Introduction
We have already discussed in the previous issue (Stewart et al. 1994) that deciding whether a baby is ‘ill’ or not, requires parents and health workers to be able to assess and recognise severity of illness so that appropriate management can be planned.  Whilst most parents and professionals are able to recognise when a baby is ‘off-colour’ or not ‘normal’, determining the extent or nature of illness from these non specific indicators may be difficult.  Why the concern about getting it right?  We are all aware of how rapidly babies and children become ill and of the few sudden, unexpected infant deaths which, with hindsight, had signs and symptoms which could have been treated (Social Services Committee 1988; Patrick et al 1989).  This issue is especially important for health workers such as Plunket nurses, practice nurses, midwives, public health nurses, general practitioners (GPs), paediatric and Accident & Emergency staff, from whom families seek advice and who themselves may only have limited experience of ‘ill’ babies.  Trying to decide if a baby is really ill, or just unsettled and hot with crying, is not helped by the lack of agreement between eminent experts about which signs or symptoms predict illness (Stanton et al 1978; Valman 1985; Gilbert et al 1990).