Question Score
Have these symptoms been present in the last 24 hours?
(1) Has the baby vomited at least half the feed after each of the last three feeds?4
(2) Has the baby had any bile stained (green) vomiting?13
(3) Has the baby taken less fluids than usual in the last 24 hours? If so, score for the total amount of fluids taken as follows:
Taken slightly less than usual (more than 2/3 normal)3
Taken about half usual amount (1/3–2/3 normal)4
Taken very little (less than 1/3 normal)9
(4) Has the baby passed less urine than usual?3
(5) Has there been any frank blood (not streaks) mixed with the baby's stools?11
(6) Has the baby been drowsy (less alert than usual) when awake?
If so, score as follows:
Occasionally drowsy (but usually alert)3
Drowsy most of the time (occasionally alert)5
(7) Has the baby had an unusual cry (sounds unusual to mother)?2
Now examine the baby awake
(8) Is the baby more floppy than you would expect?4
(9) Talk to the baby. Is the baby watching you less than you expect?47-150
(10) Is the baby wheezing (not snuffles or upper respiratory noises) on expiration?3
(11) Is the baby responding less than you would expect to what is going on around?57-150
Now examine the baby naked for the following checks
(12) Is there any indrawing (recession) of the lower ribs, sternum or upper abdomen? If so, score as follows:
Just visible with each breath?4
Obvious and deep indrawing with each breath?15
(13) Is the baby abnormally pale or has the baby looked very pale in the last 24 hours?3
(14) Does the baby have blue fingernails or toenails?3
(15) Squeeze the big toe to make it white. Release and observe colour for three seconds. Score if the toe is not pink within three seconds, or if it was completely white to start with?37-150
(16) Has the baby got an inguinal hernia?13
(17) Has the baby an obvious generalised trunkal rash or a sore and weeping rash covering an area greater than 5 × 5 cm?4
(18) Is the baby's rectal temperature 38.3°C or more?47-151
(19) Has the baby cried (more than just a grizzle) during this assessment?37-150
  • 7-150 These questions were not asked.

  • 7-151 Because prospective temperature data could not be collected parents were asked whether their infant had recently had a fever.

  • Copies of the Baby Check scoring system can be obtained from: Baby Check, PO Box 324, Wroxham, Norwich NR12 8EQ, UK. Telephone: +44 (0)1603 784400.