If a child is struggling to breathe, is floppy or will not wake, or their skin, lips or tongue look blue or grey: call 999 now. Colour changes are harder to see on brown and black skin, so check the palms, soles, lips and tongue. If you are worried but it is not an emergency, call NHS 111. In Northern Ireland use your GP out-of-hours service.

MarionSleep help for families

Emergencies: 999 and 111

The signs that mean call now, including sepsis and croup.

The short version

  • Call 999 now if your child has difficulty breathing, pauses in breathing, or is floppy and will not wake or stay awake.
  • Also 999 if their skin, tongue or lips are blue, grey or unusually pale, or a baby's cry is weak or high-pitched.
  • Colour changes are harder to see on brown and black skin, so check the palms, the soles of the feet, the lips and the tongue.
  • Sepsis in an under-5: emergency help for a rash that does not fade when pressed, a temperature under 36°C, or no wee for 12 hours.
  • You do not need to be certain. Being told all is well is a good outcome, not a wasted call.

The rest of this page explains where this comes from. You do not have to read it tonight.

About 4 minutes to read

Call 999 now if

  • Your child is having difficulty breathing. You may notice grunting noises, their tummy sucking under their ribs, or they may be breathing quickly.
  • There are pauses when your child breathes.
  • Your child's skin, tongue or lips are blue, grey or unusually pale. This is harder to see on brown and black skin, so check the palms of the hands, the soles of the feet, the lips and the tongue.
  • Your child is floppy and will not wake up or stay awake.
  • Your baby has a weak or high-pitched cry, or a cry that does not sound like their normal cry.

The NHS adds this, and it matters: "As a parent, you may know if your child seems seriously unwell and should trust your own judgement." You do not need to be certain. Being told all is well is a good outcome, not a wasted call.

Sepsis: call 999 or go to A&E

In a child under 5, get emergency help if they:

  • are breathing very fast, or having difficulty breathing
  • have blue, grey, pale or blotchy skin, lips or tongue
  • have a rash that does not fade when you press it
  • have a very high temperature, or a very low temperature, under 36°C
  • have a weak, high-pitched or continuous cry
  • are not responding as they normally do, are not feeding, are difficult to wake or are more sleepy than usual
  • have not had a wee for 12 hours

The low temperature catches people out: a child who has gone cold and quiet can be as unwell as one who is burning up.

Where to check a baby's colour, and what laboured breathing looks like An outline of a baby lying on its back. Labels point to the lips and tongue, the palms of the hands and the soles of the feet as the places to check for a blue, grey or pale colour. A further label points to the space below the ribs, where the skin pulls inwards when breathing is hard. Lips and tongue check colour here Palms of the hands and soles of the feet Below the ribs: skin pulling in with each breath
On brown and black skin a blue or grey colour is hardest to see on the face, so check the lips, tongue, palms and soles. Skin sucking inwards under the ribs is a 999 sign.

Call 111 or see a GP urgently if

These are the in-between signs: not an emergency, but not something to sit on until Monday.

NHS temperature thresholds for getting urgent advice
AgeGet urgent advice at
Under 3 months38°C or above
Over 3 months39°C or above

For a child under 5, phone 111 rather than using 111 online

NHS 111 online says to call 111 instead if you need help for a child under 5, so go straight to the phone. It is free, 24 hours a day. In Scotland 111 is NHS 24 and in Wales it is 111 Wales. Northern Ireland has no 111 service, so use your area's GP out-of-hours number.

The free Baby Check app

If you are often unsure whether a baby is unwell enough to ring anyone, the Baby Check app takes you through 17 simple checks for babies under six months. It is free on both app stores, from The Lullaby Trust with the University of Cambridge and Birmingham Community Healthcare NHS Foundation Trust.

Croup

Croup has a sound that is unmistakable once you have heard it. The NHS describes a barking cough that may sound like a seal, and a high pitched, rasping sound when your child breathes in. It usually comes on after a few days, and is often worse at night.

Call 111 if you think your child has croup. If any of the 999 breathing signs at the top of this page are there, call 999 instead.

Where this comes from

  • NHS (nhs.uk) bronchiolitis, sepsis, croup, colic, anaphylaxis, fever and baby weight guidance, for the 999 and 111 criteria, croup, colic, the crying advice and the centile rule. These pages are cited by name; we have linked the ones whose exact addresses we hold.
  • NHS, reflux in babies, for posseting, the timescales and the instruction not to raise the head of the cot or Moses basket.
  • Great Ormond Street Hospital, obstructive sleep apnoea, for the child-specific signs, the 1 to 3% figure, risk groups and the overnight sleep study.
  • ICON, the UK infant crying programme, for the crying curve, the four ICON messages and the walking-away instruction.
  • Cry-sis, for the helpline number and hours and the average two hours of crying a day.
  • The Lullaby Trust, Baby Check app, for the 17 checks for babies under six months.
  • The Sleep Charity, National Sleep Helpline, for the hours, the age limits and what the service cannot cover.
  • Sheffield Children's Sleep Service and the GOSH Respiratory Sleep Unit, for how tertiary sleep services take referrals.
  • NHS, postnatal depression and Samaritans, for the parental crisis red flags and the 116 123 line.
  • Allergy UK, for the IgE and non-IgE timings, the symptom groups, the over-attribution caveat and the 01322 619898 helpline.
  • NICE guidance on referral for snoring and for autistic children, reproduced second hand: nice.org.uk blocks automated checking, so we have avoided quoting any threshold from it.

Last checked 1 August 2026. This page is general information, not medical advice. If you are worried about your child, speak to your health visitor or GP.