Sniffles or SOS? Common Childhood Illnesses — When to Worry (and When to Just Breathe)

With insights from Dr Noraini Mat Zain, Consultant Paediatrician and real-world parenting chaos.

Introduction: Welcome to the Sick Season (Aka: All Year Long)

There’s a moment every parent experiences: your child spikes a fever, sneezes like a tiny hurricane, or throws up something suspicious — and your brain goes into overdrive.

Is it just a bug?Should I call the paed?Do we go to the clinic, wait it out, or Google until you convince yourself it’s something obscure and terrifying?

Take a breath. Here’s your practical, professional-backed guide to decoding the most common childhood illnesses — what’s normal, what’s not, and when you can confidently say, “Let’s ride it out.”

Fever: Friend or Foe?

Let’s get this straight — fever isn’t a disease. It’s a symptom. A sign your child’s body is fighting something. Most fevers in kids are caused by viruses and don’t need antibiotics.

“A fever under 38.5°C in a playful, hydrated child is usually not dangerous,” says Dr Noraini Mat Zain. “It’s how they look — not just the number — that matters.”

Worry if:

• Baby under 3 months has a fever over 38°C

• Fever lasts more than 3–5 days

• Child is unusually sleepy, unresponsive, or breathing fast

• You see a rash that doesn’t fade when pressed (glass test)

• Seizures or dehydration signs (dry lips, no tears, no pee)

Don’t panic if:

• Your child is still eating, playing, or watching Bluey

• Fever comes down with paracetamol

• It’s been less than 3 days

Coughs, Colds & Runny Noses (aka The Never-Ending Trilogy)

Preschoolers get 6–8 colds a year, sometimes more if they’re in daycare. Snot is practically a personality trait at this age.

Most are caused by viruses, not bacteria — which means no antibiotics needed.

“Coughs that linger for weeks are usually post-viral and not dangerous, but watch for signs of breathing difficulty,” adds Dr Noraini.

Worry if:

• Fast or laboured breathing, wheezing, chest indrawing

• Barking cough (croup) or whooping sound

• Child seems exhausted or unable to sleep due to coughing

• Fever + cough + no improvement after 5–7 days

Don’t panic if:

• Snot changes colour (it’s part of healing)

• Child is still energetic

• You hear a mild dry or wet cough, especially at night

Tummy Troubles: Vomiting & Diarrhoea

The dreaded duo. Could be viral (most common), food-related, or — in Malaysia’s humid climate — a million other things.

“Hydration is key,” says Dr Noraini. “It's not about stopping the diarrhoea — it’s about replacing what’s lost.”

Worry if:

• Baby under 6 months has diarrhoea or vomiting

• Signs of dehydration: sunken eyes, dry mouth, no pee in 6 hours

• Bloody stool or green vomit

• Lethargy or refusal to drink at all

• Vomiting persists beyond 24 hours

Don’t panic if:

• They’re drinking well and peeing

• Diarrhoea lasts 3–7 days but gradually improves

• Appetite is low, but energy is decent

Oral rehydration solution (ORS) is your best friend here.

Rashes: Itchy, Spotty, or Just Mysterious

Babies and toddlers are rash magnets — viral rashes, heat rashes, eczema flares, and “what is THAT” spots.

“Not all rashes are emergencies. Most childhood rashes are harmless, especially if the child seems fine otherwise,” notes Dr Noraini.

Worry if:

• Rash spreads rapidly or is painful

• Child is unwell with high fever + rash

• Blisters, peeling skin, or open wounds

• Purple spots that don’t fade with pressure (meningitis warning)

Don’t panic if:

• It’s a faint, lacy, post-viral rash

• Heat rash from sweat and humidity

• Eczema that’s red but not infected

Ear Infections: The Silent Screamer

One minute your child is fine. The next, they’re screaming and yanking their ear like it owes them money.

Often triggered after a cold, ear infections are painful — but many resolve on their own.

“Not all ear infections need antibiotics,” says Dr Noraini. “If pain is mild and the fever is low, give it a day or two.”

Worry if:

• Severe ear pain that’s not improving

• Pus or fluid draining from the ear

• High fever or hearing loss

• Child is under 6 months

Don’t panic if:

• Pain responds to paracetamol

• Symptoms improve in 48 hours

• It’s one-sided and follows a cold

When It’s Just Intuition

Sometimes, you just know something’s off. Trust that.

Even if symptoms don’t check every box, if your gut says “this isn’t normal,” speak up.

“Parents know their children better than anyone,” Dr Noraini reminds. “If something feels wrong, don’t wait.”

Final Words

You don’t need to be a doctor — just a calm(ish), informed parent with access to a thermometer, common sense, and Google only in moderation.

Pro tip:

Create a “sick kit” at home:

• Paracetamol & ibuprofen (age-appropriate)

• ORS packets

• Digital thermometer

• Nasal spray, suction bulb

• Clean towel, fresh PJs, cartoon playlist on standby

And above all — don’t parent through panic. You’re allowed to worry — just don’t let it run the show.