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FOR PARENTS AND CARERS of childrenaged birth-5 years

Commonchildhood

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This handbook has been produced byNHS Southwark Clinical Commissioning Group

There are many everyday illnesses or health concerns which parents and carers need advice and information on.

BreastfeedingWorried, need

support and advice?

Speak to your HealthVisitor or contact your

local BreastfeedingSupport Team

ImmunisationsConfused, unsure or

need advice?

Speak to your HealthVisitor or Practice

Nurse

Oral healthNeed advice about

teething, oral healthor registering?

Speak to your HealthVisitor or Dentist

SmokingIf you smoke - now is

the time to quit.

Call 0800 022 4332 or visit

www.smokefree.nhs.uk

1548-SE London CCI 2:6521-Cornwall 18/12/13 11:19

WelcomeWho can help?

A guide to services 4

Know the basics 6

The first monthsBeing sick 8

Crying 10

Nappy rash 12

Rashes & dry skin 14

Safer sleeping 16

Sticky eyes & conjunctivitis 18

Teething trouble 20

Common childhood illnessesAsthma 22

Chickenpox & measles 24

Constipation 26

Coughs, colds & flu 28

Ear problems 30

Fever 32

More serious conditionsMeningitis 34

General welfareAllergies 36

Upset tummy 38

Burns & scalds 40

Choking 42

Household accidents 44

How to resuscitate a child 46

Immunisations 48

Useful contacts 50

Contents

3

This book has been put together by NHS Southwark Clinical CommissioningGroup.

Every parent or carer wants to know what to do when a child is ill - use thishandbook to learn how to care for your child at home, when to call your GP andwhen to contact Emergency Services.Most of the problems you will come up against are simply an everyday part ofgrowing up, often helped by a chat with your Midwife, Health Visitor or School Nurse.Almost all babies, toddlers and children will get the most common childhood illnesseslike chickenpox, colds, sore throats and ear infections. While these are not very niceat the time they are easily treated by your GP or at home with the support from a GPor Health Visitor rather than a trip to Accident & Emergency.

This handbook helps point you in the right direction and explains what you can do athome to help, or where you need to go to get assistance and advice. It has been puttogether with help from healthcare professionals. If you are worried you must get furtheradvice. Trust your instincts, you know your child better than anybody else.

This handbook also contains general welfare information which will help you keep youand your child safe and healthy.

All factual content has been sourced from Department of Health, Birth to Five, 2009 edition, NHS Choices,British Association of Dermatologists, Meningitis Now. This information cannot replace specialist care. Youneed to get specialist help if you are worried, you know your baby best.

1548-SE London CCI 2:6521-Cornwall 18/12/13 11:19 Page 3

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GPYou will need to register with aGP - to find a GP in your area,use the NHS Choices FindServices System on:www.nhs.uk/servicedirectoriesYour GP can advise, givemedicines and information onother services. You will need tomake an appointment butmost GPs will see a baby quitequickly if you are worried. We offer a GP out-of-hoursservice. See page 51 fordetails.

Health VisitorHealth Visitors will support youand your family during theearly years. They will visit youat home or see you in yourlocal clinic. They assess yourchild’s health and developmentneeds and can tell you whereto get extra help if you need it.They are there for you untilyour child is almost five whencare is handed to the SchoolNurse.

Children’sCentres

Families can access awide range of informationin a friendly environment.Children’s Centresprovide a range of adviceincluding healthpromotion and advice onsafety. They promote allaspects of child healthand well-being.

DentistMake sure you see aDentist on a regularbasis. To find your nearestDentist visit www.nhs.ukFor out-of-hours Dentistinformation call 08444 06 08 99.

A&EFor immediate, life-threatening emergencies,please call 999. A&E and999 are emergencyservices that should onlybe used when babiesand children are badlyinjured or showsymptoms of criticalillness such as breathingdifficulties, fits,dehydration and severepain.

Urgent CareCentres

If your child has anurgent and severe butnon life threateningillness or injury thenattend your local UrgentCare Centre. They haveaccess to x-ray andother services to treaturgent conditions thatare not critical such as awound, cut, burn, sprainor suspected break.

PharmacistYour local Pharmacists canprovide advice on mostcommon health issues. Theycan suggest and dispensemedicine and other healthproducts. There are oftenPharmacists in supermarketsand many are open late. Visitwww.nhs.uk where you canfind the service locator thatwill help you find thePharmacist nearest to you.

A guide to servicesWe have a wide range of healthcare services. See page 51 for details of your local services.


Parents are usually good at noticing when something is wrong with their babyfrom quite early on. It is normal to worry that you won't recognise the signs thatyour 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 accidenthappens. If you know the basics and you are well prepared, you will find it easierto cope - and less scary. Keep a small supply of useful medicines in a lockedcabinet or somewhere up high where a child cannot reach them. There is a usefullist in the box on the right, of things to have at home just in case. Make sureyou’ve got the right strength of medicine for the age of your child, always followinstructions 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 attentionas soon as possible.

Being prepared and knowing the signs

Source: NHS choices7

Thermometer

Natural oils like vegetable oil (for dry skin)

Plasters

Liquid painkillers(e.g. baby paracetamol oribuprofen)

Barrier cream

Know the basics

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

1 2 3My baby is cryingmore than usualand seems to beirritable and hot.

Is there a fever, have youchecked their temperature? Have you tried paracetamol?Remember to check the label togive the right dose.

If you have tried this and ithas not worked, see page32 for more information onfever.

6

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

Grazed knee,Sore throat,Coughs and colds

As a parent if you are:Unsure,Confused,Need help

Mild diarrhoea,Mild skin irritations (includingspots/rash),Mild fever

Minor bumps, Headache,Tummy pain, High temperatureHead injuries not involving loss of consciousnessPersistent coughWorsening health conditions(inside GP hrs)

Choking,Loss of consciousness,Fitting,Broken bones

Self Care

NHS ChoicesFor 24 hour health adviceand information.

PharmacistFor advice on commonillnesses, injuries andmedication.

GPFor the treatment of illnessesand injuries that will not goaway.

Urgent CareIf you have an urgent andsevere but non lifethreatening illness orcondition.

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

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

www.nhs.uk

To find your local pharmacy and its contact details visit:www.nhs.uk/chemist OR text ‘pharmacy’ to 64746 for your nearest 3 pharmacist details.

Write your GP’s (family doctor) telephone number here:

Urgent Care

A & E

Wounds, Cuts, Sprains, Suspected breaks, Minor illnesses in children andadults, including fever, infections,and rashes,Severe pain,Worsening health conditions(outside GP hrs)

Antihistamine


A problem likely to get better on its own

Being sickGP says

After the first few months, ifyour baby is suddenly sick it ismore likely to be caused by astomach virus rather thanpossetting. Gastroenteritis is atummy bug which can comewith diarrhoea (runny poo).

This is more serious in babiesthan older children becausebabies easily lose too muchfluid from their bodies andbecome dehydrated. If theybecome dehydrated theymay not pass enough urine,lose their appetite and havecold hands and feet.

Get expert advice. If yourbaby is unwell, or if vomitinghas lasted more than a day,get your GP’s advicestraightaway.

It is common for babies to be sick, often in the early weeks as they get used tofeeding 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 foryour baby, so they are likely to cry. Lots of things can cause your baby to be sick.

Make sure your baby is positioned correctly when breast or bottle feeding asincorrect positioning can cause a baby to be sick.

Being sick often or lots of it, may be due to ‘gastric reflux’ where acid from thetummy can come up again. Babies can be grumpy and it can sometimes lead topoor feeding. If your baby is feeding well but doesn't seem themselves, you mayjust need to change the baby's position during a feed to make them more upright.Feeding smaller amounts and more often may also help.

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1 2 3I have a new baby. I have just given my baby a feed.

They always seem to bringup small amounts of milk.

This is known as‘possetting’. As theydevelop it will stopnaturally. Talk to yourHealth Visitor.

Health Visitor saysPossetting is ‘normal’ duringor after a feed. If this carrieson at other times, betweenfeeds it may be a tummybug. It is important for babiesto have plenty of fluids tostop any dehydration.


10

CryingUnderstanding why

All babies cry, especially in the first few weeks after birth. Crying is their way ofletting you know they need something or are uncomfortable. They may needchanging, they may be hungry or just need a cuddle. Always burp your baby aftera feed as this will help.

If your baby cries suddenly and often, but they otherwise appear to be happy andhealthy, they may have colic. Colic is common and although uncomfortable it is notserious and usually affects babies only in the first few months of their lives. Themost common symptom of colic is continuous crying, which typically occurs in thelate afternoon or evening. Other signs include a flushed appearance, drawing theirlegs 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’tbe afraid to ask for help. Try taking your baby for a walk in the pram or a drive inthe car to soothe them. Do not shake your baby.

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Health Visitor saysKnow your baby. Try tounderstand what it is theyneed. Try and find out whyyour baby is crying by goingthrough this list.

Things to check first are:

� Does their nappy needchanging?

� Could they be hungry?

� Could they be too hot?

� Could they be too cold?

� Does their cry sounddifferent?

These are simple thingswhich could be causing yourbaby to cry.

GP saysIf your baby's crying seemsdifferent in any way (such asa very high-pitched cry or awhimper), then seek medicaladvice. Crying cansometimes be a sign thatyour baby is unwell. Trustyour instincts - you knowyour baby best.

1 2 3My baby is crying morethan usual.

Have you followed theadvice given by your HealthVisitor? Have you thoughtabout what your baby istrying to tell you, it may besomething really simple.

If you have tried this and ithas not worked speak toyour Health Visitor, orcontact your GP if you areworried.


Nappy rashNappy rash is very common and can affect lots of babies. It is usually caused whenyour baby's skin comes into contact with wee and poo that collects in their nappy.

A nappy rash causes your baby's skin to become sore. The skin in this area may becovered in red spots or blotches. You might need to change their nappy more often.

Most nappy rashes can be treated with a simple skincare routine and by using acream you can get from the Pharmacist. With a mild nappy rash, your baby won'tnormally feel too much discomfort.

Dry skinA 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. Ifyour baby is well but has a rash you are worried about contact your Midwife orHealth Visitor.

A common problem that’s easy to treat

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Pharmacist saysCall in and talk to us aboutcreams we can provide youwith over the counter.

There are two types of nappycream available. One is abarrier cream to keep weeaway from your baby's skin.The other is a medicatedcream, that is good forclearing up any soreness but should only be usedwhen advised by a healthprofessional.

1 2 3There is a red, sore rasharound the nappy area.Baby is uncomfortable andcries a lot.

Has baby been in a dirtynappy for a long time? Have you followed advicefrom your Health Visitor, orspoken to your Pharmacist?

Change nappy often.Speak to your HealthVisitor and if you areworried see your GP.

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

Use a barrier cream.(see Pharmacist saysbox opposite).

Remember tochange and checktheir nappy often.

Health Visitor’s nappy rash tips


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Rashes & dry skinBaby skin needs extra care

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. Ifyour baby is well but has a rash you are worried about contact your Midwife orHealth Visitor. Another common rash for babies is heat rash. This mainly appearson the head and neck as tiny red spots and is nothing to worry about. Keep themwarm but not hot and try to dress them in natural cotton clothes, with nothing thatcan rub on their skin.

Your baby may also suffer from something called cradle cap. This is the namegiven to the yellowish, greasy scaly patches on the scalp of newborns and usuallyappears in the baby’s first three months. It can look like a bad case of dandruffand is harmless, it doesn’t cause any irritation to your baby and usually clears upby the time they are two years old.

The above information cannot replace specialist treatment. If you are worried contact your GP.15

Health Visitor’s cradle cap tips

Baby skin is more delicatethan ours. Try to limit theamount of products you useon their skin and never leaveyour baby out in the sun.

Cradle cap needs no specifictreatment, although gentlywashing the baby’s hair andscalp may stop build-up ofthe scale. Use just a smallamount of a pure, natural oil -such as vegetable oil - onyour baby's scalp and leave iton at least 15 minutes beforewashing it off. 1 2 3

Your baby’s skin may beflaky and dry.

Dry skin is common innewborn babies, as theirskin is 15 times thinnerthan that of an adult.

Avoid soap and using products on yourbaby’s skin. Wash yourbaby in clean water.

GP saysGo to A&E immediately if yourbaby has a rash that does notdisappear when you press aglass to it. This may be a signof meningitis and needs to beseen by a Doctor no matterhow well your baby seems.

Call 999 or go to A&E if yourbaby has a rash and a hightemperature or vomiting (seepage 34 for more informationon meningitis).


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Safer sleepingReducing the risks of cot death

A cot in your room is the safest place for your baby to sleep in their first sixmonths. Keep the cot tidy and do not use plastic sheets. Babies can overheat, sotry to keep the room between 16-20°C. Do not use duvets, quilts or pillows untilyour baby is one year old, and never use hot water bottles or electric blankets.Always position your baby in the ‘Feet to Foot’ position, with their feet at the footof the cot so that they can’t move down inside their blanket.

Unless a health professional has told you to do something different, always put yourbaby to sleep on its back. Never let your baby fall asleep propped up on a cushion,on a sofa or chair, and don’t let anyone fall asleep while nursing your baby.

Remember - keep the house smokefree. Babies exposed to secondhand smokehave a greater risk to cot death.

For further advice or support you could speak to your Health Visitor or GP orcontact The Lullaby Trust (formerly FSID) 0808 802 6869 www.lullabytrust.org.uk

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Health Visitor saysThe safest place for your babyto sleep for the first six monthsof life is in a cot in your room. Ifyou decide to take a baby intoyour bed, make sure you oryour partner have not taken anymedicine, drugs or alcohol thatmay make you sleep moreheavily than usual. Being obesecan increase risks. Remember,they face a bigger health risk ifyou or your partner is a smoker.Sleeping next to you your babywill be warmer anyway, so ifthey fall asleep they may get toohot. Taking your baby into yourbed is never risk free.

Flat head syndromeFlat head syndrome can occur inthe womb or can be caused by ababy sleeping, resting and playingin one position.

Many babies develop a flattenedhead when they are a few monthsold, usually from sleeping on theirback. FHS occurs when the back orone side of the baby's head issquashed against a firm mattressfor a long time, which eventuallyforces the soft bone of the skull toflatten.

It often corrects itself over time andis usually nothing to worry about.

1 2 3Always put your baby tosleep in the ‘Back toSleep’ and ‘Feet to Foot’position.

Babies aren’t good atkeeping their temperatureconstant, so make surethey don’t get too hot ortoo cold.

Keep your baby’s cot inyour room for the first sixmonths.

Call 0800 022 4332 or visitwww.smokefree.nhs.uk


18

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

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

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

Two different issues

Source: DoH 2006.19

GP says -Conjunctivitis

The signs of ‘sticky eyes’ cansometimes be confused with aninfection called ‘conjunctivitis’.With conjunctivitis the signs areyellowy, green sticky goo whichcomes back regularly. If younotice this, contact your HealthVisitor or GP. This can bepassed on easily, so wash yourhands and use a separate towelfor your baby.

1 2 3Is there discharge in thecorner of your baby’s eyeand do their eyelashesappear to be stucktogether?

Sticky eyes is a commoncondition that affects mostbabies, speak to yourHealth Visitor.

Use cooled boiled water ona clean piece of cottonwool for each wipe.

Sticky eyes & conjunctivitis


Source: DoH Birth to five edition 2009.

Every baby goes through it

2120

Teething trouble

Pharmacist saysIf your baby is uncomfortable,you may want to give them amedicine which has beenmade for children which youcan buy from the Pharmacist.These medicines contain asmall dose of painkiller, suchas paracetamol, to help easeany discomfort. The medicineshould also be sugar free.Make sure you read allinstructions or ask yourPharmacist about how to use them.

For babies over four monthsold, you can try sugar-freeteething gel rubbed on the gum.

Health Visitor saysIt can help to give your babysomething hard to chew on,such as a teething ring.Teething rings give your babysomething to safely chew on,which may help to ease theirdiscomfort or pain. Someteething rings can be cooledfirst in the fridge.

All sorts of things are put downto teething - rashes, crying, badtemper, runny noses, extra dirtynappies - but be careful not toexplain away what might be thesigns of illness by saying it’s‘just teething’.

Source: DoH Birth to five edition 2009.

1 2 3My baby has red cheeksand seems a bitfrustrated and grumpy.

Have you asked yourHealth Visitor aboutteething? Have youdiscussed options withyour Pharmacist?

Try some of the gels or babyparacetamol available. If youare worried and things donot feel right contact yourHealth Visitor or GP.

The time when babies get their first primary teeth (milk teeth) varies. A few areborn with a tooth already, whilst others have no teeth at one year. Teeth generallystart to show when a child is four to nine months old, although every babydevelops at their own pace. This is known as ‘teething’. Some babies show fewsigns while others find it more uncomfortable. Some teeth grow with no pain ordiscomfort at all. At other times you may notice that the gum is sore and redwhere the tooth is coming through, or that one cheek is flushed. Your baby maydribble, gnaw and chew a lot, or just be fretful.

Some people attribute a wide range of symptoms to teething, such as diarrhoea andfever. 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 symptomsare severe or causing you concern, talk to your Health Visitor. Source: www.nhs.uk

Think about your child’s tooth care routine. You can brush their teeth with a softbaby toothbrush and a smear of family toothpaste. Make sure you are registeredwith a Dentist and take your baby with you. Discuss registration of your child.


22

AsthmaKnow the symptoms

Asthma is a common long-term condition that can be well controlled in mostchildren. The severity of asthma symptoms varies between children, from verymild to more severe. Parents learn how to be prepared and how to recognisesymptoms and deal with them.

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. Asthmaattacks 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 dustmites, animal fur, grass and tree pollen or exposure to air pollution, especiallytobacco smoke or a cold virus. Asthma often runs in families.

Call 999 to seek immediate medical assistance if your child has severesymptoms of asthma.

Source: Department of Health, Birth to five 200923

GP saysYour GP will normally be able todiagnose asthma by askingabout your child’s symptoms,examining their chest andlistening to their breathing. Theywill want to know about yourchild’s medical history andwhether there is a history ofallergic conditions in your family.They will also want to knowabout the circumstancessurrounding the onset of yourchild's symptoms, such aswhen and where it happened,because this could help toidentify the possible trigger(s) oftheir asthma.

Symptoms ofasthma

Symptoms include repeatedcoughing and wheezing,shortness of breath andbringing up mucus. Symptomsoften get worse at night.

1 2 3

Health Visitor saysSmoking during pregnancy oraround your child can increaserisk of asthma. Breastfeedingfor as long as possible can helpreduce risk of getting asthma.

My child seems towheeze and cougha lot, it seems toget worse at night.

Have you tried reducing any possibleamounts of dust around the home? Do you smoke? Have you discussedwith your Health Visitor?

If symptoms persistsee your GP. If yourchild has a seriousasthma attack call999.


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Take rashes seriously

ChickenpoxChickenpox is a mild disease that most children catch atsome point. The spots often look like mosquito bites andcan appear on any part of the body. After havingchickenpox, the virus stays in the body. Later in life thevirus can come back in a different form known as shingles.

Chickenpox is easy to pass on to someone who has nothad it before. If your child has chickenpox keep them awayfrom others.

Chickenpox can be incredibly itchy, but it's important forchildren to not scratch the spots so as to avoid futurescarring. One way of stopping scratching is to keepfingernails clean and short. You can also put socks overyour child's hands at night to stop them scratching the rashas they sleep.

If your child's skin is very itchy or sore, try using calaminelotion or cooling gels. These are available in pharmacies andare very safe to use. They have a soothing, cooling effect.

MeaslesMeasles is a very infectious illness. About one in fivechildren with measles experiences complications such asear infections, diarrhoea and vomiting, pneumonia,meningitis and eye disorders. One in 10 children withmeasles ends up in hospital. There is no treatment formeasles. Vaccination is the only way of preventing it. If yourchildren haven’t yet had the MMR vaccination, don’t delay.Speak to your Health Visitor.

Once the rash starts, your child will need to rest and you cantreat the symptoms until your child’s immune system fightsoff the virus. If there are no complications due to measles,the symptoms will usually disappear within 7-10 days.

Closing curtains or dimming lights can help reduce lightsensitivity.

Damp cotton wool can be used to clean away any crustinessaround the eyes. Use one piece of cotton wool per wipe foreach eye. Gently clean the eye from inner to outer lid.

PainkillersIf your child is in pain or has a high temperature (fever), you can give them a mild painkiller, such asparacetamol (available over-the-counter in pharmacies). Always read the manufacturer's dosage instructions.Do not give aspirin to children under the age of 16.

Chickenpox & measles

Midwife saysIf you are pregnant and have hadchickenpox in the past it is likelythat you are immune tochickenpox. However, pleasecontact your GP or Midwife foradvice.

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ConstipationCommon and easy to treat

Constipation means passing hard poos, with difficulty and less often thannormal. Babies can have a poo several times a day or once every few days.Babies often appear to strain and go red in the face when having a poo - thisis normal. In children, having a poo anything from 3 times a day to once everyother day can be normal so long as the poos are soft and easily passed.Sometimes bad constipation can cause a child to dirty their pants.

It is not always clear why children become constipated but it is important toget it treated because if a child is constipated they may find it painful to go tothe toilet. This creates a vicious circle; the more it hurts, the more they holdback, the more constipated they get. Once a child is really constipated theymay stop wanting to go to the toilet altogether. Ask your Health Visitor if astool softener might help. If it doesn’t solve the problem, talk to your GP.

Source: NICE guidelines 2009, Constipation in children.27

Health Visitor saysTo avoid constipation and help stopit coming back make sure yourchild has a balanced diet includingplenty of fibre such as fruit,vegetables, baked beans andwholegrain breakfast cereals. Wedo not recommend unprocessedbran (an ingredient in some foods),which can cause bloating, flatulence(wind) and reduce the absorption ofmicronutrients. Drink plenty of fluids.

If a bottle fed baby becomesconstipated you can try offeringwater between feeds (never dilutebaby milk). If the problem doesn’tgo away, talk to your Health Visitoror GP again.

1 2 3Has you child stoppedwanting to go to thetoilet altogether?

If your child is constipated,they may find it painful togo to the toilet.

Ask your HealthVisitor or Pharmacistwhether a suitablestool softener mayhelp.


28

Coughs, colds & fluYou will probably find when your child goes to playgroup or nursery that they getlots of coughs, colds and sniffles. There are some good things about this thoughas it helps the body build up a natural immune system.

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

Most bugs will run their course without doing any real harm because they will getbetter on their own. An annual nasal spray flu vaccine is available for all childrenaged two and three as part of the NHS Childhood Vaccination Programme. Askyour Health Visitor.

Things you can do at home to help:

� Give your child lots to drink.

� Try infant 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 ofkeeping the lungs clear.

See your GP 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.

Not usually serious

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Pharmacist saysChildren can often be treatedusing over the countermedicines to help to bringdown a raised temperature.Junior paracetamol and coughmedicines can help. Check thelabel carefully. Some areavailable as a liquid for childrenand can be given from the ageof about three months. Checkwith the Pharmacist and tellthem how old your child is. Flu symptoms are more severeand you may need to see yourGP.

Don't pass it on:Catch it Germs spread easily. Always carrytissues 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 youtouch. Clean your hands as soon as you can.

Paracetamol - junior paracetamol can be given for pain orfever to children over 2 months. Check you have the rightdose and strength for your child’s age. Read the box carefully.Ibuprofen - junior form can be given to babies and childrenof 3 months and over who weigh more than 5kg. Read thebox carefully. Do not give if your child has asthma unlessadvised by a Doctor.Aspirin - do not use for children under 16.

1My child keeps coughing andsneezing, has a mild temperatureand seems generally unwell.

2Have they recently startednursery? Catching colds isvery common. Have youspoken to your Pharmacistabout junior paracetamoland cough medicines?

3If symptoms last formore than 10 days oryour child is coughingup yellow ‘goo’ theymay have an infection.Contact your GP.


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What are the signsof an ear infection?

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

Ear problemsA 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 maypull at their ear, but babies often cannot tell where their pain is coming from, sothey just cry and seem generally uncomfortable.

Babies have some natural protection against infections in the first few weeks - thisis boosted by breastfeeding. In babies and toddlers, bacteria pass from the noseto the ears more easily. Ear infections can be painful and your child may just needextra cuddles and painkillers from the Pharmacist. Your child may have swollenglands in their neck - this is the body’s way of fighting infection.

Children who live in households where people smoke (passive smoking) or whohave a lot of contact with other children, like those who go to nursery, are morelikely to get ear infections. Speak to your Health Visitor about safely cleaning yourbaby’s ears as they can be easily damaged.

Source: DoH Birth to five edition 2009.31

Health Visitor’s tips

� A baby’s ears need to betreated with care whencleaning.

� Never use a cotton budinside your child’s ear.

� If they have atemperature wax mayooze out.

� Use different, cleandamp cotton wool oneach ear to gently cleanaround the outer area.

1 2 3My toddler hasearache but seemsotherwise well.

Have you tried infantparacetamol or ibuprofenfrom your Pharmacist? Donot put oil or cotton budsinto your child’s ears.

Most ear infections get better bythemselves. Speak to a GP if noimprovement with painkillers, ortemperature remains raised after2 days, your child seems in a lotof pain or you notice fluid comingfrom the ear.


32

Babies under 6 months:Always contact your Practice Nurse orGP without delay if your baby has othersigns of illness, as well as a raisedtemperature and/or if your baby’stemperature is 38 ̊C (102 ̊F) or higher.

Older children:A little fever isn’t usually a worry.Contact your GP if your child seemsunusually ill, or has a high temperaturewhich doesn’t come down.• It is important to ensure your child

drinks as much fluid as possible. • Keep the room at a comfortable

temperature (18 ̊C).• Give liquid paracetamol in the correct

recommended dose for your child.• Aspirin should not be given to children

for treatment of pain or a fever.• Please ask your local Pharmacist to

advise about medicines.

FeverCommon in young children

Source: DoH Birth to five edition 2009.33

If your child has a fever, he or she will have a body temperature above 38˚C. Yourchild may also feel tired, look pale, have a poor appetite, be irritable, have aheadache or other aches and pains and feel generally unwell.

A fever is part of the body’s natural response to infection and can often be left torun its course provided your child is drinking enough and is otherwise well. It isimportant to prevent your child from becoming dehydrated, which can lead tomore serious problems. As a guide, your child’s urine should be pale yellow - if itis darker, your child may need to drink more fluids.

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

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

GP’s tipsThese are things you can do athome to help:• Children with fever should not

be under or overdressed.• It is important to ensure your

child drinks as much fluid aspossible.

• Keep them in a wellventilated room.

1 2 3My toddler is hot andgrumpy.

Have you tried liquidparacetamol? Have youmade sure they are drinkinglots of fluids?

If their temperature staysat 38˚C contact your GP.


34

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

In this example the spots are stillvisible through the glass. Contact aDoctor immediately (e.g. your ownsurgery). If you cannot get helpstraight away go to A&E.

In this example the spots under theglass have virtually disappeared. It isunlikely to be meningitis but if youare still worried contact NHS Direct, your GP or go to A&E.

Source: Meningitis Now

Go straight to the Accident and Emergency Department

MeningitisA serious, contagious illness

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

Meningitis is a swelling around the brain. It’s a very serious, contagious illnesswhich can sometimes get confused with other more common illnesses, but if it’streated early most children make a full recovery.

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 childmay have a cluster of red or purple spots. Do the glass test. This rash can beharder to see on darker skin, so check for spots over your baby or child’s wholebody as it can start anywhere (check lightest areas first). However, the rash isnot always present - be aware of all the signs/symptoms.

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

If you are worried, contact a Doctor. If you cannot get help straight away go to A&E. 35

Fever, cold hands and feet

Floppy andunresponsive

Drowsy anddifficult to wake

Spots/rash.Do the glass test

Rapid breathing or grunting

Fretful, dislikesbeing handled

Unusual cry or moaning

GP saysIf any of the signs below arepresent contact a Doctor.

�

1 2 3My child is showingsome of the signsof meningitis.

Have you triedthe glass test?

Treat all cases of suspectedmeningitis as an emergency. If the spots do not fade underpressure call 999 or go to A&E.


36

AllergiesManaging and understanding your child’s allergy

Source: NICE - Testing for food allergy in children and young peopleSource: Allergy UK37

GP saysIf you suspect you or your childmay have a food allergy, it isvery important to ask for aprofessional diagnosis from yourGP, who may refer you to anallergy clinic.

Many parents mistakenlyassume their child has a foodallergy when in fact theirsymptoms are due to acompletely different condition ora food intolerance. Mild allergieswill respond to antihistaminesfrom your pharmacist.

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

An allergy is when the body has a reaction to a protein such as foods, insectstings, pollens, house dust mite or other substance such as antibiotics. There aremany common allergies. Some families seem to include more individuals withallergies than other families. Children born into families where allergies alreadyexist show a higher than average chance of developing allergies themselves.

Allergic symptoms can affect the nose, throat, ears, eyes, airways, digestion andskin in mild, moderate or severe form. When a child first shows signs of an allergyit is not always clear what has caused the symptoms, or even if they have had anallergic reaction, since some allergic symptoms can be similar to other commonchildhood illnesses. If the reaction is severe, or if the symptoms continue to re-occur, it is important that you contact your GP.

1 2 3Food allergies occurwhen the body’simmune systemreacts negatively toa particular food orfood substance.

Allergens can cause skin reactions(such as a rash or swelling of thelips, face and around the eyes),digestive problems such as vomitingand diarrhoea, and hay-fever-likesymptoms, such as sneezing.

Children are mostcommonly allergic tocow’s milk, hen’s eggs,peanuts and other nuts,such as hazelnuts andcashew.

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

Spotting symptomsThis example shows areas where allergysufferers may experience symptoms.Many of these symptoms can develop asa result of other common childhoodillnesses. With an allergy, symptoms oftenappear more quickly or suddenly.

Nose, throat and earsRunny nose, blocked nose, itchynose, sneezing, pain in sinuses,headaches, post-nasal drip (mucusdrips down the throat from behindthe nose), loss of sense of smell andtaste, sore throat, swollen larynx(voice box), itchy mouth and/orthroat, blocked ear and glue ear.

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

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

AirwaysWheezy breathing, difficulty inbreathing, coughing (especially atnight time), shortness of breath.

Call 0800 022 4332 or visitwww.smokefree.nhs.uk


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

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

� Being extra careful with handhygiene (use soap and water oranti-bacterial hand gel and dryhands well with a clean towel).

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

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

Pharmacist says

38

Upset tummyNot nice for you or your baby

Sickness and diarrhoea bugs are caught easily and are often passed on in placeswhere there are lots of children - like playgroups or nurseries.

Feeling sick and suddenly being sick are normally the first signs. Diarrhoea canfollow afterwards. Take them to see your GP if they are unwell for longerthan 24 hours or sooner if they are newborn or if you notice signs ofdehydration.

If you're breastfeeding, keep on doing so. Offer older children plenty of water, oran ice-lolly for them to suck. If they want to eat, give them plain foods like pastaor boiled rice (nothing too rich or salty).

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

39

Signs ofdehydration

� Sunken fontanelle (i.e.the soft spot is moredipped in than usual).

� Less wet nappies (i.e.they wee less).

� More sleepy than usual.

� Diarrhoea.

� Dry mouth.

Try rehydrating solution fromyour Pharmacist.

1 2 3My baby hasrunny poo andis being sick.

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

Speak to a Doctor if symptomsshow no sign of improvementafter 24 hours or straight awayif they are newborn.

VomitingThe most common cause ofvomiting is gastroenteritis. Thisis an infection of the gut. It alsocauses diarrhoea. This is usuallynothing to worry about and willpass in a few days. Being sickcan sometimes be caused byother things like food allergies,accidentally swallowing a poisonor drug, or an infection.

You should contact your GP if:• Your child has been vomiting

for more than 24 hours.• Your child has not been able

to hold down fluids for the lasteight hours, or you think theyare dehydrated

• They are floppy, irritable,won't eat their food, or theyare not their usual self.

• They have severe tummy pain.• They have a headache and

stiff neck.


40

Burns & scaldsA burn is damage to the skin, which is caused by direct contact with somethinghot. Burns can also be caused by certain chemicals, electricity and friction. Ascald is a burn that is caused by a hot liquid or steam. Scalds are treated in thesame way as burns.

Treat any burn or scald straight after the accident but always take your child tohospital for anything more than a very small burn or scald. A baby’s skin is verydelicate and can be scarred without the right treatment.

Cool the burnt area by placing under cool running water for at least twentyminutes. When the burn has cooled, cover it with a sterile dressing, food qualitycling 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.

Knowing what to do

If you are still worried, contact your GP out-of-hours service. If you cannot get help straight away go to the Accident and Emergency Department.41

DoHold the affected area undercold water for at least 20minutes. Cover the burn withcling film if you have some,then wrap in a cloth soakedin cool water.

Don’tApply fatty substances likebutter or ointment as thiswon't do any good and willonly waste time for hospitalstaff who'll have to clean thearea before it can be treated.

1 2 3Treat the burn or scaldstraight after the accidentby running under coldwater for 20 minutes.

Do not use creams,lotions or ointments onthe burn or scald.

For small burns take yourchild to the Practice Nurseor Urgent Care Centre. Forlarge or facial burns youshould go to A&E.


4342

ChokingAct immediately and calmlyChildren particularly between the ages of about one and five, often put objects intheir mouth. This is a normal part of how they explore the world. Some smallobjects, like marbles and beads, are just the right size to get stuck in a child’sairway and cause choking. The best way to avoid this is to make sure smallobjects like these are out of your child’s reach.

In most cases you, or someone else, will see your child swallow the object thatcauses the choking. However, there can be other reasons for coughing. If yourchild suddenly starts coughing, is not ill and often tries to put small objects in theirmouth, then there is a good chance that they are choking.

If your child is still conscious but either they are not coughing or their coughing isnot effective, use back blows. If back blows don’t relieve the choking, and yourchild is still conscious, give chest thrusts to infants under one year or abdominalthrusts to children over one year. Even if it is expelled, get medical help.

Try these suggestions:• If you can see the object, try

to remove it but don't feelwith your fingers if youcannot see it. You couldmake things worse bypushing the object in further.

• If your child is coughingloudly, there is no need to doanything. Encourage them tocarry on coughing and don’tleave them.

• If your child’s coughing is noteffective (it’s silent or theycannot breathe in properly),shout for help immediatelyand decide whether they arestill conscious.

• If your child is still consciousbut either they are notcoughing or their coughingis not effective, use backblows.

Babies and toddlers can easilyswallow, inhale or choke onsmall items like lolly sticks,balloons, peanuts, buttons,nappy sacks, plastic toy piecesor cords.

Unconscious child with choking:If a choking child is, or becomes unconscious, put them on a firm flat surface.• Call out or send for help if you are still alone.• Don’t leave the child at this stage.• Open the child’s mouth. If the object is clearly visible, and you can grasp it

easily, remove it.• Start cardiopulmonary resuscitation (CPR).Don’t use blind or repeated finger sweeps. These can push the object further in,making it harder to remove and cause more injury to the child.


Keeping your child safe in and around the home

45

FallsFor babies the biggest danger is rolling off the edge of abed, or changing surface. For toddlers it is more aboutfalling from furniture or down stairs.PREVENTION:Make sure baby cannot roll off any surfaces, put pillowsaround them. Do not put a bouncing cradle or car seaton a surface where they could wriggle off.Use stair gates for toddlers. Make sure balconies arelocked and fit restrictors and safety locks to windows.WHAT TO DO:If your child has a serious fall dial 999.

ChokingBabies and toddlers can easily swallow, inhale or chokeon small items like balloons, peanuts, buttons or plastictoy pieces or strings or cords.PREVENTION:Check on the floor and under furniture for small items.Find out more about CPR (a first aid techniquethat is a combination of rescue breaths and chestcompressions. Sometimes called the ‘kiss of life’).

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

Head injuryOne of the signs of a severe head injury is being unusuallysleepy, this does not mean you cannot let your child sleep.You need to get medical attention if:• They are vomiting persistently (more than 3 times).• They are unsteady or confused.• 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 anyway about their drowsiness, then you should wake yourchild an hour after they go to sleep.WHAT TO DO:Check that they are okay, and that they are respondingnormally throughout the night.

CutsGlass causes serious cuts with many children ending up inA&E.PREVENTION:Do not leave drinking glasses on the floor. Make sure glassbottles are up high.WHAT TO DO:If the cut is not serious bathe the area, make sure thereis no glass left and cover with a clean non-fluffy cloth.

If the cut is serious, is bleeding a lot or has a piece ofglass under the skin (maybe they trod on some glass) go to A&E.

DrowningMany children drown, often in very shallow water. Ithappens in the bath, in garden ponds, paddling poolsand water butts.PREVENTION:Supervise children near water at all times. Use a grille onponds and fill in a garden pond to use as a sand pit. Learnto swim. Do not leave unattended with a young sibling.WHAT TO DO:Get your child out of the water. Try to get them to coughup any water. If they are not responding call 999.

PoisoningPoisoning from medicines, household products andcosmetics are common.

PREVENTION:Lock all chemicals, medicines and cleaning productsaway.WHAT TO DO:Find out what your child has swallowed and take it withyou to A&E.

StrangulationWindow blind cords and chains can pose a risk forbabies and children who could injure or even stranglethemselves on the hanging looped cords.PREVENTION:• Install blinds that do not have a cord, particularly in a

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

near a window. • 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 hang toys or objects that could be a hazard on

the cot or bed.• Don't hang drawstring bags where a small child could

get their head through the loop of the drawstring.WHAT TO DO:Untangle child, contact the emergency services andstart CPR.Source: RoSPA

Household accidents

44


Back blows forchildren under one year• Support your child in

a head-downwardsposition. Gravity canhelp dislodge theobject.

• Sit or kneel and support the child on yourlap. If this is not possible, support your child ina forward-leaning position and give the backblows from behind.

• Don’t compress the soft tissues under the jawas this will make the obstruction worse.

• Give up to five sharp blows to the back withthe heel of one hand in the middle of the backbetween the shoulder blades.

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 theback blows from behind.

Chest thrusts for children under one year• Support the baby down your arm, which is

placed down (or across) your thigh as you sitor kneel.

• Find the breastbone and place two middlefingers in the middle.

• Give five sharp chest thrusts, compressingthe chest by about a third of its diameter.

Abdominal thrusts forchildren over one year• Stand or kneel behind the

child. Place your armsunder the child’s armsand around their upperabdomen.

• Clench your fist and place it between naveland ribs.

• Grasp this hand with your other hand and pullsharply inwards and upwards.

• Repeat up to five times.• Make sure you don’t apply pressure to the

lower ribcage as this may cause damage.

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.46

If back blows don’trelieve the chokingand your child is stillconscious, andunder one year givechest thrusts.

If back blows don’trelieve the chokingand your child is stillconscious, and overone year giveabdominal thrusts.

Babies under one year old1. Open the baby's airway by placing one hand on the

forehead while gently tilting the head back and liftingthe chin. Remove any visible obstructions from themouth or nose.

2. Place your mouth over the mouth and nose of the infantand blow steadily and firmly into their mouth, checkingthat their chest rises. Give five initial rescue breaths.

3. Place two fingers in the middle of the chest and pressdown by one-third of the depth of the chest. After 30chest compressions at a steady rate (slightly faster thanone compression a second), give two rescue breaths.

4. Continue with cycles of 30 chest compressions andtwo rescue breaths until they begin to recover oremergency help arrives.

Children over one year old1. 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 andblow steadily and firmly into their mouth, checking thattheir chest rises. Give five initial rescue breaths.

3. Place your hands on the centre of their chest and, withthe heel of your hand, press down by one-third of thedepth 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), givetwo breaths.

5. Continue with cycles of 30 chest compressions andtwo rescue breaths until they begin to recover oremergency help arrives.

Source: NHS Choices, DoH birth to five 2009.

How to resuscitatea childBack blows, chest thrusts & cardiopulmonary resuscitation (CPR)

47


1 2 3Immunisation begins attwo months, when baby'snatural immunity to illness,begins to drop.

Your Health Visitor willtell you when localimmunisation sessionsare taking place.

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

When to immunise

Two months old

Three months old

Four months old

Twelve months old

Fifteen months old

Three years four monthsold or soon after

Diseases protected against

• Diphtheria, tetanus, pertussis (whooping cough),polio and haemophilus influenzae type b (Hib)

• Pneumococcal disease• Rotavirus vaccine

• Diphtheria, tetanus, pertussis, polio and Hib• Meningococcal group C disease (MenC)• Rotavirus vaccine

• Diphtheria, tetanus, pertussis, polio and Hib• Pneumococcal disease

• Hib/MenC• Pneumococcal disease• Measles, mumps and rubella (German measles)

• Measles, mumps and rubella (second dose)

• Diphtheria, tetanus, pertussis and polio

Source: NHS Immunisation Information.

48

ImmunisationsProtect your child now and in the future

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

Immunisations are mainly given during the first five years. It’s important to havevaccinations at the right age to keep the risk of disease as low as possible. It isnormal to worry about vaccinations, so don’t hesitate to ask your Health Visitor orGP for advice - that’s what they are there for! Childhood immunisations are free andmost are given at your GP’s surgery.

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

An annual nasal spray flu vaccine is available for all children aged 2 and 3 years oldas part of the NHS Childhood Vaccination Programme. Ask your Health Visitor.

The whooping cough vaccine is recommended for all women between 28 and 38weeks pregnant. You should be offered this at your routine antenatal appointment.

49

GP saysImmunisations are used toprotect children from diseaseswhich can be very serious andsometimes even cause death.

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

You may have concerns aboutthe safety of immunisations,discuss these with your GP.Mild side effects are possible.

Health Visitor saysMake sure you keep yourchild’s Red B ook in a safeplace. It is your only completerecord of their childhoodimmunisations and they areoften needed later in life.Check with your Health Visitoron any updates and futureimmunisations.


Useful national contacts Useful local contacts

50

Asthma UK0800 121 62 44www.asthma.org.uk

Child Accident Prevention Trust (CAPT)020 7608 3828www.capt.org.uk

Meningitis Now0808 80 10 388www.meningitisnow.org

National Breastfeeding Network Helpline0300 100 0212www.breastfeedingnetwork.org.ukemail: [email protected]

NetmumsParenting advice and information inEngland, Wales, Scotland and NorthernIreland.www.netmums.com

NHS Choiceswww.nhs.uk

Self Care Forumwww.selfcareforum.org

Call 999 in an emergency

51

GP out of hoursWhen your GP surgery is closed, callSouth East London Doctors’ Co-operative (SELDOC) on 020 86939066 from 6.30pm to 8.00amweekdays and all day Saturday,Sunday and bank holidays.

Urgent Care CentreIf you have an urgent and severe butnon-life-threatening illness orcondition then attend the Urgent CareCentre. The following conditions canbe treated on site:• Wounds• Cuts• Sprains• Suspected breaks• Minor illnesses in children and

adults, including fever, infections,and rashes.

Guy’s Urgent Care CentreGuy’s Hospital, Tabard Annexe,Great Maze Pond, London SE1 9RT.020 3049 8970 Open 8.00am-8.00pm (last patientarrival at 7.00pm), 7 days a week,365 days a year.www.guysandstthomas.nhs.uk

NHS ChoicesIf you need help finding your nearest GPpractice, call NHS England on 0300 311 2233 or visit www.nhs.uk

Health Visiting Service020 7138 7813 (general)BermondseyBermondsey Health Centre 020 3049 7183 Borough & WalworthAylesbury Health Centre 020 3049 8710DulwichTownley Road Clinic 020 3049 7470 Dulwich Hospital 020 3049 8858 Peckham & CamberwellLister Health Centre 020 3049 8322

Contact a Family SouthwarkSupport for families with disabledchildren 0-19.020 7358 7799Email: [email protected]

Southwark Family InformationServiceInformation and guidance on childcareand children services.0800 013 0639 Email: [email protected]

School Nursing Service020 3049 4488

A&EAccident and Emergency (A&E)departments should only be used in acritical or life-threatening situation. A&E departments provide immediateemergency care for people who showthe symptoms of serious illness or haveinjuries that could be life-threatening -THINK FIRST BEFORE YOU GO TOA&E.

At A&E the most seriously ill patientswill be seen before those with lessurgent care conditions. This means thatsome people have to wait for severalhours or they may be signposted totheir GP, Pharmacist or other healthcare service who will be able to help.

In an emergency dial 999 or go to yournearest A&E department:St Thomas' Hospital A&EWestminster Bridge Road,London SE1 9RT.020 7188 7188www.guysandstthomas.nhs.uk

King’s College Hospital A&EDenmark Hill, London SE5 9RS.020 3299 9000www.kch.nhs.uk


1548-se london cci 2:6521-cornwall - nhs southwark … your gp’s (family doctor) telephone number...

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