Your Child's Health: From Newborn to Age Five

A new parent makes more health calls in the first year than in any other year of their life. Most of them turn out fine. The hard part is the difference between fine and not fine, and how to tell from the sofa at three in the morning. This guide walks through the routine checks every newborn gets, the vaccine schedule and what it actually does, the everyday illnesses you will see, and the patterns that mean you stop reading articles and pick up the phone. Healthbooq keeps a running record of symptoms and visits, which makes it easier to spot patterns and easier for the GP when you do call.

The First Hours: Apgar, NIPE and Heel-Prick

Within minutes of being born, your baby gets an Apgar score — a quick five-point check at one minute and five minutes covering colour, heart rate, reflex response, muscle tone, and breathing. Each gets 0, 1 or 2 points. Most healthy newborns score 7–10 at five minutes. A lower score does not necessarily mean a problem; it often reflects a slower transition from womb to room or the effects of pain relief in labour. It tells the team whether to watch closely.

Within the first 72 hours every UK baby has the Newborn and Infant Physical Examination (NIPE), which checks heart, hips, eyes and (for boys) testes. Around day five, a midwife does the heel-prick blood spot test, screening for nine rare but serious conditions including phenylketonuria, congenital hypothyroidism, sickle cell disease and cystic fibrosis. Catching any of these in the first week prevents permanent harm; missing them can be life-altering.

Babies also get vitamin K (by injection or oral drops) to prevent vitamin K deficiency bleeding, and a hearing screen in the first few weeks. The first vaccinations come at eight weeks.

Vaccinations: What and When

The UK schedule covers the most dangerous childhood infections, given on a timetable based on when babies are most vulnerable and when their immune systems can mount a useful response.

The current schedule (NHS, 2024):

• 8 weeks: 6-in-1 (diphtheria, tetanus, pertussis, polio, Hib, hepatitis B), rotavirus (oral), MenB
• 12 weeks: 6-in-1 (second), pneumococcal, rotavirus (second)
• 16 weeks: 6-in-1 (third), MenB (second)
• 1 year: Hib/MenC, MMR, pneumococcal booster, MenB booster
• 2–11 years: annual flu vaccine (nasal spray)
• 3 years 4 months: MMR booster, 4-in-1 pre-school booster (DTaP/IPV)

Vaccines work by showing the immune system a harmless version of a pathogen so it can recognise the real thing later. Most contain inactivated viruses or specific proteins; live attenuated vaccines (MMR, rotavirus) are weakened versions that cannot cause disease. The painful diseases they prevent — measles encephalitis, whooping cough that kills babies, meningitis B that can take a child's life in twelve hours — are far worse than the brief soreness, low fever and grumpiness that follow most jabs.

Serious adverse reactions are rare. Anaphylaxis is the main acute risk and runs at roughly one in a million doses. The decades-old myth linking MMR to autism has been disproven by very large studies, and the original 1998 paper that started it was retracted and the lead author struck off the medical register.

If your child is mid-illness or has had an anaphylactic reaction to a previous dose or to an ingredient (egg, gelatin, neomycin), check before the next vaccination. Otherwise the routine answer to "should I delay because she has a cold?" is no — mild illness is not a contraindication.

Fever: The Number Matters Less Than the Child

Fever is the immune system working, not an illness in itself. The thresholds:

• Under 3 months: any temperature of 38°C or above warrants a same-day medical review (NICE guidance). Babies this young have less mature immune systems and serious infection can progress fast.
• 3–6 months: 39°C or above warrants assessment.
• Over 6 months: the height of the fever matters less than how the child looks and behaves.

A toddler with a temperature of 39.5°C who is up, drinking, and watching telly is much less worrying than one with 38°C who is floppy and not engaging. Look at the child, not the thermometer.

Practical management: light clothing (not bundling), regular fluids, paracetamol or ibuprofen for discomfort if older than the relevant age cut-offs (paracetamol from 2 months at the right weight-based dose; ibuprofen from 3 months and over 5 kg). Tepid sponging is no longer recommended — it can cause shivering and trap heat.

Get urgent help if your child:

• Is under 3 months with any fever
• Looks mottled, blue, or grey
• Is unusually drowsy, floppy or hard to wake
• Has a non-blanching rash (does not fade when pressed under a glass)
• Has fever and a stiff neck, severe headache, or dislike of bright light
• Is breathing fast or with effort, or grunting between breaths
• Has had a fever for over five days
• Has a febrile seizure (most are brief and harmless but always need a check the first time)

Common Rashes and How to Tell Them Apart

Babies and toddlers produce a lot of rashes. The most common ones:

• Nappy rash — red, sore patches where the nappy sits, sometimes with bumps. Caused by friction, urine and stool against skin. Treat with frequent changes, nappy-free time, and a barrier ointment (zinc oxide). Bright red rash with small "satellite" spots in skin folds is usually thrush — needs an antifungal cream.
• Heat rash (miliaria) — tiny red bumps in sweaty areas (neck, chest, folds). Cool down, lighter clothing.
• Eczema (atopic dermatitis) — dry, itchy patches, classically on cheeks in babies, behind knees and elbows in toddlers. About one in five UK children gets it. Daily emollients (a thick one, not aqueous cream which can irritate), short lukewarm baths, and steroid creams from the GP for flares.
• Cradle cap — yellow, greasy scales on the scalp. Harmless, common, usually clears by twelve months. Soft brushing with olive or coconut oil after a bath helps.
• Baby acne — looks like teenage acne on the cheeks and nose, peaks at 4–6 weeks, gone by three months. No treatment needed.
• Erythema toxicum — blotchy red patches with white centres, comes and goes in the first week of life. Harmless.
• Slapped cheek (parvovirus B19) — bright red cheeks like a slap, then a lacy rash on the body. Mild illness in children, but pregnant women near someone with it should let their midwife know.
• Hand, foot and mouth — small blisters on hands, feet, mouth and bottom. Lasts about a week. Common in nursery outbreaks.

Two rashes need urgent care. A non-blanching petechial or purpuric rash — small red, purple, or brown spots that do not fade when pressed with the side of a clear glass — can be a sign of meningococcal sepsis and is a 999 call. A rash with rapid breathing, swelling of lips or tongue, or wheeze suggests anaphylaxis and needs immediate adrenaline if available, then 999.

Crying, Colic and Reflux

Newborns cry a lot. By six weeks, the average is two to three hours a day, often clustered in the late afternoon and evening. Colic is defined as crying for more than three hours a day, more than three days a week, for more than three weeks, with no other cause. It usually starts around two weeks, peaks at six to eight weeks, and resolves by three to four months. Despite years of research, no single cause is established and no specific treatment has strong evidence; gripe water, simethicone drops, lactase drops, and probiotics each work for some babies and not others. Holding, white noise, motion (a sling or pram walk), and a warm bath all help in the moment.

Reflux — milk coming back up — is normal in babies because the valve at the top of the stomach is immature. Most babies posset (small, effortless spit-ups) without any distress; this is not a problem. GORD (gastro-oesophageal reflux disease) is when reflux is causing pain, poor feeding, weight gain difficulties, or back-arching during feeds. The GP can help. Smaller, more frequent feeds, upright after feeding, and sometimes thickeners or acid suppression are the steps.

Constipation, Diarrhoea, and Vomiting

Constipation is about consistency, not frequency. Exclusively breastfed babies can go a week between stools and be entirely fine, as long as the stool when it comes is soft. Hard, pellet-like stools, straining with pain, or blood streaks suggest constipation. Most respond to extra fluids and (in older infants and toddlers) more fibre and water. The GP can prescribe macrogols if it persists; iron-fortified formula sometimes contributes.

Diarrhoea and vomiting — usually viral gastroenteritis (rotavirus is now rarer due to vaccination; norovirus is everywhere, especially in nurseries). The main risk is dehydration. Small, frequent sips of fluid (oral rehydration solution if available; water, breast milk or watered-down apple juice if not). Worry signs: no urine for over twelve hours in older babies or eight hours in young babies, sunken eyes or fontanelle, dry mouth and lips, drowsy, no tears when crying. Bilious (green) vomit, blood in stool or vomit, or severe abdominal pain need same-day review.

Choking and Basic First Aid

This is the single piece of knowledge it is worth seeking out before you need it. The infant and child first aid course (Red Cross, St John Ambulance) takes a couple of hours and is genuinely lifesaving. Quick recap:

• Infants (under 1): five back blows between the shoulder blades, head down, then five chest thrusts (two fingers, lower half of the breastbone). Repeat. Call 999 if not cleared.
• Children over 1: five back blows, then five abdominal thrusts (Heimlich, fist above the belly button, sharp inward and upward pulls). Repeat. Call 999 if not cleared.

Common choking foods to avoid for under-fives or to prepare safely: whole grapes (cut lengthwise into quarters), whole nuts, popcorn, raw carrot sticks, marshmallows, hot dog rounds, sticky lumps of bread or peanut butter.

When to Call, When to Wait, When to Run

Call 999 / go to A&E:

• Not breathing, gasping, or breathing with chest sucking in
• Blue lips, blue tongue, or grey
• Floppy, hard to wake, or unresponsive
• Non-blanching rash (especially with fever)
• A first seizure, or seizure over five minutes
• Suspected swallowed poison, button battery, or magnet
• Severe injury, possible broken bone, deep cut bleeding through pressure
• Anaphylaxis (swelling of lips/tongue, wheeze, collapse)

Same-day GP or NHS 111:

• Any fever in a baby under three months
• Persistent vomiting, especially green
• Signs of dehydration
• Fever over five days
• A rash you do not recognise with other symptoms
• Refusing feeds for more than a few hours in a baby

Watch and wait at home:

• Most colds and coughs
• Mild fever in a child who is otherwise themselves
• Diarrhoea or vomiting if the child is keeping fluids down and producing wet nappies
• Most rashes without other symptoms

The thing parents are best at is noticing when their child is not themselves. Trust that. "She just isn't right" is a perfectly valid reason to call.

Well-Child Visits Are Worth Keeping

In the UK these are part of the Healthy Child Programme: the new-baby review at around two weeks, the eight-week check, the one-year review, and the two-to-two-and-a-half-year review. These appointments are not just for vaccines — they cover growth, feeding, sleep, development, hearing and vision, and family wellbeing. They are also a chance to ask the things you have been wondering about for weeks. Bring the list.

Knowing what is routine, what to manage at home, and what needs urgent care saves a lot of unnecessary worry — and catches the rare emergency in time. The early years are dominated by small, self-limiting illnesses interrupted occasionally by genuinely worrying ones, and the difference is mostly in how the child looks rather than the number on a thermometer.