When to get help

Ask for an urgent GP appointment or contact NHS 111 — or your GP or out-of-hours service in Ireland, your paediatrician in the US or Canada, healthdirect on 1800 022 222 in Australia, Healthline on 0800 611 116 in New Zealand — if any of these apply. The NHS lists them explicitly:

You think your baby may have measles.
Your child is under one year old and has come into contact with someone who has measles. This one needs no symptoms at all.
Your baby has a high temperature that has not come down after paracetamol or ibuprofen.
Your baby has difficulty breathing.
Your baby is not feeding well, or is taking less milk or fluid than usual.
Your baby is passing less urine than usual, or has fewer wet nappies.
Your baby feels very unwell, or you are worried something is seriously wrong.

Call emergency services — 999 in the UK, 112 or 999 in Ireland and across the EU, 911 in the US and Canada, 000 in Australia, 111 in New Zealand — if your baby has a fit, is drowsy and hard to wake, is breathing fast or grunting, has a rash that does not fade under a glass, or has a temperature of 38°C or higher and is under three months, which NICE guideline NG143 places in the high-risk group for serious illness.

Phone before you go

Measles is one of the most infectious diseases there is, and a waiting room full of unvaccinated babies and pregnant women is exactly where it does the most damage. The NHS asks you to call the GP surgery before going in, so they can talk to you by phone or arrange for you to come in through a separate route away from other patients. Do the same before an emergency department, unless it is a 999 situation.

The order symptoms arrive in

Measles does not start with the rash, which is why it is often mistaken for an ordinary virus for the first few days.

It begins with cold-like symptoms: a high temperature, a runny or blocked nose, sneezing, a cough, and red, sore, watery eyes. A few days later small white spots may appear inside the cheeks and on the back of the lips, and these usually last a few days.

The rash typically appears a few days after those first symptoms. It starts on the face and behind the ears before spreading to the rest of the body. The spots are sometimes raised, and they join together into blotchy patches. They are not usually itchy. On white skin the rash looks brown or red; the NHS notes it may be harder to see on brown and black skin, where checking the palms, the soles and inside the mouth in good light helps.

Why babies under one are the group everybody worries about

Two things stack up. First, most babies are not vaccinated against measles until around their first birthday in most national schedules, so a baby under one is usually unprotected. Antibodies passed across the placenta fade during the first months, and they fade sooner if the mother's own immunity came from vaccination rather than infection.

Second, the World Health Organization notes that children under five are among those most at risk of serious complications. Those include ear infections, severe diarrhoea and dehydration, pneumonia, and, rarely, encephalitis. Measles also suppresses the immune system for a period afterwards, which is why some children pick up other infections in the weeks that follow.

The American Academy of Pediatrics advises parents of babies too young to be vaccinated to be particularly careful during an outbreak, and to speak to their paediatrician about whether an earlier dose is appropriate before travel or during local transmission. In several countries an early dose can be given from six months in those circumstances, and it does not replace the routine doses that follow.

How long it is infectious

Someone with measles is infectious before they look obviously ill, which is what makes it spread so efficiently. The infectious period spans several days before the rash appears and several days after it starts, so by the time a rash is recognised, contacts have already been exposed.

The virus spreads through coughing, sneezing and breathing, and it can linger in the air of a room after the infected person has left. That is why a shared waiting room, a soft play centre or a plane counts as contact even without touching.

Looking after a baby with measles at home

Most cases start to improve in about a week. Keep your baby comfortable and keep fluids going: more frequent breast or formula feeds are the priority, and solids matter far less for a few days.

Paracetamol or ibuprofen for children may help a distressed or uncomfortable baby, but check the packaging or leaflet to confirm the product is suitable for your baby's age, or ask a pharmacist. Never give aspirin to a child under 16. Do not give cough or cold remedies to a baby.

Keep the room dimly lit if the eyes are sore, and clean sticky eyes with cooled boiled water and a fresh piece of cotton wool for each wipe. Watch for the signs in the help list above, particularly breathing changes and reduced wet nappies, and ring again if any appear.

Staying away from others

Keep your baby off nursery or childcare and away from other children for at least four full days after the rash appears, and avoid contact with anyone who is pregnant, anyone with a weakened immune system, and any baby who has not been vaccinated. Tell nursery, and tell anyone you saw in the days before the rash, because they may need advice themselves.

Protecting a baby who cannot yet be vaccinated

Everybody else in the household being up to date is what actually protects a young baby. That includes older siblings, adults who are unsure whether they had two doses, and anyone providing childcare. UKHSA publishes current measles guidance and outbreak data, and vaccination is free on the NHS at any age for people who missed doses.

During an outbreak, ask your GP or paediatrician about the timing of your own baby's first dose and whether an earlier one is advised, rather than deciding either way from what you read online.

Measles in Babies