Tommy's PregnancyHub

Illnesses in a premature baby

Viruses and stomach bugs are common in babies. Premature babies are particularly at risk because their immune system is not fully developed.

Stomach bugs in premature babies

If your baby has a stomach bug, they may poo more often or their poo may be different to their normal bowel movements. They may also suddenly start being sick (vomiting). 

Stomach bugs are common in young children, but they can be serious for babies because they can lead to dehydration. This is when your baby loses more fluid than they can take in. It can lead to serious health problems if it’s not treated. 

Speak to your GP, health visitor, community neonatal nurses or midwife if your baby starts vomiting or has diarrhoea.

How can I treat a stomach bug at home?

It’s important to prevent your baby becoming dehydrated. You can do this by giving them their usual milk feeds. You could try giving them smaller amounts more often. 

If you’re breastfeeding, you can give your baby extra fluids by cup, spoon or bottle. If you’re formula feeding your baby, never water down their formula, but you can give them small sips of water in between feeds.  

Other infections

Common infections include colds, flu, and chest and ear infections. 

Colds

Young children often get several colds each year, with each one lasting up to 2 weeks. Symptoms can include a blocked or runny nose, a sore throat and a cough.  

If your baby has a stuffy nose, saline nose drops can sometimes help. You can buy them from a pharmacy. If your baby has a high temperature (over 38°C) or low temperature (less than 36.5°C), make sure they’re drinking enough fluids. 

Contact your healthcare team or GP if: 

  • your baby has a high temperature of more than 38°C or a low temperature (less than 36.5°C) and seems unwell
  • your baby has had a cough for more than 3 weeks
  • you are worried about your baby.

Liquid paracetamol may help to regulate your baby’s temperature. Ask your GP or pharmacist for advice about how much paracetamol premature babies can have before you give any to your baby.

If your baby is finding it hard to breathe, call 999 or take them to A&E straight away. 

Chest infections

Respiratory Syncytial Virus (RSV) is a common winter virus that causes coughs and colds. Premature babies are more likely to get RSV than full-term babies.  

If your premature baby has bronchopulmonary dysplasia (BPD), congenital heart disease or a problem with their immune system, they are more likely to get a more serious form of RSV. This can lead to chest and ear infections. 

RSV is the most common cause of a chest infection called bronchiolitis. This affects many children under the age of 2.  

Symptoms may include: 

  • a high temperature 
  • not feeding well
  • wheezing
  • shallow or rapid breathing
  • a fast heartbeat.

Contact your GP if you’re worried about your baby or if your baby: 

  • isn’t feeding as much as usual
  • hasn’t had a wet nappy for 12 hours
  • has a high temperature that won’t come down
  • seems tired or irritable.  

Bliss has more information about RSV and the NHS has more information about bronchiolitis.

Smoking at home

Children who inhale other people’s smoke have an increased risk of developing bronchiolitis.  

Do not smoke around your baby and don’t let other people smoke around them. If you are struggling to quit, there is plenty of friendly, professional support available online and by phone to help you stop.

Visit NHS Smokefree, Quit or Action on Smoking and Health (ASH).

Find out more about smoking after pregnancy.

Ear infections

Ear infections are common after a cold and often get better by themselves. 

If your baby has a high temperature 3–5 days after getting a cold and keeps pulling at their ear, they could have an ear infection. You could give your baby paracetamol or ibuprofen to ease the pain.

Ask your GP or pharmacist for advice about how much paracetamol or ibuprofen premature babies can have before you give any to your baby.

Children who have asthma shouldn’t have ibuprofen unless advised to by a doctor.  

Contact your GP if your baby has: 

  • ear pain that doesn’t get better after 3 days
  • fluid coming out of the ear
  • other symptoms, such as being sick
  • pain in both ears
  • a weakened immune system or long-term health problem.

If the infection is caused by bacteria, your GP may give your baby antibiotics. 

NHS has more information about ear infections.

Meningitis and septicaemia

Meningitis is an inflammation of the lining of the brain. It is a serious illness, but most children make a full recovery if they get treatment quickly.  Septicaemia is a blood infection, caused by the same germs that cause meningitis.

The symptoms of meningitis and septicaemia are similar to a cold or flu to start with. But they get worse within a few hours.

Get urgent medical advice if your baby has any of these symptoms: 

  • a high temperature (38°C or over)
  • cold hands and feet
  • being sick (vomiting)
  • refusing feeds
  • a rash that doesn’t fade when you roll a glass over it
  • a stiff neck
  • not liking bright lights
  • drowsiness
  • a high-pitched cry
  • being irritable and unsettled
  • a bulging soft spot on their head (fontanelle)
  • seizures.

They may only have a few of these and they may not get a rash. If you’re worried about your baby’s symptoms, contact your GP or call 111 straight away. 

Call 999 or take your baby to A&E if you think they are seriously ill. 

If you think something is wrong

Most new parents feel a little insecure in their new role at first. It’s natural to be unsure about whether your concerns are valid or if you are being overprotective. 

But it’s important to try and trust your instincts if you think something is wrong. if you notice anything about your baby that worries you, don’t hesitate to contact your healthcare team.

Find out more about support for you and your premature baby at home

  

NHS.Diarrhoea and vomiting. https://www.nhs.uk/conditions/diarrhoea-and-vomiting/ (Page last reviewed: 7 December 2020. Next review due: 7 December 2023)

NHS. Bronchiolitis. https://www.nhs.uk/conditions/bronchiolitis/ (Page last reviewed: 6 August 2018. Next review due: 6 August 2021)

EFCNI, Hüning BM et al. (2018) European Standards of Care for Newborn Health: Transition from hospital to home. European Foundation for the Care of Newborn Infants. https://newborn-health-standards.org/transition-hospital-home/ 

NICE (2009) Diarrhoea and vomiting caused by gastroenteritis in under 5s: diagnosis and management
Clinical guideline 84. National Institute for Health and Care Excellence. https://www.nice.org.uk/guidance/cg84
  
NHS. Dehydration. https://www.nhs.uk/conditions/dehydration/ (Page last reviewed: 9 August 2019. Next review due: 9 August 2022)
 
NHS. Colds, coughs and ear infections in children. https://www.nhs.uk/conditions/pregnancy-and-baby/coughs-colds-ear-infections/ (Page last reviewed: 24 September 2018. Next review due: 24 September 2021)
 
Gov.uk (2015) Respiratory syncytial virus: the green book, chapter 27a. https://www.gov.uk/government/publications/respiratory-syncytial-virus-the-green-book-chapter-27a

NICE (2015) Bronchiolitis in children: diagnosis and management NICE guideline 9. National Institute for Health and Care Excellence. https://www.nice.org.uk/guidance/ng9
 
NHS. Ear infections. https://www.nhs.uk/conditions/ear-infections/ (Page last reviewed: 16 June 2021. Next review due: 16 June 2024)

NHS. Can I give my child painkillers? https://www.nhs.uk/common-health-questions/childrens-health/can-i-give-my-child-painkillers/ (Page last reviewed: 7 November 2018. Next review due: 7 November 2021)
  
NHS. Meningitis. https://www.nhs.uk/conditions/meningitis/ (Page last reviewed: 8 March 2019. Next review due: 8 March 2022)
  
NICE (2010) Meningitis (bacterial) and meningococcal septicaemia in under 16s: recognition, diagnosis and management. Clinical guideline 102. National Institute for Health and Care Excellence. https://www.nice.org.uk/guidance/cg102