Worsening signs of a sick child

The action to take for each assigned colour
Green	Amber	Red
Normal/Low Risk	Intermediate Risk	High Risk
	Contact a health professional/GP 111 or 999	Contact 999

When checking your child use good light.

Consider their usual skin colour as darker skinned children do not always look pale.

As parents you know your child best;

Trust your own instincts

Useful websites

Symptoms and their associated risk
Green Normal/Low Risk	Amber Intermediate Risk	Red High Risk
Breathing Normal	Breathing Fast breathing, short of breath Unusually noisy or wheezy when breathing Flaring or widening of nostrils	Breathing Finding it difficult to breath Very fast breathing Making unusual or grunting noises when breathing Unusual patterns of breathing Sucking in of chest or stomach
Colour Normal colour of skin, lips and tongue	Colour Unusually pale colour of skin, lips and tongue for your child Sunken eyes with dark circles	Colour Very pale, grey or blue skin, lips or tongue Rash, red or purple that does not fade
Activity Responds normally to interaction with parent and surroundings Smiles Stays awake or wakes quickly When cries it is strong/normal or not crying	Activity Not responding normally to family or carers Not smiling Difficult to wake up or unusually sleepy Not wanting to do very much	Activity Not responding to carers Very difficult to wake up, drowsy less responsive Child is weak or floppy Child has a fit High-pitched or continuous cry in younger children
Eating and drinking Taking usual foods and fluids Normal skin and eyes Moist lips and gums	Eating and drinking Not feeding very much Dry lips and mouth Reduced weeing or fewer wet nappies than normal	Eating and drinking Unable to keep feeds or fluids down No wee or wet nappy for 12 hours or more Very few wees or wet nappies Very thirsty
Temperature and body Normal temperature 36.4-37.5 degrees	Temperature and body Raised temperature for 5 days or more Shivering or shaking Babies aged 3-6 months with any recorded temperature of 39 degrees or above Hands and feet are unusually cold to touch Temperature of below 36 degrees New lump greater than 2cm	Temperature and body Babies under 3 months with any recorded temperature of 38 degrees or above Stiff neck especially when trying to look up or down Hands and feet are mottled and very cold to touch Bulging soft spot on head in infants

Last Updated 21 Mar 2025

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