Healthier Together
The Healthier Together website offers trusted healthcare advice for families and is designed to support decision-making when children are unwell.
The site has been reviewed by local paediatricians, GPs, and clinicians and aims to boost confidence in managing children’s health at home and knowing when to seek professional help.
It can be very worrying when your child is unwell, and it may not be clear what the best course of action to take is.
The site includes a traffic light guide to help identify the severity of a child’s symptoms. Green indicates low risk, amber suggests seeking advice from a GP or NHS 111, and red advises calling 999 or visiting an emergency department.
Parents can visit the website or download the App, giving them trusted health information at their fingertips.
NHS 111
If you need medical help fast, but it’s not a 999 emergency; or you want advice about treating your child's symptoms at home; or you need to access a local medical service but you're not sure which one, start with NHS 111.
NHS 111 is available 24 hours a day, 365 days a year. Visit the NHS 111 website or call 111 free from your landline or mobile phone.
Trained advisors will ask you a series of questions to assess your child’s symptoms and then if necessary, book an appointment for you to attend the local healthcare service that’s right for them. If the NHS 111 team think you need an ambulance, they will send one immediately.
Pharmacies
Pharmacists are trained medicine experts who can give you advice on treating a range of common childhood conditions and minor injuries such as:
- sore throat
- coughs
- colds and flu
- insect bites
- earache
- skin rashes
You don't need to make an appointment to visit your local pharmacist, and many pharmacies are open during the evening and at weekends. Find your nearest pharmacy.
Respiratory illness in children
Colds, coughs and ear infections are common in babies and young children because their immune systems are still developing.
While most colds clear up on their own within two weeks, parents can make their child’s recovery more comfortable by ensuring they rest, stay hydrated and take paracetamol or ibuprofen to relieve pain or fever.
Coughs and sore throats often accompany a cold, and while the conditions usually only last for a short time, both can be extremely unpleasant, especially for babies and very young children.
Parents should seek medical advice, such as using NHS 111 or visiting a pharmacy, if their child has a sore throat for more than three days, a high temperature or their symptoms gradually worsen.
Some children’s colds may also come with an ear infection, which can be painful and particularly irritating.
It’s important for parents not to put anything in the child’s ear unless told to do so by a health and care professional.
The NHS website has dedicated advice for parents on when to keep children off school, as well as information on how to treat common childhood illnesses, both of which can be found at www.nhs.uk/live-well/is-my-child-too-ill-for-school.
Acute Respiratory Infection (ARI) Hub - Your Health
Some children under 2 years, especially those born prematurely or with a heart condition, can suffer more serious consequences from these common respiratory infections.
Find out more about RSV using the dropdown list of FAQs below
RSV FAQs
RSV can spread when an infected person coughs or sneezes and the virus droplets get in your eyes, nose or mouth. You can also get it from direct contact with the virus, e.g., from kissing the face of a child with RSV. If you do touch a surface that has the virus on it, like a doorknob, and then touch your face before washing your hands, you can also get the virus.
Children are often exposed to and infected with RSV outside the home such as in school or childcare centres. RSV can survive for many hours on hard surfaces such as tables and cot rails. On soft surfaces such as tissues and hands, the virus lives for a shorter time.
The symptoms of RSV infection are typical symptoms of a cold, such as a runny nose, coughing, sneezing, fever (high temperature), wheezing and not feeling like eating. These symptoms usually appear in stages and not all at once.
In very young infants with RSV, the only symptoms may be irritability, decreased activity and breathing difficulties. However, RSV can also cause serious illness, including bronchiolitis and pneumonia (infections in the lung).
People of any age can get another RSV infection, but infections later in life are generally less serious. People at highest risk for severe symptoms include:
- Premature babies
- Young children with congenital (from birth) heart or chronic lung disease
- Young children with compromised (weakened) immune systems due to a medical condition or medical treatment
- Adults with compromised immune systems
- Older adults, especially those with underlying heart or lung disease.
Your doctor will ask about the following: the child’s symptoms: whether other close contacts have similar symptoms: the home environment and how long they have been sick. They will also do a clinical examination and, possibly a throat swab or other tests.
There is currently no vaccine readily available for RSV. Immunity to RSV develops over the first couple of years of life, but it is never fully complete, and tends to decline again with age. This means that, older adults can also be seriously affected with the virus.
Some home remedies can help relieve some signs and symptoms:
- Create moist air to breathe. Keep the room warm but not overheated. If the air is dry, a cool-mist humidifier or vaporizer can moisten the air and help ease congestion and coughing.
- Drink fluids. Continue breastfeeding or bottle-feeding your infant as you would normally. For older children and adults, keep a steady supply of cool water at the bedside. Offer warm fluids, such as soup, which may help loosen thickened secretions. Ice pops may be soothing as well.
- Try saline nasal drops. Over-the-counter (OTC) drops are a safe, effective way to ease congestion. If you speak to the pharmacist, they will be able to provide advice on the correct way to use the drops.
- Use over-the-counter pain relievers. OTC pain relievers such as paracetamol may help reduce fever and relieve a sore throat. Ask the local pharmacist for advice.
Most RSV infections go away on their own in 1 to 2 weeks. There is no specific treatment for RSV infection. Care involves relieving symptoms, such as:
- Manage fever and pain with Paracetamol
- Drink enough fluids to prevent dehydration (loss of body fluids).
Talk to your healthcare provider before giving your child cold and cough medicines. Some medicines contain ingredients that are not good for children.
A medicine called palivizumab (pah-lih-VIH-zu-mahb) is available by injection to prevent severe RSV illness in infants and children who are at high risk of severe illness, such as babies born prematurely or with congenital heart disease or chronic lung disease. The medicine can help prevent serious RSV disease, but it cannot help cure or treat children already suffering from serious RSV, and it cannot prevent infection with RSV. This must be administered regularly to be effective.
Breastfeeding – Breastfeeding your baby protects them from getting RSV infection by boosting their infection-fighting (immune) system. Breastfeeding beyond 4 months of age offers the best protection.
Smoke-free environment – Make sure your child's environment is smoke-free.
Vaccinations – Make sure your child is up to date with all their vaccinations. There is currently no vaccine for RSV but vaccination can prevent bacterial infections following RSV infection.
A warm house – Keeping the house warm and well insulated will also decrease your baby's risk of developing RSV infection.
Stay away from people with coughs and colds – It is sensible to keep young babies away from people who have colds and coughs.
Parents of children at high risk for developing severe RSV disease should help their child when possible do the following:
- Avoid close contact with sick people.
- Wash their hands often with soap and water for at least 20 seconds.
- Avoid touching their face with unwashed hands.
- Avoid their sharing drink containers and toothbrushes.
Limit the time they spend in childcare centres or other potentially contagious settings, especially during autumn, winter and spring. This may help prevent infection and spread of the virus during the RSV season.
If you have cold-like symptoms, you should:
- Cover your coughs and sneezes with a tissue or your upper shirt sleeve, not your hands
- Wash your hands often with soap and water for at least 20 seconds
- Avoid close contact, such as kissing, shaking hands, and sharing cups and eating utensils, with others
- clean frequently touched surfaces such as doorknobs and mobile devices
- Wash solid toys and consider getting rid of soft ones.
- Ideally, people with colds should avoid close contact with new-born babies: infants born prematurely (before 37 weeks): children under 2 years born with heart or lung conditions and those with weakened immune systems.
- Smoking around young children is also a risk factor for severe RSV infection
Children can be at higher risk of severe illness from common respiratory infections like RSV.
Most cases are not serious and clear up within 2 to 3 weeks, but the symptoms can be very worrying for parents.
For some infants and babies, such as those born prematurely or with a heart condition, respiratory infections can be more severe. NHS 111 or your GP can offer advice if any parent has concerns.
It is perfectly okay for parents to ask people with colds to keep away from new-born babies, particularly in the first two months, and for babies born prematurely.
RSV is highly infectious, which is why it is important to stick to basic hand and respiratory hygiene practices to help prevent it spreading. RSV usually spreads widely in the autumn and winter months.
Symptoms generally begin 4-6 days after exposure. An ill person can spread the virus for up to 8 days and sometimes longer. It can take 1-2 weeks to feel better.
Many other viruses can cause RSV-like illness: acute viral respiratory infections include Influenza, COVID-19, Parainfluenza, Rhinovirus and Human metapneumovirus. When viruses invade cells of the respiratory tract, they trigger inflammation and production of mucus. This situation leads to nasal congestion, a runny nose, scratchy throat, high temperature and cough- these are usually the common symptoms among the respiratory viruses. Persistent cough and loss of taste and/smell usually develop with COVID-19.
Other typical symptoms in children with respiratory infections caused by viruses include decreased appetite, lethargy, and a general feeling of illness. Headaches and body aches develop, particularly with influenza.
Guidance for when to seek help is similar for most of the Respiratory viruses as they present with like symptoms: Please refer to the RSV traffic light guide (pdf, 164KB) for further guidance on when to seek help.
Caring for children with coughs
The University of Bristol have created a leaflet on how to look after a child who has a cough (not due to asthma).
Not sure what to do?
Get instant access to expert advice via a free mobile app, called Healthier Together.
The Healthier Together website offers trusted healthcare advice for families and is designed to support decision-making when children are unwell.
Parents can visit the website or download the App, giving them trusted health information at their fingertips.
Search for 'NHS Healthier Together' in your app store to download Healthier Together now.
Group A Strep
It’s always concerning when a child is unwell. GAS infections cause various symptoms such as sore throat, fever, chills and muscle aches.
As a parent, if you feel that your child seems seriously unwell, you should trust your own judgement.
Contact NHS 111 or your GP if:
- your child is getting worse
- your child is feeding or eating much less than normal
- your child has had a dry nappy for 12 hours or more or shows other signs of dehydration
- your baby is under 3 months and has a temperature of 38C, or is older than 3 months and has a temperature of 39C or higher
- your baby feels hotter than usual when you touch their back or chest, or feels sweaty
- your child is very tired or irritable
Call 999 or go to A&E if:
- your child is having difficulty breathing – you may notice grunting noises or their tummy sucking under their ribs
- there are pauses when your child breathes
- your child’s skin, tongue or lips are blue
- your child is floppy and will not wake up or stay awake
GAS is spread by close contact with an infected person and can be passed on through coughs and sneezes or from a wound.
Some people can have the bacteria present in their body without feeling unwell or showing any symptoms of infections and while they can pass it on, the risk of spread is much greater when a person is unwell.
GAS causes infections in the skin, soft tissue and respiratory tract. It’s responsible for infections such as tonsillitis, pharyngitis, scarlet fever, impetigo and cellulitis among others.
While infections like these can be unpleasant, they rarely become serious. When treated with antibiotics, an unwell person with a mild illness like tonsilitis stops being contagious around 24 hours after starting their medication.
We are currently seeing high numbers of scarlet fever cases.
The first signs of scarlet fever can be flu-like symptoms, including a high temperature, a sore throat and swollen neck glands (a large lump on the side of your neck).
A rash appears 12 to 48 hours later. It looks looks like small, raised bumps and starts on the chest and tummy, then spreads. The rash makes your skin feel rough, like sandpaper. The rash will be less visible on darker skin but will still feel like sandpaper. More information on scarlet fever can be found on the NHS website, including photos.
The most serious infections linked to GAS come from invasive group A strep, known as iGAS.
This can happen when a person has sores or open wounds that allow the bacteria to get into the tissue, breaches in their respiratory tract after a viral illness, or in a person who has a health condition that decreases their immunity to infection. When the immune system is compromised, a person is more vulnerable to invasive disease.
Necrotising fasciitis, necrotising pneumonia and Streptococcal Toxic Shock Syndrome are some of the most severe but rare forms of invasive group A strep.
Investigations are underway following reports of an increase in lower respiratory tract Group A Strep infections in children over the past few weeks, which have caused severe illness.
Currently, there is no evidence that a new strain is circulating. The increase is most likely related to high amounts of circulating bacteria.
It isn’t possible to say for certain what is causing higher than usual rates of these infections. There is likely a combination of factors, including increased social mixing compared to the previous years as well as increases in other respiratory viruses.
Good hand and respiratory hygiene are important for stopping the spread of many bugs. By teaching your child how to wash their hands properly with soap and warm water for 20 seconds, using a tissue to catch coughs and sneezes, and keeping away from others when feeling unwell, they will be able to reduce the risk of picking up, or spreading, infections.