Babies, children, pregnancy and recent pregnancy

Babies, children, pregnant people and those recently pregnant often need a lower threshold for escalation. Symptoms can change quickly; urgent clinical review, maternity triage, emergency services or safeguarding support may be the safest option.

Parents, carers and pregnant patients often use plain language. Phrases such as "my baby is not feeding", "the rash does not fade", "the baby has not moved", or "something is badly wrong" should be recorded verbatim and treated as potentially urgent rather than softened into routine notes.

Listen or look for

• Baby under 3 months with fever, poor feeding, floppy, blue, mottled, hard to wake or no wet nappies.
• Child with breathing difficulty, non-blanching rash, seizure, stiff neck, confusion, dehydration or severe pain.
• Pregnancy with reduced fetal movements, heavy bleeding, leaking fluid, severe abdominal pain, severe headache or collapse.
• Recent birth, miscarriage or termination with fever, heavy bleeding, breathlessness, chest pain, severe headache or mental health crisis.
• Parent, carer or pregnant person saying something is seriously wrong.

Use the right pathway

Pregnancy and recent pregnancy concerns often have specific local routes such as maternity triage, early pregnancy assessment or emergency services. Reception staff must know these routes and must not assume symptoms are normal for pregnancy or safe to wait.

For children, consider age and behaviour. A child who is drowsy, floppy, struggling to breathe, dehydrated or clearly different from their normal state should not be handled as a standard appointment request.

Local pathway note

Babies, children, pregnancy and recent pregnancy can change the urgency of a contact; warning words should be escalated, not normalised.