Call an ambulance now
Breathing has stopped or is severely difficult; the child is blue or grey, unresponsive, having a prolonged or repeated seizure, has major trauma or uncontrolled bleeding, or is at immediate risk of self-harm.
When should I worry?
Warning signs change with age. Use this guide to recognise what needs immediate help, urgent assessment or close observation.
Start here
Look at the child, not only the symptom.
A number on a thermometer, one vomit or one unusual breath rarely tells the whole story. The urgent clues are often changes in breathing, colour, alertness, movement, hydration and the ability to feed, drink, speak or interact. Age changes the threshold: a newborn who is feeding poorly needs faster assessment than an older child with the same complaint.
This guide is for recognising danger, not diagnosing its cause. It is not a complete list. If your child looks substantially different from normal or you believe they may be in danger, act on that concern. A child can be seriously ill without showing every sign listed here.
Choose the next action
Three levels—not one long list.
Go to emergency now
The child is hard to wake, has a non-fading rash, severe dehydration, green vomit, serious head-injury symptoms, a first seizure, sudden weakness, severe pain or another rapidly worsening red flag.
Arrange same-day assessment
The child is stable but feeding or drinking much less, urinating less, has persistent fever or vomiting, worsening pain, new wheeze, or behaviour that remains clearly different from normal.
Birth to 28 days
Newborn
Newborn illness can be subtle and can worsen quickly. A change from the baby’s usual feeding, colour, cry, movement or alertness matters even when there is no dramatic symptom. For a baby under one month, it is safer to seek assessment early.
Temperature or an unexplained change
What it may look likeA measured temperature of 38°C or higher; an unusually low temperature that does not improve with gentle warming; marked sleepiness; weak movement; a weak or strange cry; or simply looking or acting distinctly different from usual.
What to doArrange urgent in-person assessment now. Do not give fever medicine to a very young baby before medical advice, and do not wait to see whether the baby is better tomorrow.
Breathing, colour or pauses
What it may look likeGrunting with each breath, ribs or the area below the ribs pulling inward, nostrils flaring, repeated pauses, very fast or laboured breathing, or blue, grey or unusually pale lips, tongue or face.
What to doCall 108 or 112 immediately. Keep the baby in a position that makes breathing easiest, do not force a feed, and follow the emergency operator’s instructions.
Feeding and hydration change
What it may look likeA weak suck, being too tired to finish feeds, taking much less than usual, repeated vomiting, noticeably fewer wet nappies, a very dry mouth, or unusual floppiness during or after feeding.
What to doSeek same-day urgent assessment; go directly to an emergency department if the baby is hard to wake, cannot feed safely or is producing very little urine.
Green vomit, seizure or worsening jaundice
What it may look likeGreen bile-stained vomit, a swollen abdomen, rhythmic jerking or stiffness, reduced responsiveness, or yellow colour becoming deeper and extending across the body while feeding or alertness worsens.
What to doGo to an emergency department now. If a seizure is continuing, breathing is abnormal or the baby is unresponsive, call an ambulance rather than travelling without medical support.
1 to 12 months
Infant
Infants cannot describe breathlessness, pain or dizziness. Watch the work of breathing, ability to feed, wet nappies, interaction and recovery between episodes. A baby who is unusually quiet can be more concerning than one who is crying strongly.
Working hard to breathe
What it may look likeThe skin pulls in between or below the ribs, breathing is much faster than usual, the baby grunts, has repeated pauses, cannot feed because of breathlessness, or the lips or tongue look blue or grey.
What to doCall 108 or 112 for severe breathing difficulty or colour change. Keep the baby upright and calm, clear only visible nasal secretions, and do not delay for steam or home remedies.
Fever in a young infant
What it may look likeA measured temperature of 38°C or higher in a baby younger than three months, or fever at any age with extreme sleepiness, breathing difficulty, a seizure, a stiff neck or a rapidly worsening appearance.
What to doA baby under three months with fever needs prompt in-person medical assessment. With any additional red flag, go to the emergency department now or call an ambulance.
Dehydration or persistent vomiting
What it may look likeFar fewer wet nappies, no tears when crying, a dry mouth, a sunken soft spot, repeated vomiting, refusing feeds, or being too sleepy or weak to drink safely.
What to doIf fully awake and swallowing normally, offer small frequent amounts of oral rehydration solution and continue breastfeeding while arranging care. If the baby is drowsy, repeatedly vomiting or unable to drink, seek emergency care.
Seizure, unusual drowsiness or a concerning rash
What it may look likeJerking or stiffness with reduced awareness, difficulty waking, a bulging soft spot, unusual inconsolable crying, or purple or blood-coloured spots that do not fade when pressed. A serious infection may occur without a rash.
What to doCall 108 or 112 for a seizure that is ongoing, repeated, lasts five minutes or more, or affects breathing. For reduced responsiveness, a bulging soft spot or a non-fading rash, go to an emergency department immediately.
1 to 3 years
Toddler
Toddlers may show illness through behaviour: stopping play, refusing to walk, clinging, becoming inconsolable or becoming unusually still. Compare the child with their normal self, and watch whether they brighten, drink and interact between fever or pain episodes.
Breathing, choking or severe allergy
What it may look likeStruggling for each breath, ribs pulling inward, inability to cry or speak normally, blue or grey colour, sudden noisy breathing, drooling with inability to swallow, or swelling of the lips or tongue after food, medicine or an insect sting.
What to doCall 108 or 112. Use a prescribed adrenaline auto-injector immediately for suspected anaphylaxis if one is available. For choking, begin age-appropriate first aid if trained; do not make blind finger sweeps.
Vomiting, diarrhoea and dehydration
What it may look likeRepeated vomiting with nothing staying down, very little urine, no tears, dry mouth, sunken eyes, cold or blotchy hands and feet, marked weakness, green vomit, blood in vomit or stool, or severe abdominal swelling.
What to doOffer small frequent oral rehydration sips only if the child is alert and swallowing safely. Green vomit, blood, severe pain, reduced responsiveness or inability to drink needs emergency assessment now.
Behaviour or neurological change
What it may look likeA seizure, new confusion, extreme sleepiness, weakness of an arm or leg, loss of balance, a severe headache, a stiff neck, a non-fading purple rash, or crying that remains intense and cannot be consoled.
What to doGo to an emergency department now. During a seizure, protect the head, move hazards away, put nothing in the mouth and time the episode. Call an ambulance if it lasts five minutes, repeats, affects breathing or recovery is poor.
Injury, burn or possible poisoning
What it may look likeLoss of consciousness, repeated vomiting after a head injury, a deep wound or uncontrolled bleeding, a significant burn, possible ingestion of medicine or chemical, a fall from height, road injury, or refusal to use a limb after trauma.
What to doCall emergency services for altered consciousness, severe bleeding, breathing problems or major trauma. Do not induce vomiting after a suspected poisoning and take the container or medicine strip to the emergency department if it is safe to do so.
4 to 12 years
Child
Older children can describe symptoms, but may minimise them because they are frightened or want to keep playing. Listen to the words and observe function: speaking, walking, drinking, breathing, staying awake and behaving normally are useful clues.
Breathing difficulty or severe asthma
What it may look likeThe child cannot speak in full sentences, is using neck or chest muscles to breathe, is breathing very fast, looks exhausted, has blue or grey lips, or is not improving after the prescribed reliever medicine in their asthma plan.
What to doCall 108 or 112 for severe distress, colour change, exhaustion or poor response to the rescue plan. Sit the child upright, keep them calm and use only prescribed rescue treatment while help is coming.
Serious infection or brain-related symptoms
What it may look likeA severe headache with stiff neck, confusion, unusual light sensitivity, repeated vomiting, a seizure, difficulty waking, weakness, trouble speaking, or a purple or bruise-like rash that does not fade when pressed.
What to doSeek emergency assessment immediately. Do not wait for every possible symptom or for a rash to appear; meningitis and sepsis can present in different ways.
Severe pain, bleeding or significant injury
What it may look likeSevere or increasing abdominal pain, a rigid or swollen abdomen, sudden testicular pain, uncontrolled bleeding, a visibly deformed limb, worsening symptoms after a head injury, or severe pain that prevents walking or normal movement.
What to doGo to an emergency department now. Call an ambulance for major trauma, uncontrolled bleeding, collapse or altered consciousness. Keep the child still after possible neck or spine injury.
Rapid worsening with a known condition
What it may look likeAn asthma attack, diabetes-related vomiting or deep breathing, a severe allergic reaction, adrenal or heart disease symptoms, or a seizure that is different from the child’s usual emergency plan.
What to doFollow the child’s written emergency plan and give prescribed rescue medication without delay. Call emergency services when the plan says to, when treatment is not working, or whenever breathing, consciousness or circulation appears affected.
13 to 16 years
Teen
Teenagers need the same physical red-flag assessment as younger children, plus attention to exertional symptoms, substances and mental health. Give them space to speak honestly, but do not leave them alone when immediate safety is in question.
Chest pain, collapse or breathing difficulty
What it may look likeChest pain during exercise, fainting during activity, a racing or irregular heartbeat before collapse, severe breathlessness, blue or grey colour, confusion, or a family history of sudden unexplained death with new exertional symptoms.
What to doStop activity and call 108 or 112 for collapse, ongoing chest pressure, severe breathing difficulty or poor responsiveness. If the teen is unresponsive and not breathing normally, begin CPR and use an AED if available, following dispatcher instructions.
Neurological or severe infection signs
What it may look likeA first seizure, sudden weakness or facial droop, trouble speaking, the worst or rapidly worsening headache, confusion, stiff neck, repeated vomiting, difficulty waking, or a non-fading purple rash.
What to doGo to an emergency department immediately; call an ambulance if symptoms are sudden, severe or affecting consciousness, breathing, movement or speech.
Overdose, poisoning or major injury
What it may look likeTaking an unknown quantity of tablets, alcohol or drugs; unusual sleepiness or agitation; slow or abnormal breathing; repeated vomiting; a serious road or sports injury; severe bleeding; or a suspected neck or spine injury.
What to doCall emergency services and be direct about what may have been taken. Do not induce vomiting. Keep packaging, medication strips or substance information for the medical team, and do not allow the teen to drive.
Immediate self-harm or suicide risk
What it may look likeA suicide attempt, a stated plan or access to a lethal method, taking tablets intentionally, severe self-injury, saying they cannot stay safe, extreme agitation, confusion, or threats to seriously harm themselves or someone else.
What to doTreat this as an emergency, not a discipline issue. Stay with the teen, move medicines or weapons away only if it is safe, call 112 or go to the nearest emergency department, and speak calmly without arguing or promising secrecy.
While help is coming
The next five minutes.
Stay with the child. Put the phone on speaker so you can follow the emergency operator’s instructions. Unlock the door or send someone to meet the ambulance, gather the child’s medicines and allergy information, and note when the problem began.
- Check response and breathing. If the child is unresponsive and not breathing normally, start CPR if trained and use an AED if available.
- Protect, do not improvise. During a seizure, clear hazards and cushion the head; do not restrain the child or put anything in the mouth.
- Use prescribed rescue treatment. Follow an existing asthma, allergy, diabetes or seizure plan. Do not use another person’s medicine.
- Avoid unsafe food or drink. Do not force fluids into a drowsy, choking or actively seizing child. Do not induce vomiting after suspected poisoning.
- Prepare a short handover. Age, weight if known, medical conditions, allergies, medicines given, time symptoms began, urine or wet nappies, injuries and possible substances taken.
What can be watched while arranging advice?
A child who is breathing comfortably, has normal colour, wakes and interacts normally, is drinking and urinating, and shows some recovery between fever or discomfort episodes is generally more reassuring than a child whose function is deteriorating. Reassuring signs do not rule out illness, and they can change. Check regularly, especially overnight, and escalate if breathing, hydration, alertness, pain or behaviour worsens.
Children with prematurity, immune suppression, heart or lung disease, diabetes, adrenal disorders, epilepsy or a complex medical history may have an individual emergency plan and a lower threshold for hospital assessment. Follow that plan and tell the emergency team about the condition early.
Keep this page handy
Printable warning-sign summary
Dr. Rajiv Singh · Pediatric emergency recognition guide · Educational information, not a diagnosis
Immediate danger: 108 · 102 · 112Nearest hospital emergency department · Do not wait for WhatsApp or a routine appointment
Newborn Birth to 28 days
- Temperature or an unexplained change: Arrange urgent in-person assessment now. Do not give fever medicine to a very young baby before medical advice, and do not wait to see whether the baby is better tomorrow.
- Breathing, colour or pauses: Call 108 or 112 immediately. Keep the baby in a position that makes breathing easiest, do not force a feed, and follow the emergency operator’s instructions.
- Feeding and hydration change: Seek same-day urgent assessment; go directly to an emergency department if the baby is hard to wake, cannot feed safely or is producing very little urine.
- Green vomit, seizure or worsening jaundice: Go to an emergency department now. If a seizure is continuing, breathing is abnormal or the baby is unresponsive, call an ambulance rather than travelling without medical support.
Infant 1 to 12 months
- Working hard to breathe: Call 108 or 112 for severe breathing difficulty or colour change. Keep the baby upright and calm, clear only visible nasal secretions, and do not delay for steam or home remedies.
- Fever in a young infant: A baby under three months with fever needs prompt in-person medical assessment. With any additional red flag, go to the emergency department now or call an ambulance.
- Dehydration or persistent vomiting: If fully awake and swallowing normally, offer small frequent amounts of oral rehydration solution and continue breastfeeding while arranging care. If the baby is drowsy, repeatedly vomiting or unable to drink, seek emergency care.
- Seizure, unusual drowsiness or a concerning rash: Call 108 or 112 for a seizure that is ongoing, repeated, lasts five minutes or more, or affects breathing. For reduced responsiveness, a bulging soft spot or a non-fading rash, go to an emergency department immediately.
Toddler 1 to 3 years
- Breathing, choking or severe allergy: Call 108 or 112. Use a prescribed adrenaline auto-injector immediately for suspected anaphylaxis if one is available. For choking, begin age-appropriate first aid if trained; do not make blind finger sweeps.
- Vomiting, diarrhoea and dehydration: Offer small frequent oral rehydration sips only if the child is alert and swallowing safely. Green vomit, blood, severe pain, reduced responsiveness or inability to drink needs emergency assessment now.
- Behaviour or neurological change: Go to an emergency department now. During a seizure, protect the head, move hazards away, put nothing in the mouth and time the episode. Call an ambulance if it lasts five minutes, repeats, affects breathing or recovery is poor.
- Injury, burn or possible poisoning: Call emergency services for altered consciousness, severe bleeding, breathing problems or major trauma. Do not induce vomiting after a suspected poisoning and take the container or medicine strip to the emergency department if it is safe to do so.
Child 4 to 12 years
- Breathing difficulty or severe asthma: Call 108 or 112 for severe distress, colour change, exhaustion or poor response to the rescue plan. Sit the child upright, keep them calm and use only prescribed rescue treatment while help is coming.
- Serious infection or brain-related symptoms: Seek emergency assessment immediately. Do not wait for every possible symptom or for a rash to appear; meningitis and sepsis can present in different ways.
- Severe pain, bleeding or significant injury: Go to an emergency department now. Call an ambulance for major trauma, uncontrolled bleeding, collapse or altered consciousness. Keep the child still after possible neck or spine injury.
- Rapid worsening with a known condition: Follow the child’s written emergency plan and give prescribed rescue medication without delay. Call emergency services when the plan says to, when treatment is not working, or whenever breathing, consciousness or circulation appears affected.
Teen 13 to 16 years
- Chest pain, collapse or breathing difficulty: Stop activity and call 108 or 112 for collapse, ongoing chest pressure, severe breathing difficulty or poor responsiveness. If the teen is unresponsive and not breathing normally, begin CPR and use an AED if available, following dispatcher instructions.
- Neurological or severe infection signs: Go to an emergency department immediately; call an ambulance if symptoms are sudden, severe or affecting consciousness, breathing, movement or speech.
- Overdose, poisoning or major injury: Call emergency services and be direct about what may have been taken. Do not induce vomiting. Keep packaging, medication strips or substance information for the medical team, and do not allow the teen to drive.
- Immediate self-harm or suicide risk: Treat this as an emergency, not a discipline issue. Stay with the teen, move medicines or weapons away only if it is safe, call 112 or go to the nearest emergency department, and speak calmly without arguing or promising secrecy.
Clinical references and sources
This guide was framed for an Indian audience and checked against emergency information from the Government of India Emergency Response Support System, parent emergency guidance from the American Academy of Pediatrics, its newborn warning-sign guidance, and NHS meningitis guidance. Emergency services and hospital capabilities can vary by location.
Important: Online information cannot assess an individual child. If the child appears seriously unwell, seek urgent in-person care.