Tommy's PregnancyHub

Illnesses in a premature baby

Most babies have to fight colds and tummy bugs. The good news is that each infection your baby gets will strengthen his immunity.

With a premature baby, the immune system is weaker and premature babies have a higher chance of being re-admitted to hospital after being sent home. That means that for the first few months you need to be extra careful - especially during the colder months when cold and flu viruses are circulating.

How to protect your premature baby

Try not to put him in situations where he is likely to pick up infections. As your baby grows and becomes more robust, you can relax a little. Eventually he will deal with colds and other infections in the same way as any other child.

Diarrhoea and vomiting in premature babies

Diarrhoea and vomiting are usually caused by a bug. Tummy bugs are common among young children, but they can be serious for babies because of the risk of dehydration.

How to treat a tummy bug

The most important thing you can do is to keep your baby well hydrated through the illness. Breastfeed frequently, or give cooled boiled water mixed with rehydration salts (available over the counter - talk to the pharmacist for advice). Even if you are breastfeeding, you can give your baby extra liquids by cup, spoon or bottle.

When to go to the doctor with your premature baby

Contact your doctor immediately if your premature baby:

  • vomits more than three times within 24 hours
  • has diarrhoea six or more times in 24 hours
  • has fewer than six wet nappies in 24 hours
  • has a dry mouth
  • has a sunken face, eyes, or fontanelle (the soft spot at the top of the head)
  • is very lethargic or irritable.

 Coping with a baby with a cold

A cold is an extremely common viral infection. Symptoms include a runny or blocked nose, a cough and a temperature. It's very normal for babies to get colds, but it can be uncomfortable for them, and they may be tetchy or have difficulty sleeping, which can take its toll on the whole family.

If your baby seems to be in discomfort or has a high fever, you may want to give him some baby paracetamol or ibuprofen. You can buy this over the counter from the pharmacist.

When a cold develops into a more serious illness

In premature babies, however, a cold can develop into more severe complications, so if you are at all concerned about your baby, contact your healthcare team or see your GP. The common cold can develop into the following, more serious illnesses.


It's easy to confuse flu with a severe cold, but if your baby has a temperature of more than 38oC and is shivery, he may have flu.

Chest infections

If your baby has a high temperature, wheezing, shallow or rapid breathing, a rapid heartbeat or goes off his food, or if the muscles in his chest are sunken in, he may have a chest infection such as bronchiolitis.

Ear infections

If your baby develops a high temperature three to five days after cold symptoms start, seems very ill and distressed, and keeps pulling at his ear, he could have an ear infection.

When to go to the doctor

  • If you think your baby may have a chest or ear infection or seems dehydrated, or the fever isn't coming down, go to your GP as soon as possible, as he may need antibiotics to prevent further complications.
  • Flu is not normally treated with medication, but if your baby is considered to be at high risk, he may be given an antiviral drug.

Signs of meningitis

Seek urgent medical advice if your baby:

  • has a high temperature, with cold hands and feet
  • has pale skin with a rash or blotches that don't fade when you press the side of a glass against them
  • breathes fast or grunts
  • has an unusual cry or moaning
  • is floppy, unresponsive and drowsy, with staring eyes
  • has convulsions
  • is refusing food and throwing up
  • has a bulging or tensing fontanelle (the soft spot on his head)
  • is arching his back
  • has a sore neck and dislike of bright lights (though these symptoms can be hard to spot in babies)
  • is being fretful and doesn't want to be touched. 

When to call 999

  • if your baby is having trouble breathing
  • if your baby is unconscious or doesn't seem aware of what's going on
  • if your baby won't wake up
  • if your baby has his first fit or convulsion, such as twitching or eyes rolling into the back of your his head
  • if you think your baby could have meningitis or septicaemia 

The following organisations can give you more information about the topics covered in this section.

  1. Atkins JT, et al (2000) Prophylaxis for respiratory syncytial virus with respiratory syncytial virus-immunoglobulin intravenous among preterm infants of thirty-two weeks gestation and less: reduction in incidence, severity of illness and cost, The Paediatric Infectious Disease Journal, Vol 19, No 2, p138-43
  2. Brodsky D, Ouellette MA (2008) Primary care of the premature infant, p5
  3. NHS Choices (accessed Sept 2011) Health A-Z, Flu Treatment,
  4. NHS Choices (accessed Sept 2011) Health A-Z, Birth to five, Health and development, Recognising signs of serious illness,
  5. NHS Choices (accessed Sept 2011) Live Well, How to deal with colds and flu,
  6. NHS Choices (accessed Sept 2011) Health A-Z, Birth to five, Health and development, Colds, coughs and earaches in children,
  7. NHS Choices (accessed Sept 2011) Health A-Z, Birth to five, Health and development, Diarrhoea and vomiting in children,
  8. NICE (2007) Fever in children younger than 5 years, National Institute of Health and Clinical Excellence
  9. Mupanemunda RH, Watkinson M (2004) Key topics in neonatology, p175
  10. The Meningitis Trust (accessed Sept 2011) Meningitis symptoms,
Review dates

Last reviewed: 1 April, 2017
Next review: 1 April, 2020