of asthma symptoms varies between children, from very
mild to more severe. Parents learn how to be prepared and how to recognise
symptoms and deal with them.
Health Visitor says
Smoking during pregnancy or
around your child can increase
risk of asthma. Breastfeeding
for as long as possible can help
reduce risk of getting asthma.
Symptoms of severe
Symptoms include repeated
coughing and wheezing,
shortness of breath and
bringing up phlegm.
Symptoms often get worse
at night.
Asthma affects the airways and makes it difficult to breathe and causes wheezing,
coughing, shortness of breath and can make the chest feel tight.
A sudden, severe onset of symptoms is known as an asthma attack. Asthma
attacks can sometimes be managed at home but may require hospital treatment.
They are occasionally life threatening.
Triggers can include exercise (especially in cold weather), an allergy with dust
mites, animal fur, grass and tree pollen or exposure to air pollution, especially
tobacco smoke or a cold virus. Asthma often runs in families.
Call 999 to seek immediate medical assistance if your child has severe
symptoms of asthma.
My child seems to
wheeze and cough
a lot, it seems to
get worse at night.
Have you tried reducing any possible
amounts of dust around the home?
Do you smoke? Have you discussed
with your Health Visitor?
Source: Department of Health, Birth to five 2009
If symptoms persist
see your Doctor. If
your child has a
serious asthma
attack call 999.
Doctor says
Your Doctor will normally be able
to diagnose asthma by asking
about your child’s symptoms,
examining their chest and
listening to their breathing. They
will want to know about your
child’s medical history and
whether there is a history of
allergic conditions in your family.
They will also want to know
about the circumstances
surrounding the onset of your
child's symptoms, such as
when and where it happened,
because this could help to
identify the possible trigger(s) of
their asthma.
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Babies under 6 months:
Always contact your Practice Nurse,
Doctor or Health Visitor without delay if your baby has other signs of illness, as
well as a raised temperature and/or if
your baby’s temperature is 38 ̊C (102 ̊F)
or higher.
Older children:
A little fever isn’t usually a worry.
Contact your Doctor if your child seems
unusually ill, or has a high temperature
which doesn’t come down.
• Make sure they are not too hot from
too many clothes or blankets.
• Give liquid paracetamol in the correct
recommended dose for your child.
• It is important to ensure your child
drinks as much fluid as possible.
• Keep the room at a comfortable
temperature (18 ̊C).
• Aspirin should not be given to children
for treatment of pain or a fever.
• Please ask your local Pharmacist to
advise about medicines.
Common in young children
As a general rule, in children, a temperature of over 37.5°C (99.5°F) is a fever. Your
child may also feel tired, look pale, have a poor appetite, be irritable, have a
headache or other aches and pains and feel generally unwell.
A fever is part of the body’s natural response to infection and can often be left to
run its course provided your child is drinking enough and is otherwise well. It is
important to prevent your child from becoming dehydrated, which can lead to
more serious problems. As a guide, your child’s urine should be pale yellow - if it
is darker, your child may need to drink more fluids.
Fevers are common in young children. They are usually caused by viral infections
and clear up without treatment.
Always seek medical advice if your child develops a fever soon after an operation,
or soon after travelling abroad.
My baby/toddler is
hot and grumpy.
Are they wearing too many clothes?
Are they sleeping under too many
blankets? Have you tried liquid
paracetamol? Have you made sure
they are drinking lots of fluids?
Source: DoH Birth to five edition 2009.
If their temperature
remains over 38˚C and
doesn’t come down,
contact your Doctor.
Doctor’s tips
These are things you can do at
home to help:
• Keep them comfortable give regular paracetamol as
directed on the bottle.
• Children with fever should not
be left in light clothing.
• It is important to ensure your
child drinks as much fluid as
1553-West Leicester CCI:6521-Cornwall
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A serious, contagious illness
The glass test
The glass test is a really useful way of spotting suspected meningitis. If your
child has a cluster of red or purple spots, press the side of a clear drinking
glass firmly against the rash.
Go straight to the Accident and
Emergency Department
Babies and toddlers are most vulnerable as they cannot easily fight infection
because their immune system is not yet fully developed. They can’t tell you how
they are feeling and can get a lot worse very quickly. Keep checking them.
In this example the spots under the
glass have virtually disappeared. It is
unlikely to be meningitis but if you
are still worried contact NHS 111,
your Doctor or go to A&E.
Source: Meningitis Now
If any of the signs below are
present contact a Doctor.
You should always treat any case of suspected meningitis as an 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 child
may have a cluster of red or purple spots. Do the glass test. This rash can be
harder to see on darker skin, so check for spots over your baby or child’s whole
body as it can start anywhere (check lightest areas first). However, the rash is
not always present - be aware of all the signs/symptoms.
In this example the spots are still
visible through the glass. Contact a
Doctor immediately. If you cannot get
help straight away go to A&E.
Doctor says
Meningitis is a swelling around the brain. It’s a very serious, contagious illness
which can sometimes get confused with other more common illnesses, but if it’s
treated early most children make a full recovery.
Fever, cold hands
and feet
Floppy and
Drowsy and
difficult to wake
Do the glass test
Rapid breathing
or grunting
Fretful, dislikes
being handled
The presence of fever and any other of the above symptoms should be taken
extremely seriously. Not all children will show all the signs listed on the right.
My child is showing
some of the signs
of meningitis.
Have you tried
the glass test?
Treat all cases of suspected
meningitis as an emergency.
If the spots do not fade under
pressure call 999 or go to A&E.
Unusual cry or moaning
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A baby’s ears need to be treated with care
Ear infections, which can result in earache are common in babies and toddlers.
They often follow a cold and can sometimes cause a temperature. A child may
pull at their ear, but babies often cannot tell where their pain is coming from, so
they just cry and seem generally uncomfortable.
What are the signs
of an ear infection?
The signs are a raised
temperature, general irritability
and pain or discomfort. The ears
may be red and your baby may
pull them because they are
uncomfortable. They may even
have a pus-like discharge, which
can also be associated with a
blocked feeling in the ear or
hearing loss. Although most ear
infections settle down without
any serious effects, there can be
mild hearing loss for a short time
(two to three weeks).
Babies have some natural protection against infections in the first few weeks - this
is boosted by breastfeeding. Ear infections can be painful and your child may just
need extra cuddles and painkillers (paracetamol) from the Pharmacist. Your child
may have swollen glands in their neck - this is the body’s way of fighting infection.
Children who live in households where people smoke (passive smoking) or who
have a lot of contact with other children, like those who go to nursery, are more
likely to get ear infections. Speak to your Health Visitor about safely cleaning your
baby’s ears as they can be easily damaged.
My toddler has
earache but seems
otherwise well.
Source: DoH Birth to five edition 2009.
baby’s ears need to be
with care when
use a cotton bud
inside your child’s ear.
they have a
wax may
ooze out.
Have you tried
paracetamol or ibuprofen
from your Pharmacist?
Do not put oil or cotton
buds into your child’s ears.
Health Visitor’s tips
Most ear infections get better by
themselves. Speak to a Doctor if
symptoms show no sign of
improvement after 24 hours, your
child seems in a lot of pain or you
notice fluid coming from the ear.
different, clean
damp cotton wool on
each ear to gently clean
around the outer area.
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Upset tummy
Not nice for you or your baby
Sickness and diarrhoea bugs are caught easily and are often passed on in places
where there are lots of children - like playgroups or nurseries.
Pharmacist says
There are lots of ways you can care for
your child at home. Things to try are:
Give them regular drinks - try small
amounts of fluids. Breastfeed on
demand if breastfeeding.
Being extra careful with hand
hygiene (use soap and water or
anti-bacterial hand gel and dry
hands well with a clean towel).
solutions come in
pre-measured sachets to mix with
water. It helps with dehydration.
If your child is unwell for more than 24
hours see your Doctor. If your baby is
newborn or very unwell contact your
Doctor straight away.
Feeling sick and suddenly being sick are normally the first signs. Diarrhoea can
follow afterwards. Take them to see your Doctor if they are unwell for longer
than 24 hours or sooner if they are newborn or if you notice signs of
Signs of
If you're breastfeeding, keep on doing so. Offer older children plenty of fluids, or
an ice-lolly for them to suck. If they want to eat, give them plain foods like pasta
or boiled rice (nothing too rich or salty).
fontanelle (i.e.
the soft spot is more
Keep them away from others, especially children, who may pick up infection. Be
extra careful with everyone’s handwashing.
wet nappies (i.e.
they wee less).
sleepy than usual.
Dry mouth.
My baby has
runny poo and
is being sick.
Have you given them lots of
water? This will help prevent
them becoming dehydrated if it
is a tummy bug. Speak to your
Pharmacist and ask about
rehydrating solutions.
Speak to a Doctor if symptoms
show no sign of improvement
after 24 hours or straight away
if they are newborn.
dipped in than usual).
Try rehydrating solution from
your Pharmacist.
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Easy to treat
Constipation is a very common problem in children. Many children normally
pass stools as far apart as every few days. Regardless, you should treat hard
stools that are difficult to pass and those that happen only every three days as
Breastfed infants will generally have more stools per day. Their stools vary
more in frequency when compared to bottle-fed infants. For example,
breastfed infants produce anywhere from 5 to 40 bowel movements per week
whereas formula-fed infants have 5 to 28 bowel movements per week.
Switching the type of milk or formula can also cause constipation.
Many things contribute to constipation but infants and children who get wellbalanced meals typically are not constipated. When babies are weaned onto
solid food their poos can change colour, smell and frequency.
Ask your Health Visitor for advice. In rare cases, constipation can be due to an
underlying illness, so if the problem doesn’t go away in a few days, it’s
important to talk to your Doctor.
Does your child have a
balanced diet?
If your child is constipated,
they may find it painful to
go to the toilet.
Source: NICE guidelines 2009, constipation in children
Ask your Health Visitor or
Pharmacist whether a
suitable laxative may help.
Health Visitor says
To avoid constipation and help stop
it coming back make sure your
child has a balanced diet including
fruit, vegetables, baked beans and
wholegrain breakfast cereals. We
do not recommend unprocessed
bran (an ingredient in some foods),
which can cause bloating, flatulence
(wind) and reduce the absorption of
micronutrients. Drink plenty of fluids.
Keeping your child physically active
will also help to prevent constipation.
If a bottle fed baby becomes
constipated you can try offering
water between feeds (never dilute
baby milk). If the problem doesn’t
go away, talk to your Health Visitor
or Doctor again.
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Glass causes serious cuts with many children ending up in
Do not leave drinking glasses on the floor. Make sure glass
bottles are kept up high.
• 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 (maybe they trod on some glass)
go to A&E.
Many children drown, often in very shallow water. It
happens in the bath, in garden ponds, paddling pools
and water butts.
• Supervise children near water at all times. Use a grille
on ponds and fill in a garden pond to use as a sand pit.
• Make sure your child learns to swim.
Get your child out of the water. Try to get them to cough
up any water. If they are not responding call 999.
Poisoning from medicines, household products and
cosmetics are common.
Lock all chemicals, medicines and cleaning products
Find out what your child has swallowed and take it with
you to A&E.
Window blind cords and chains can pose a risk for
babies and children who could injure or even strangle
themselves on the hanging looped cords.
• Install blinds that do not have a cord, particularly in a
child's bedroom.
• Pull cords on curtains and blinds should be kept short
and kept 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, playpen or highchair
near a window.
• Do not hang toys or objects that could be a hazard 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
Untangle child, call 999 and start CPR.
Source: The Royal Society for the Prevention of Accidents (RoSPA)
Household accidents
For babies the biggest danger is rolling off the edge of a
bed, or changing surface. For toddlers it is more about
falling from furniture or down stairs.
• Make sure your baby cannot roll off any surfaces, put
pillows around them.
• Do not put a bouncing cradle or car seat on a surface
where they could wriggle off.
• Use stair gates for toddlers. Make sure balconies are
locked and fit restrictors and safety locks to windows.
If your child has a serious fall call 999.
Babies and toddlers can easily swallow, inhale or choke
on small items like balloons, peanuts, buttons, plastic toy
pieces, strings or cords.
• Check on the floor and under furniture for small items.
• Check that toys are age appropriate and in good
• 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’).
If your child is choking act immediately and calmly. Make
sure you do not push the object further down the throat.
Encourage your child to cough. Use back blows, if they
become unconscious call for help (do not leave your child
alone) and start CPR. www.redcrossfirstaidtraining.co.uk
Head injury
One of the signs of a severe head injury is being unusually
sleepy, this does not mean you cannot let your child sleep.
You need to get medical attention if:
• They are vomiting persistently (more than 3 times).
• They are complaining it hurts.
• They are not responding at all.
• 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 any
way about their drowsiness, then you should wake your
child an hour after they go to sleep.
Check that they are okay, and that they are responding
normally throughout the night.
1553-West Leicester CCI:6521-Cornwall
Back blows for
children under
one year
Page 41
If back blows don’t
relieve the choking
and your child is still
conscious, and
under one year give
chest thrusts.
• Support your child in
a head-downwards
position. Gravity can
help dislodge the
• Sit or kneel and support the child on your
lap. If this is not possible, support your child in
a forward-leaning position and give the back
blows from behind.
• Don’t compress the soft tissues under the jaw
as this will make the obstruction worse.
• Give up to five sharp blows to the back with
the heel of one hand in the middle of the back
between the shoulder blades.
If your
child is
Back blows for children over one year
• Back blows are more effective if the child
is positioned head down.
• Put a small child across your lap as you
would a baby.
• If this is not possible, support your child in
a forward-leaning position and give the
back blows from behind.
If back blows don’t
relieve the choking
and your child is still
conscious, and over
one year give
abdominal thrusts.
Chest thrusts for children under
one year
• Support the baby down your arm, which is
placed down (or across) your thigh as you sit
or kneel.
• Find the breastbone and place two middle
fingers in the middle.
• Give five sharp chest thrusts, compressing
the chest by about a third of its diameter.
Abdominal thrusts for
children over
one year
• Stand or kneel behind the
child. Place your arms
under the child’s arms
and around their upper
• Clench your fist and place it between navel
and ribs.
• Grasp this hand with your other hand and pull
sharply inwards and upwards.
• Repeat up to five times.
• Make sure you don’t apply pressure to the
lower ribcage as this may cause damage.
How to resuscitate
a child
Back blows, chest thrusts & cardiopulmonary resuscitation (CPR)
Babies under one year old
Children over one year old
1. Open the baby's airway by placing one hand on the
forehead while gently tilting the head back and lifting
the chin. Remove any visible obstructions from the
mouth or nose.
2. Place your mouth over the mouth and nose of the infant
and blow steadily and firmly into their mouth, checking
that their chest rises. Give five initial rescue breaths.
3. Place two fingers in the middle of the chest and press
down by one-third of the depth of the chest. After 30
chest compressions at a steady rate (slightly faster than
one compression a second), give two rescue breaths.
4. Continue with cycles of 30 chest compressions and
two rescue breaths until they begin to recover or
emergency help arrives.
1. Open their airway by placing one hand on the forehead
and gently tilting their head back and lifting the chin.
Remove any visible obstructions from the mouth or nose.
2. Pinch their nose. Seal your mouth over their mouth and
blow steadily and firmly into their mouth, checking that
their chest rises. Give five initial rescue breaths.
3. Place your hands on the centre of their chest and, with
the heel of your hand, press down by one-third of the
depth of the chest using one or two hands.
4. After every 30 chest compressions at a steady rate
(slightly faster than one compression a second), give
two rescue breaths.
5. Continue with cycles of 30 chest compressions and
two rescue breaths until they begin to recover or
emergency help arrives.
Following chest or abdominal thrusts, reassess your child:
• If the object is not dislodged and your child is still conscious, continue the sequence of back blows and either chest
thrusts or abdominal thrusts. • Call out or send for help if you are still on your own. • Don’t leave the child at this stage.
Source: NHS Choices, DoH birth to five 2009.
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Bumps & bruises
Part of growing up
Minor cuts, bumps and bruises are a normal part of growing up. Allowing your
child to explore the world around them (with supervision) helps them develop and
learn. Most of your toddler's bumps will require no more than a cuddle to make
them better. If your child has unexplained bruising or injury you need to find out
how this happened.
If it looks like the bump may swell then use a cold flannel (soaking the cloth with
cold water) or ice pack (but don't put ice directly onto the skin) to help reduce
swelling and to cool the area for at least a few minutes.
If your child has had a bump to the head and it looks serious or
symptoms worsen call a Doctor. Read the information on the right.
Keeping them safe
Being a toddler means your
child is discovering the world
around them. This can result in
bumps and bruises. It is
almost impossible to prevent
every accident although there
are things we can do at home
which might help.
After a fall comfort
the child, check for
injuries, treat bumps
and bruises.
Give the child
some painkillers
and let the child
rest whilst
watching your
child closely.
Seek immediate help if:
• They have seriously injured
• They are unconscious.
• They have difficulty breathing.
• They are having a seizure.
Head injury
One of the signs of a severe
head injury is being unusually
sleepy, this does not mean you
cannot let your child sleep.
You need to get medical
attention if:
• They are vomiting
persistently (more than 3
• They are complaining it
• They are not responding
at all.
• 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 any way about
their drowsiness, then you
should wake your child an hour
after they go to sleep.
Check that they are okay, and
that they are responding
normally throughout the night.
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Burns & scalds
Knowing what to do
A burn is damage to the skin, which is 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 steam. Scalds are treated in the
same way as burns.
Treat any burn or scald straight after the accident but always take your child 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.
Cool the burnt area by placing under cold running water for at least twenty
minutes. When the burn has cooled, cover it with a sterile dressing, food quality
cling film or a plastic bag. Don’t wrap it too tightly. Give paracetamol or ibuprofen.
Then take your child to hospital.
Remember to keep hot drinks out of children’s reach.
Hold the affected area under
cold water for at least 20
minutes. Cover the burn with
cling film if you have some,
then wrap in a cloth soaked
in cold water.
Treat the burn or scald
straight after the accident
by running under cold
water for 20 minutes.
Do not use creams,
lotions or ointments on
the burn or scald.
Always take your child or
baby to hospital.
Apply fatty substances like
butter or ointment as this
won't do any good and will
only waste time for hospital
staff who'll have to clean the
area before it can be treated.
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Domestic abuse
Keeping your child safe
Getting help
For advice and signposting to
support services for men, women,
concerned friends and professionals.
Leicester City Helpline (run by
SAFE Project)
8am-10pm each weekday
10am-6pm Saturdays
12pm-4pm Sundays
9am-5pm Bank Holidays
0300 123 0918
Free from landlines and most
mobiles - 3, O2, EE, Virgin and
Leicester County Helpline (run by
Womens Aid)
Monday-Friday, 9am-4pm
0300 303 1844
Children at risk
Domestic abuse is a major social problem, which affects many families. It includes
threatening behaviour, violence, psychological, sexual, financial and emotional
abuse. Children who see, hear, witness or become aware of violence in the family
are affected in many ways, all of which can have a major harmful impact on their
health and well-being that might make them appear to be ill. Children do hear,
they do see and they are aware of violence in the family.
If you are worried about domestic abuse, discuss it with someone else, such as
your Health Visitor or Doctor, or phone the National Domestic Violence Helpline
(0808 2000 247). If you are violent and have children, you can seek help to stop
what is happening.
Remember, domestic abuse is a crime. It can have serious long-term
Is domestic abuse
affecting your child.
There are many possible
signs of abuse, ranging
from injury to changes in
the way a child is
Be aware that abuse, or
fear of abuse, can make
children seem ill.
Children will learn how to act
from what their parents do.
Domestic abuse teaches children
bad things about relationships
and how to deal with people.
Long-term abuse is much more
likely to cause problems for a
child or young person.
It is also important to recognise
if you or your partner need help
with an alcohol or drug
problem. This does not mean
you will be seen as bad
parents, but there are services
that can help and support you,
that will be beneficial for the
sake of your children.
Also, post-natal depression, like
any mental illness, can have a
negative impact on children and
their well-being.
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Page 49
The eatwell plate
Use the eatwell plate to help you get the balance right. It shows
how much of what you eat should come from each food group.
Fruit and
Meat, fish,
eggs, beans
and other non-dairy
sources of protein
Bread, rice,
potatoes, pasta
and other starchy foods
Foods and
drinks high in fat
and/or sugar
Milk and
dairy foods
What can I do?
Many parents are unaware of the dangers of
childhood obesity but by following the top tips
below you can make a difference to your child’s
1. Sugar Swaps - Swapping sugary snacks and
drinks for ones that are lower in sugar can
make a huge difference.
2. Meal Time - It’s important for kids to have
regular, proper meals as growing bodies
respond better to routine.
3. Snack Check - Many snacks are full of the
things that are bad for us - sugar, salt, fat and
calories. So try and keep a careful eye on how
many the kids are having.
4. Me Size Meals - It’s important to make sure
kids get just the right amount for their age.
5. 5 A Day - 5 portions of fruit and/or vegetables
a day.
6. Cut Back Fat - Too much fat is bad for us.
It’s not always easy to tell where it’s lurking.
7. Up and About - Most of us spend too long
sitting down. Keep active. Encourage your
child to walk, you may need to use child
safety reins.
Source: Start4Life
Children in shape
Obesity is rarely due to a medical problem
Obesity is a medical term used to describe kids (and adults) who carry 20 per
cent extra body weight. This extra weight, if not treated early on, could cause
serious health problems such as arthritis, cancer, heart disease, stroke, diabetes
and depression in later life. Help stop obesity before it starts by making sure they
eat a balanced diet and get enough exercise.
Being overweight is rarely to do with a medical problem, many kids simply have
unhealthy diets and don’t do enough exercise. It is better to prevent your child
becoming overweight or obese in the first place. Many parents feel guilty (or in
denial) that their child is overweight and ignore it, but this will have a damaging
effect on your child in many ways including their physical health, mental health
and self-esteem. If your child feels bad about themselves they can comfort eat to
make themselves feel better, so leading to them being more overweight - this
creates a vicious circle.
You are responsible for your child’s health and well-being, this includes what they
eat. A healthy balanced diet (see the eatwell plate opposite) and exercise is the
simple answer to many worries about being overweight. Try to have family outings
which include walking and cycling so you can all get fitter together. Being active
burns more energy and the body then starts to use up its fat stores.
My child looks chubby
and seems to only want
to eat junk food.
Exercise together as a
family and find out more
about healthy eating.
If you are worried discuss
with your Doctor.
Dietician says
Salt and sugar is added to
nearly all processed products.
Three-quarters of the salt and
sugar we eat is already in the
food, the rest is what we add to
cooking or shake on our meals.
Children aged 7 to 10 years
need less than 5g of salt a day
(1 teaspoon).
Juice drink
23g sugar
(5 teaspoons)
Cereal bars
8g sugar
(1.5 teaspoons)
Fromage frais
12.4g sugar
(2 teaspoons)
Source: The Food Standards Agency www.food.gov.uk
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Protect your child now and in the future
When to immunise
Diseases protected against
Two months old
• Diphtheria, tetanus, pertussis (whooping cough),
polio and Haemophilus influenzae type b (Hib)
• Pneumococcal disease
• Rotavirus vaccine (repeat dose at three months)
Three months old
• Diphtheria, tetanus, pertussis, polio and Hib
• Meningococcal group C disease (MenC)
Four months old
• Diphtheria, tetanus, pertussis, polio and Hib
• Pneumococcal disease
Between 12 and 13
• Hib/MenC
months old - within a
• Pneumococcal disease
month of the first birthday • Measles, mumps and rubella (German measles)
Three years four months
old or soon after
• Diphtheria, tetanus, pertussis and polio
• Measles, mumps and rubella
Source: NHS Immunisation Information.
Immunisations, also known as vaccinations are usually given by injection. Children
in the UK are offered vaccinations against a variety of diseases as part of the
Healthy Child Programme. You can get advice on the vaccinations from your Doctor
or Health Visitor. A record is kept in the Parent Held Child Health Record (Red
Book), which is a book you keep containing information on your child’s health.
Health Visitor says
Make sure you keep your
child’s Red Book in a safe
place. It is your only complete
record of their childhood
immunisations and they are
often needed later in life.
Check with your Health Visitor
on any updates and future
Immunisations are mainly given during the first five years. It’s important to have
vaccinations at the right age to keep the risk of disease as low as possible. It is
normal to worry about vaccinations, so don’t hesitate to ask your Health Visitor or
Doctor for advice - that’s what they are there for! Childhood immunisations are
free and most are given at your Doctor’s surgery.
Some immunisations are given more than once to make sure the protection
continues. This is known as a booster, so make sure your child gets it.
An annual nasal spray flu vaccine is available for all children aged 2 and 3 years
old as part of the NHS childhood vaccination programme. Ask your Health Visitor.
The whooping cough vaccine is recommended for all women between 28 and 38
weeks pregnant. You should be offered this at your routine antenatal appointment.
Immunisation begins at
two months, when baby's
natural immunity to illness,
begins to drop.
Your Health Visitor will
tell you when local
immunisation sessions
are taking place.
Immunisations don’t just
protect your child during
childhood, they protect
them for life.
Doctor says
Immunisations are used to
protect children from diseases
which can be very serious and
sometimes even cause death.
The protection immunisations
offer your child are worth the
small amount of pain.
You may have concerns about
the safety of immunisations,
discuss these with your
Doctor. Mild side effects such
as a mild fever, are common
after immunisation.
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If children are not ‘school ready’ it can be difficult for them to learn
and for the opportunities of education, play and learning to be
available to them. The key areas are: personal, social and
emotional development, physical development and
communication and language.
If you are worried about aspects of your child’s development chat
to your local Children’s Centre or your Health Visitor.
School readiness
Is my child ready for school?
The phrase 'readiness for school', seems to be cropping up all over the place.
Part of the problem is that there is no clear definition of the term, and it can be
difficult for parents to understand what their child will be expected to know and
do. School readiness is more than just about children. It involves children, families,
early environments (like nurseries and playgroups), schools and communities.
The earliest years in a child's life provide the foundation for everything that follows. We
must all make sure that children are supported and encouraged to achieve their full
potential as inquisitive, confident and secure individuals. This isn’t just about making
sure they can hold a pencil - children need the resilience, confidence and personal
skills to be able to learn. If children lack the tools to benefit from education before they
even get to the school gate it makes their chances of learning more difficult.
Basic skills like toilet training, communications skills, being able to understand and
follow simple tasks, taking turns and having some social skills all prepare a child
to be ready for learning. Teachers and Classroom Assistants are then freed up to
teach rather than spend time toileting, feeding children and helping them with the
most basic social skills.
My child seems to have
no friends and makes
no effort at nursery to
mix with other children.
Closeness between parent and
child, combined with consistent
rules, are most likely to lead to
children doing well and
becoming more social.
Do not panic. Invite one or
two children over for tea
with their parents. Chat to
your Health Visitor or local
Children’s Centre.
Teacher’s tip
One helpful pre-school activity
that parents can practice is
giving their children the
opportunity to listen to and
learn language through story
telling. One of the best ways to
prepare children for school is to
read to them. Not only does
story reading offer a one-toone quiet time, it helps develop
children's listening and
language skills.
If you want to improve reading
skills, there are lots of
opportunities. There are adult
learning courses, find out more
from your local Children’s Centre.
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Safer sleeping
Keeping your baby safe and healthy:
• Place your newborn baby on their back to sleep, in a cot
in your bedroom for the first six months.
• Place your newborn baby in the ‘feet to foot’ position i.e.
baby’s feet at the foot of the bed/cot. Once babies move
around and roll, they will find a position that's comfortable
for them.
• Do not let your baby get too hot and keep their head
• Never sleep with your baby on a sofa or armchair.
• Do not smoke in pregnancy or let anyone smoke in the
same room as your baby.
It's dangerous for your baby to sleep in your bed if you
(or your partner):
• Are a smoker (even if you never smoke in bed or at home).
• Have been drinking alcohol or taken any drugs.
• Have taken any medication that makes you drowsy.
• If your baby was premature (born before 37 weeks).
• If your baby was low birth weight (less than 2.5kg or
5 1/2 lb).
• If you or your partner are overweight.
It is very dangerous to fall asleep together on a sofa,
armchair or settee and it is also risky to allow a baby to
sleep alone in an adult bed.
Sleeping difficulties
Patience, praise and peace
There are many different reasons why babies and toddlers do not sleep through
the night. Feel confident in yourself to know whether your child is really distressed
or just restless. Trust your instincts.
Try to establish a regular day and night time sleep routine for your child until they
are 2-3 years old. Put them to bed at a regular time, routine is important. Prepare
a warm, comfortable place for them to relax in. Reading to your child at bedtime
helps them to unwind, and gives you some special time together. If your child is
scared of the dark, try keeping a night light on. Adult beds are not designed for
babies and toddlers and do not conform to safety standards. Only breastfeeding
babies should ever be fed in bed, and if so, should be positioned on the outside
of the bed and returned to the cot after the feed has finished.
Bedwetting may be stressful for both of you and can wake your child. It is not
easy to know why some children take longer to be dry at night than others. Try
not to lose your patience or punish them, your child is not doing this on purpose.
Children learn at their own pace and praise and support will help.
I am so tired when my
baby wakes up at
night it seems easier
to share the bed.
The safest place for your
baby to sleep is in a cot by
your bedside for at least the
first 6 months. Try to establish
a regular sleep routine.
Speak to your Health Visitor
about how to keep baby
safe and get some sleep.
Health Visitor
If your sleep is often disturbed,
arrange for a trusted relative
or friend to care for your baby
or child so that you can get
some sleep. Talk to your
Health Visitor.
Your child’s sleep may be
disturbed by bedwetting.
Between the ages of three and
four they are likely to have the
occasional accident but
gradually more and more
nights will be dry.
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Smokefree homes
Protecting your child’s health
Secondhand smoke is made up of two types of smoke: mainstream (breathed in
and 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 to
secondhand smoke.
• Children exposed to secondhand smoke are more likely to get coughs and
colds, as well as middle ear disease, which can cause deafness.
‘Step right out’ of your home to ensure it does not affect your children. Also, have
a smokefree car at all times as exposure to the chemicals in secondhand smoke
is increased in a confined space even with the windows open!
Call 0116 2954141
Smoking anywhere near
your children, like in the
car, affects their health
as well as yours.
Source: www.steprightout.org.uk
Opening a window or
standing by the door is not
enough to protect children
from the effects of smoking.
‘Step right out’ to ensure
you are protecting your
Make your home
• Tell everyone in your house,
and any visitors, that your
home is now smokefree.
• Keep a pair of slip-on shoes
and other all-weather bits by
your back door, so you can
go out anytime.
• Keep an ashtray outside
away from your back door
as a reminder. It’ll help keep
the garden tidy too.
• Can’t make it outside?
Nicotine replacement
methods like patches and
gum can help.
• If you smoke, or are exposed
to secondhand smoke
during pregnancy, it means
that your baby shares
chemicals from the smoke
you breathe.
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Good oral health
Tooth care matters
In theory tooth care should be quite simple - don’t allow children to have
sugary things too often and make sure their teeth are brushed well twice a
day. In practice it’s not that easy, the way sugary products are advertised
and promoted can make it difficult to limit them.
Good habits
Be firm and try to give healthier
sugar-free snacks and drinks in
between meals. Use a family
fluoride toothpaste right from
the start. Remember that good
tooth care will come from you,
mums and dads, brothers and
sisters. Take opportunities to
let them watch you brushing
your teeth. Explain what you
are doing and why you are
doing it. Try to make it fun.
Although it’s not always easy you should get your child into good habits at
an early age. They will need your help until they are seven. Make sure your
child brushes their teeth twice a day with a family fluoride toothpaste.
When you child turns 3 use a pea sized amount of toothpaste, prior to
that use just a smear. Children (particularly young children) should spit not
rinse after brushing with a fluoride toothpaste for maximum effectiveness.
Get your child used to visiting the Dentist and take them to an
appointment with you to reassure them. Talk to your Health Visitor
and take your child to a Dentist as soon as you can. Ask your
Dentist to brush on FLUORIDE VARNISH for added protection
against tooth decay (for children aged 3 and above) - IT’S FREE !
Golden rule - never
give a sugary drink
last thing at night.
It’s never too early to
start taking your child
to the Dentist.
Tooth decay is almost
totally preventable.
Get it right from the start.
Know what causes teeth
to go bad.
Dentist says
As soon as teeth appear in the mouth,
parents should brush their baby’s
teeth in the morning and last thing
before bed.
Provide a healthy, balanced diet and
limit sugary food and drinks to
mealtimes only. Sugar or honey should
not be added to weaning foods.
Introduce drinking from a cup from
6 months and stop bottle feeding by 1
year. If children are brought up to care
for their teeth early on, it should stand
them in good stead for the rest of
their lives.
A healthier diet means better
resistance to infections, less time off
nursery or school, enough energy to
last the day and less tooth decay.
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There are 3,100 new cases of
Skin Cancer in England every
year. Cancer groups are
working together to tell us
about sun damage from an
early age. As parents we can
take simple measures to
protect our children.
Remember babies and
toddlers are not interested in
tanning and sunburn can
cause damage to their skin.
Source: www.qub.ac.uk/nicr
Vitamin D
Is your child getting enough?
Vitamin D is important for good health, strong
bones and growth. Most foods contain very
little vitamin D naturally and it is mostly made
in the skin by exposure to sunlight. However,
you shouldn’t over-expose your child to the
sun, as casual sun exposure is enough.
Vitamin D helps your baby's body absorb
calcium, which is needed for the healthy
development of strong bones and teeth.
Sun safety
Protect their skin
Keep your child cool and protect them from the sun and heat. Babies under six
months should be kept out of the sun and older children should be allowed in the sun
for a limited time only, and their skin should be well protected. Stay out of the sun,
especially during the middle of the day. All types of skin, fair or dark, need protection.
Attach an effective sunshade to the pushchair to keep them out of direct sunlight. A
sun hat, with a wide brim or a long flap at the back, will protect your child's head and
neck from the sun. Try to use loose long sleeved clothing. Apply high factor suncream
regularly, particularly if your child is in and out of the sea or a paddling pool.
If your baby is under 6 months, offer more fluids and if breastfeeding, breastfeed
more often. If your baby is over six months old encourage them to drink water. For
older toddlers and children, plenty of fruit will also help to keep their fluid levels up.
It is a bright day and your
child is playing outside.
Are they in the shade
and wearing sunscreen?
Are they wearing a hat,
long sleeves and
Make sure you protect
your child’s head, skin and
eyes especially during the
middle of the day.
Pharmacist says
The higher the SPF (Sun
Protection Factor) the better
the protection for the skin. You
should use a complete sun
block on your baby or toddler.
SPFs of up to 60 are available
and these block out almost all
of the sun’s rays. Even with
suncream, keep them in the
shade whenever you can and
make sure newborn babies
are never in the sun. Don’t
forget to protect their head,
skin and eyes. For older
children, you can buy
sunglasses from a pharmacy.
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Useful contacts
National contacts
Local contacts
NHS Choices
Choose the best service for your needs
Patient Advice and Liaison Service (PALS)
Tel: 01509 564444 or 01455 441971
National Domestic Violence Helpline
0808 2000 247
To find a GP, Pharmacist, Dentist or Optician
Contact Leicestershire Area Team on 0116 2957500 or visit
National Smoking Helpline
0800 0224 332
Meningitis Now
0808 80 10 388
British Nutrition Foundation
020 7557 7930
Child Accident Prevention Trust
020 7608 3828
Family Lives
0808 800 2222
For support in North West Leicestershire and Hinckley and Bosworth
text feed to 60777. Other areas visit www.leicspart.nhs.uk/infantfeeding
Urgent Care and Walk-in Centres
Loughborough Urgent Care Centre
(24 hrs, 365 days a year)
Loughborough Hospital, Hospital Way, Loughborough LE11 1BE.
Tel: 01509 553998
Leicester Urgent Care Centre
(24 hrs, 365 days a year)
Leicester Royal Infirmary, LE1 5WW. Tel: 0116 295 7200
Other Urgent Care Centres and Walk-in
Centres adjacent to West Leicestershire
are situated in:
• Derby • Nottingham • Swadlincote
Oadby and Wigston Walk-in Centre • Burton-on-Trent • Rugby • Coventry
(8.00am-8.00pm, 365 days a year)
If you do not have a dentist and require
Oadby, LE2 5BJ. Tel: 0116 271 1360
urgent dental care: Dental Access
Feilding Palmer Hospital
Centre, Nelson Street, Leicester
(8.00am-10.00pm, 365 days a year)
Tel: 0116 2951278 (Mon-Fri 9am-5pm)
Lutterworth, LE17 4DZ.
Out of hours helpline 0845 840 0065
Tel: 01455 552150
(Mon-Fri 6.30pm-8.00am) and 24 hours
Camp Hill Walk-in Centre
during weekends and Bank Holidays.
(8.00am-10.00pm, 365 days a year)
Accident & Emergency Departments
Nuneaton, CV10 9EB.
In and around Leicestershire
Tel: 024 7639 0008
Leicester Royal Infirmary
Market Harborough Minor Injury
(Includes separate children’s A&E)
and illness Unit
Infirmary Square, Leicester LE1 5WW.
(9.00am-9.00pm, 365 days a year)
Tel: 0300 303 1573
Coventry Road, Market Harborough
SSAFA Walk-in Centre
(8.00am-10.00pm, 365 days a year)
Leicester, LE5 3GH.
Tel: 0116 242 9450
LE16 9DD. Tel: 01859 410500
Latham House Medical Practice
Minor Inujry Unit
(Monday-Friday 8.30am-6.30pm)
Sage Cross Street, Melton Mowbray
Leicester LE13 1NX.
Tel: 01664 503000
George Eliot Hospital
College Street, Nuneaton CV10 7DJ.
Tel: 024 7635 1351
University Hospital
(Separate children’s A&E)
Clifford Bridge Road, Coventry CV2 2DX.
Tel: 024 7696 6200
Queen’s Hospital
Belvedere Road, Burton-on-Trent
DE3 0RB. Tel: 01283 566333
Royal Derby Hospital
Uttoxeter Road, Derby DE22 3NE.
Tel: 01332 340131
Queen’s Medical Centre
Derby Road, Nottingham NG7 2UH.
Tel: 0115 924 9924
Leicestershire Family Information
(Includes SureStart Children’s Centres)
Tel: 0116 305 6545
email: family@leics.gov.uk
Rutland Family Information Service
Tel: 01572 722577
Email: fis@rutland.gov.uk
The Family Information Directory
Information, advice and guidance
aimed at helping parents, carers, young
people and professionals with many
aspects of family life.
Contact your local Sure Start Children's
Centre or email family@leicester.gov.uk
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