Colds, Fevers and Childhood Bugs: What’s Normal and When to Worry

The first winter of nursery is a rite of passage: a new virus seemingly every fortnight, a permanently running nose, and a parent wondering whether this can possibly be normal. It is — and knowing the genuine red flags is what lets you ride out everything else calmly.

Why is my child always ill — is their immunity low?

Almost certainly not. A young child's immune system is untrained, not weak — 8–10 viral illnesses a year is normal, and starting nursery or school compresses years of virus exposure into months. Each infection builds memory; the "always ill" phase genuinely passes, usually within a year or two of starting childcare.

What supports the training rather than shortcutting it: routine vaccinations on schedule (the single biggest immunity intervention there is), vitamin D drops for under-5s, ordinary varied food, sleep, outdoor time and handwashing. What doesn't: multivitamin gummies marketed as "immune support", supplements beyond vitamin D, or avoiding all germs — although basic hygiene around newborns under 8 weeks is worth being firmer about, since their untrained systems have the least in reserve.

What counts as a fever — and what should I do?

38°C or above is a fever. Under 3 months: 38°C+ needs same-day medical advice, always. 3–6 months: 39°C+ does. Beyond that, treat the child, not the thermometer — a hot but alert, drinking, consolable child is usually fine at home; a floppy, unresponsive or persistently distressed one needs help regardless of the number.

Fever home care that the NHS actually endorses: fluids often, normal amounts of clothing (no bundling, no cold sponging), and paracetamol or ibuprofen for a child who is distressed by the fever — not simply to force the number down, since fever is the immune system working. Check dosing against the bottle by weight and age, never double-dose both at once without advice, and remember aspirin is never for under-16s. A fever lasting more than five days, or one accompanied by refusing all fluids and far fewer wet nappies, moves it into contact-the-GP territory. For the full age-by-age A&E vs 111 table, see when to take a baby with a fever to A&E. HealthAnswers' childhood illness guides cover the individual bugs — chickenpox, hand-foot-and-mouth, scarlet fever, bronchiolitis — in symptom-by-symptom detail.

When should I call NHS 111, the GP — or 999?

NHS 111 (phone or 111.nhs.uk) is the 24/7 route when you need medical advice today and the GP is shut — they triage and can book urgent slots. The GP handles anything persistent or worsening. Call 999 or go to A&E for: struggling to breathe, blue/grey/mottled colour, unresponsiveness, a first seizure, signs of severe dehydration, or a non-fading rash.

The escalation ladder, honestly applied:

• Home + pharmacist — snotty colds, mild temperatures in an otherwise-fine child, teething, mild rashes in a well child. UK pharmacists are underused and excellent for "is this anything?" questions.
• NHS 111 — out-of-hours worries, fevers in the under-3-month category, "not right but I can't name it", croup barking at midnight. They would rather you called than didn't.
• Same-day GP — fevers beyond five days, ear pain with fever, possible scarlet fever (sandpaper rash + red tongue), wheezing without distress, any illness in a baby under 8 weeks.
• 999 / A&E — the breathing, colour, responsiveness and rash red flags above. Trust the pattern: parents who "just knew something was wrong" are right often enough that every NHS pathway says act on it.

What is the glass test for meningitis?

Press the side of a clear glass firmly against the rash: spots that stay visible through the glass (don’t fade under pressure) can signal meningococcal septicaemia — call 999. But don’t wait for a rash: fever with a stiff neck, dislike of bright light, unusual drowsiness, an odd high-pitched cry, or cold hands and feet with a bulging fontanelle warrants emergency advice on its own.

The rash is often the last sign to appear, and on darker skin it can be harder to see — check paler areas (palms, soles, inside eyelids, roof of the mouth). Meningitis is rare, vaccination has made it rarer, and almost every non-fading-rash scare turns out benign — but this is the one childhood emergency where minutes genuinely matter, which is why every parent should know the test and its limits.