What are the warning signs that a sick b

If your baby is hard to wake, floppy, will not feed at all, breathing fast or hard, has blue lips, dark-green vomit, blood in the stool, or has passed almost no urine — call your local emergency number now, or go to the nearest children's emergency department; do not wait for the morning.

If none of those are true, tonight's job is three things only: breast milk or formula exactly as usual, small sips of ready-made ORS if a sachet is already in the house, and every feed, wet nappy and vomit written down with times.

Your own notes put the baby at ~11 weeks on 26 October, so about 12 weeks (just under three months) now. At this age "not right" without a fever still means same-day assessment, and vomiting in a baby this small is its own red flag. This is home care and observation, not a diagnosis, and not a substitute for a clinician — it changes no medicine, no feed and no fluid volume; the amounts and any decision about a drip belong to a clinician.

---

1) What you've already tried → the better version

2) Tonight's plan (kitchen only, nothing to buy)

1. Split the roles now. One adult stays with the baby and does the writing; the other covers the older children, the elder and the school morning. Protect one unbroken sleep block for whoever will decide in the morning.
2. Milk as usual, more often if the baby takes it. Nothing new, nothing withheld, no fasting, no stretched gaps on your own.
3. Ready-made ORS only. Mix exactly as the packet says, small sips or spoonfuls the baby can keep down, never forced, discard what's left after an hour. No sachet → do not improvise; homemade sugar-and-salt water can be the wrong balance for a small baby. Ask the pharmacy or clinic.
4. Keep the baby warm. Light clothing, warm but ventilated room, your usual holding. Take a temperature and write the reading, the time and how you took it. A baby this small who feels hot or cold, or "isn't right" — with or without a number — needs assessment today.
5. Keep the log (this is what the clinic actually needs): each feed and whether it stayed down; each wet nappy with time; each vomit with time and colour (yellow ≠ dark green); stools and any blood; temperature; time of last wet nappy.
6. Weigh in the morning: same scale, nappy off, before the first feed, next to yesterday's number. Serial weights are the best home record of fluid change — for the clinician, not a "safe to stay home" cut-off.
7. Protect the rest of the house: hand washing before and after every nappy change and feed; the baby's own bottles and cup only; the elder's plate, cup and towel separate; schoolchildren wash hands on coming home. If the elder also has vomiting or diarrhoea, that's a separate call — an older adult can be seriously dehydrated without looking unwell.

3) Red flags — when to stop home care

Call your local emergency number now

• Hard to wake, floppy, unusually quiet, not lifting the head
• Will not feed at all, or keeps vomiting everything
• Breathing fast, hard, grunting, ribs sucking in, pauses in breathing, blue or grey lips
• Dark-green (bile) vomit, blood in stool or vomit
• A fit, or a rash with purple/red spots that does not fade when you press a clear glass on it
• Cold hands and feet, pale or mottled skin, weak high-pitched cry, deep heavy breathing
• Eyes or fontanelle deeply sunken (late sign — absence means nothing)
• A baby this young who feels hot or cold, or is "just not right"

Same-day clinic or children's urgent care — don't wait for tomorrow

• Markedly fewer wet nappies than the baby's own normal (fewer than 4 in a whole day is the number clinicians treat as worrying), or no wet nappy since this morning
• Taking roughly half or less of the usual milk, or feeds getting shorter
• Repeated vomiting or diarrhoea, swollen or hard belly, persistent crying that won't settle
• Temperature 38 °C or above, unstable temperature, or hot/cold to touch
• Not clearly improving after tonight
• The baby is under 6 months and is vomiting (age under 6 months is a red flag on its own)

Home care tonight is reasonable only if all are true: feeding reasonably, urine near normal, bright and responsive when awake, no fever, no blood, no green vomit — and the log is being written.

4) Decision tree (screenshot this)

```
THE BABY (about 3 months old)
├─ Hard to wake · floppy · will not feed at all · fast or hard breathing, blue lips
│ · dark-green vomit · blood in the stool · a fit · a rash that does not fade
│ · cold, mottled skin · eyes or fontanelle deeply sunken
│ → EMERGENCY NOW: call your local emergency number, or go to the nearest
│ children's emergency department. Do not wait for the morning.
│
├─ Markedly fewer wet nappies than usual · feeds under about half the usual
│ · vomiting everything · swollen or hard belly · persistent crying
│ · temperature 38 °C or above, or hot/cold to touch · no clear improvement
│ → SAME-DAY CLINICAL REVIEW: call your paediatric service or go to a
│ children's urgent care today, with the feeding log, the nappy log and
│ this morning's weight. Ask what should bring you back.
│
└─ Feeding reasonably · urine near normal · bright and responsive when awake
· no fever, no blood, no green vomit
→ HOME CARE TONIGHT (section 2). Then: if the baby is not clearly better
by morning, go today. "Not better" is itself a reason to be seen.

THE HOUSEHOLD
├─ You are alone with the baby, the schoolchildren and the elder tonight
│ → Decide now who covers the elder's night routine and the school morning,
│ so the adult with the baby is not also cooking and carrying.
├─ Anyone at home has vomiting, diarrhoea or a fever
│ → Separate cups, plates and bottles; hand washing after every nappy
│ change and before every meal; the elder gets their own call if unwell.
└─ You cannot hold it together tonight
→ Ask for help today (family, respite, your paediatric or maternity
service). Asking is not failing the baby.
```

5) Scripts you can read out or send

To the paediatric service or urgent care:
> "Hello — our baby is about 12 weeks old. The vomiting and loose stools started on [day, time]. In the last 24 hours there have been [number] feeds and [most / about half / none] of them stayed down. The last wet nappy was at [time], and there have been [number] wet nappies since yesterday morning. The baby is [alert / sleepy / floppy]. Temperature [number], taken [where], at [time]. Nothing has been given except [anything already prescribed]. We have this morning's weight and the feeding and nappy log. Our questions: does the baby need to be seen today, what exactly should bring us back, and what should we give while we wait — and how much?"

To the other adult at home tonight:
> "Tonight's rule: milk as usual, small sips of the ORS sachet if we have one, and every feed, wet nappy and vomit written down with its time. If the baby is hard to wake, floppy, not feeding, breathing fast, blue, has green vomit or blood in the stool, or has no wet nappy since [time] — call the emergency number or go straight to urgent care. Don't wait for me to wake up."

To the school and the elder:
> "The baby has a stomach illness, so hand washing after nappy changes and before meals, and the baby uses only their own bottles and plate. If we have to go to the clinic in the morning, [name] will do the school run."

6) What "getting better" looks like in the next 24 hours (a measure, not a promise)

• Urine back toward the baby's own normal number, with times written down
• Feeds taken and kept down, back to the usual pattern
• Bright and responsive when awake, normal cry, warm hands and feet
• Vomits stopping or less frequent; stools firming up
• Weight stable or up versus yesterday's number — any drop written down with times, for the clinician
• No fever, no blood, no green vomit
• And the honest part: this is a measure, not a promise. If by tomorrow morning the baby is not clearly better — or you can't tell — that is itself a reason to go today. If milk goes off again or urine drops again, don't wait for the appointment you planned.

7) Who decides what

• You two: the rota for tonight, the log, the food in the house, who goes to the clinic
• The paediatric clinician: whether IV fluids are needed, any medicine or anti-sickness treatment, the exact ORS amount and frequency, whether tests or a weight check are needed, and what should bring you back
• The pharmacist: ready-made ORS and anything already prescribed
• Emergency services: anything on the "call now" list

A printable one-pager of this is ready here: sick-baby-dehydration-tonight-2026-11-02-24bbb33c.pdf

Two quick things that would sharpen tonight's plan: is the baby still finishing feeds and keeping them down right now, and when was the last wet nappy? Also, is there a sealed ORS sachet in the house, or should the other adult fetch one from the pharmacy on the way home?

Sources: RCH clinical guidelines (dehydration, gastroenteritis, vomiting, febrile child, seriously unwell young infant), Merck Manual (oral rehydration therapy in children), WHO diarrhoeal disease fact sheet.