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By Casey De Farria
Casey De Farria
09 Mar, 2022

How many of the 8 ‘red flags’ for unwell babies and children, do you know?

‘Red flags’ are the really concerning signs and symptoms when your child is sick, that indicate the need for urgent medical help.

As parents and carers, we often know the ‘cut and dry’ incidents for when an ambulance needs to be called, like a funnel-web spider bite, or if your child is unconscious.

When little ones get sick they can be generally unwell… but you need to trust your gut. You know best, and you can tell if something is just not right or if your little one is just not themselves.

Here are our 8 ‘red flags’ for the unwell baby or child:

  1. Abnormal or distressed breathing

This is a big one – we suggest watching our video on ‘breathing difficulties in children’ for further explanation and visual examples of what abnormal or distressed breathing can look like.

Breathing faster than normal, if your baby’s nostrils are flaring, head bobbing, sucking in under their rib cage, tummy see-sawing, and sucking in around the neck, are all indications of breathing difficulties. There can be many reasons a baby is struggling to breathe or breathing faster than normal, but regardless of the cause, this is a red flag.

2. Not feeding properly (babies in particular)

One of the things you may notice when your child becomes unwell is that they are refusing/not wanting to have their feeds. Babies can get dehydrated very quickly. If their feeding has dropped off quickly or consistently and they are refusing to feed, that is a red flag. For example, they may be taking less than half of their usual feeds in a 24 hour period, or not waking for feeds at all.

3. Urine output/fewer wet nappies than usual

Not producing enough urine is concerning. If your child has fewer than half her normal number of wet nappies over 24 hours, this is a red flag.

4. Not alert, can’t awaken

Is baby floppy? Can they be easily roused? If bub is lethargic and drowsy when it isn’t their normal sleep time, has a weak (or absence of) a cry, or is unusually unsettled and unable to be consoled, these are all considered to be red flags.

5. Fever accompanied by a non-blanching rash

If a rash doesn’t disappear when pressed (watch our demonstration for testing this, here), this can be a sign of meningococcal. However, in most cases, you will see other red flags before a rash like this appears – don’t wait for a rash if you are seeing other red flags. Note – babies may not have a fever – this does not mean they aren’t in need of urgent medical attention.

Here are some visual examples of a non-blanching rash – credit: Meningitis Research Foundation

6. Babies under 3 months with a temperature over 38 degrees

In older children, we look at the child as a whole and not just the number (their temperature) – but in babies from 0 to 3 months old, a temperature of 38 degrees or higher is an automatic trip to the hospital!

7. Unusual skin colour

A change from their normal skin colour. If they are blue (this could present on their lips, torso, nail beds etc), this is a medical emergency. They may also become very pale compared to their usual colour, or even grey.

Mottled skin – If your child’s skin is mottled and they are not normally like that, this is a concern. Note that mottling can be normal for babies, and for some children in cold weather etc. – but you know what is ‘normal’ for your child better than anyone. Remember that!

An example of what mottled skin looks like – credit: Dermnet NZ


This one is capitalised for a reason – because it is so so important. If your gut feeling is telling you that something is wrong, then TRUST that and ACT on it. Don’t underestimate your ability to pick up that something is not right with your child, and that they need urgent medical attention.

The above information can be viewed in video format here


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