It's always alarming when your baby is unwell, especially if they are really tiny, but what signs should you look out for to determine whether calling the doctor is the right course of action?

Every baby is different and responds differently. For brand new parents it hard to know what is normal and what is not... here are some signs to look out for which might indicate you baby needs medical help. But remember, a baby's state can deteriorate quickly, so if you are concerned in any way, don't hang around, call for medical advice immediately if your baby or child...

• Is unresponsive: you know what they are normally like, so if they seem unresponsive to a favourite game or toy then they may be ill.
• Has a persistent high temperature: if they seem warm and the temperature won't reduce despite cooling them.
• Refuses feeds: if your baby is still feeding and refuses one feed and then refuses a second feed.
• Vomits: if they vomit up their feed twice in a row or the vomit seems discoloured in any way (ie is greenish or has blood in it).
• Has diarrhoea; if it is blood stained or persistent.
• Shows signs of lethargy: very tired all the time and weary.
• Has a rash: any kind of rash.
• Is irritable or restless: if they won't settle or relax or sleep.
• Has breathing difficulty: if they are struggling to breathe or are breathing in an unusual way.
• Is coughing: unusual or painful coughing
• Has a bulging fontanelle: if there is a bulge at the forehead.

You know your baby best.  If in doubt, call the doctor or NHS Direct!

Doctors are being advised to take parent's fears seriously when it comes to sick children. A parent's instinct is to be considered and taken into account when diagnosing a sick child. The idea that "Mother knows best" may be laughed at by some professionals, but parents can offer important information when discussing their child and doctors should listen, according to research published in The Lancet.

Why should doctors listen to untrained, non-medical parents?

• A parent can be trusted to want the best for the child so are more likely to convey a concern if they think it's important.
• They have probably nursed their child before through other ailments.
• They know the child's 'normal' character and can tell when something is not right.

Previously a parent's view was not officially (or routinely) taken into account, but things may change and guidelines my encourage doctors to listen more to the parent; especially when it comes to serious childhood diseases.

Doctors themselves sometimes use 'gut feeling' for some diagnoses. Rapid detection of serious diseases (such as meningitis and pneumonia) can be vital and quick diagnoses can mean saving a life. If a parent's instinct says its serious, this could help get the child rushed into hospital for medical treatment.

Keep an eye out for:

• Rapid breathing
• High temperature
• Poor blood circulation to the skin especially on fingers and toes
• Lethargy and tiredness

If you feel you're not being heard by your doctor and that your concerns are not being taken seriously - GET A SECOND OPINION!