If you feel that something is not quite right, consult your midwife or doctor. Keep your important telephone numbers handy - your doctor's surgery, the hospital A&E department, a reliable local taxi firm and someone who can look after any other children in an emergency.

If you are asked to take your baby to a health centre out of hours, remember that it may be better that your baby is examined somewhere fully equipped for treatment, rather than at home.

These are the signs that your baby may be ill.

• breathing quickly, especially if noisy and it started suddenly
• blood in the bowel motions or urine
• persistent, unusual crying
• baby is listless or floppy
• a skin rash
• off their food - less than half the normal intake over 24 hours
• vomiting persistently
• less than 4 wet nappies in 24 hours
• irritability

Always call the doctor or midwife if you are worried.

The signs to watch out for if you are anxious about meningitis are

• stiff neck
• the soft spot on top of your baby's head (fontanelle) bulging
• pale, floppy body
• baby not showing signs of alertness
• purple rash
• high-pitched moaning cry.

Meningitis is uncommon. Although tt is a serious disease, it can be treated if caught in time.

These are the recommendations for immunisation for babies up to 12 to 15 months. (Further immunisations are required between the ages of one year and 18 years.)

After birth

• Hepatitis - only given if mother is a carrier

Two months

• Polio (by mouth)
• DTP (diphtheria/tetanus/pertussis - whooping cough) and Hib form of meningitis (one injection).

Three months

• Polio (by mouth)
• DTP (diphtheria/tetanus/pertussis) and Hib form of meningitis (one injection)
  

Four months

• Polio (by mouth)
• DTP (diphtheria/tetanus/pertussis), and the Hib form of meningitis (one injection).

12-15 months

• MMR (measles/mumps/rubella - German measles). The Hib vaccine is given to prevent meningitis, but doesn't prevent meningitis C for which a vaccine was introduced in 1999.
  At present, there is no vaccine against the B strain.

You can postpone immunisation if your baby is very ill when the jab is due. If your baby has a cold or a cough, but no temperature, you don't need to delay the immunisation. Your practice nurse will advise you. Booster doses may not be given if there was a severe reaction to a previous dose. Babies are often grumpy and may a mild fever after immunisation. It is normal for the injection area to be swollen.

Make sure you have paracetamol in the house when you baby is immunised and give the recommended dose for their age. This should help him or her settle. Watch out for a fever five to 11 days after the MMR vaccination. Use paracetamol if your baby's temperature goes up. Scares involving vaccines are reported periodically in the press. Your GP will be able to give you an up-to-date, unbiased opinion or your health visitor can arrange for you to talk to a doctor from the community paediatric team.

Congenital means 'present at birth' and includes any hereditary conditions, and abnormalities arising through complications in labour or when the baby is growing in the womb.

Two organisations that can give information on congenital problems are

• Contact-a-Family - helping families who care for children with disabilies or special needs.
  Telephone: 0207 383 3555
  Website
• Birth Defects Foundation Its telephone 'Here to Help' service can provide information on conditions, relevant addresses, background on medical terms, contacts and much more.
  Telephone: 08700 707020
  Website

Spina bifida
With spina bifida, a baby is born with a raw swelling over part of the spine. This can lead to partial or complete paralysis of the legs, loss of sensation below the level of the spina bifida and problems with bladder control. There may also be retention of water on the brain (hydrocephalus). If possible, the raw swelling will be closed surgically in a specialist unit. All pregnant women, and women planning a pregnancy are now encouraged to take folic acid supplements in the prenatal period and early months of pregnancy to reduce the risk.

Umbilical hernias
Umbilical hernias arise from weakness around the navel. This means that part of the digestive system sticks out outside the cavity of the abdomen. Most congenital umbilical hernias (ie that is those around the navel) resolve themselves and only need surgery if they do not.

Sickle cell disease
Sickle cell disease is an inherited condition found in people of West African or African-Caribbean origin and descent. The red blood cells containing haemoglobin that carry oxygen around the body break down quicker than usual leading to anaemia and painful blockages of blood vessels in the limbs or abdomen. Episodes can last several days and should be treated with a painkiller such as paracetemol.

Cystic fibrosis
Cystic fibrosis is an inherited disease that causes body tissue to produce abnormally thick mucus, in the air passages for example. As a result these become blocked and susceptible to infection. The bowel and the pancreas gland may also be affected. Children with cystic fibrosis cannot digest food properly and may have foul-smelling bowel movements and constipation. For their age, they will be undernourished and small. Cystic fibrosis affects approximately one in every 3,000 children in the UK. There is no cure, but damage to the lungs can be prevented if it is diagnosed early. Children with cystic fibrosis are prone to chest infections that are likely to require antibiotics. To dislodge the thick phlegm, parents usually have to perform chest physiotherapy daily.

Coeliac disease
This affects about 2% of the UK population and is a condition in which the intestine is badly affected by gluten, a protein found in wheat. Children with coeliac disease might have chronic diarrhoea, or loose stools that are pale, fatty and difficult to flush away. The child will not gain weight as expected. A blood test is required to detect the disease and once diagnosed, a child will have to exclude gluten from his or her diet - ie any food made from flour. There is a huge range of suitable substitute foods now available on prescription from your GP. Bowel motions return to normal when gluten is excluded from the diet and the child will gain weight. However the sensitivity to gluten will remain for life.

Club foot
Club foot - also known as talipes - is a condition which means the foot curves inwards or outwards. It is more likely in babies born in the breech position. Your baby will be checked for club foot after the birth. In most cases the foot can be manipulated into the correct position with very simple treatment. In more severe cases, an operation may be needed.

Cleft palate
A harelip is an obvious gap in the middle of the upper lip and a cleft palate is linked with harelip. However, a cleft palate is obvious only if you look inside the baby's mouth where you will see a gap in the roof of the mouth. Plastic surgery is available to treat this condition.

Congenital dislocation of the hip
Babies are checked at birth and at the eight-week screen for dislocation of the hip. It can cause problems with walking in later life if the condition is missed. Babies with dislocation of the hip may have to wear a special splint. Most cope without too much trouble and very few need an operation. This condition is more common in girls and in babies born in the breech position.

Cerebral palsy
Cerebral palsy results from damage to the parts of the brain controlling the body's movement. It may occur before or during birth, or in the first two years of life. In many cases doctors are unable to establish the exact cause. The damage is not always evident at birth and may become obvious only as the baby grows. Some of the tests at the 8-week screen check for cerebral palsy.