Babies and children with possible sepsis

Babies and young children can become seriously unwell without being able to explain symptoms. Parents and carers often report changes in feeding, alertness, breathing, skin colour, nappies or behaviour before a diagnosis is clear.

Reception staff should treat these reports seriously and follow local escalation procedures when warning words are used. A baby or child who is floppy, hard to wake, not feeding, breathing abnormally or has a rash that does not fade should not remain in routine workflow.

Listen or look for

• Baby or child not feeding, not drinking or unable to keep fluids down.
• No wet nappies or very reduced urine.
• Floppy, difficult to wake, unusually drowsy or not responding normally.
• Breathing fast, grunting, ribs sucking in, blue lips or pauses in breathing.
• Rash that does not fade when pressed or mottled, very pale, blue or grey skin.
• Parent or carer saying the child is not themselves or that something is badly wrong.

Age and behaviour matter

Very young babies require extra caution. Parents may not know whether the problem is infection, feeding or breathing, but words such as "floppy", "not feeding" and "hard to wake" should trigger urgent action.

Do not convert a parent's urgent wording into a vague note such as "baby unwell" or "feeding query". Preserve the parent's exact words for the clinician or urgent service receiving the contact.

Clinical background

In babies and children, parent or carer descriptions of behaviour, feeding, breathing, colour and nappies can carry urgent safety information.