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Recognising serious illness in babies

(Aust Prescr 2000;23:61)

A, B, C, FLUIDS IN, FLUIDS OUT
The best indicators of serious illness in young babies can be remembered by using the A, B, C, Fluids in, Fluids out system.

A for Arousal, Alertness and Activity
Your baby is at higher risk if more drowsy than usual, cannot wake properly, does not respond to normal stimulation, and is less active. The more drowsy, the more likely is serious illness. If there are periods of normal activity and alertness, serious illness is less likely.

B for Breathing difficulty
This is characterised by a heaving chest with indrawing of ribs and sternum or grunting with breathing.

C for Circulation
Poor circulation is shown by being suddenly and persistently pale all over or having cold legs up to the knees.

FLUIDS IN
Feeding less than half normal over 24 hours. If your baby is breast fed then consider the frequency of feeding and the duration of active sucking over 24 hours. If bottle fed, count up the volume of milk taken over 24 hours and compare it to your baby's normal intake.

FLUIDS OUT
Less than four wet nappies per 24 hours in babies under six months of age is an indication of increasing risk of becoming dehydrated.

The more of these signs and symptoms present, the higher the risk of serious illness.
The worst combination of signs is being drowsy and pale whilst having a high temperature.
The shorter the duration of illness, the less predictable the presenting symptom. Regular review is required to accurately identify when the situation has changed.

See a doctor immediately if your baby:

  • is pale, drowsy and hot

  • is pale, inactive and cries

  • vomits green fluid

  • has convulsions

  • stops breathing for more than 15 seconds.

(Article reproduced courtesy of Associate Professor Peter Hewson, Paediatrician, Geelong, Vic.)



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