1 Are there swellings in two or all of the following places?

• Neck
• Armpit
• Groin

2 Does your child have tender swellings in his or her neck with or without a sore throat?

3 Does your child have a swelling around or near the navel?

4 Does your child have a swelling in the groin?

5 Does the swelling get bigger when your child coughs or cries?

6 Does your child have a red, tender swelling on the skin?

7

Possible cause The swellings are probably enlarged lymph nodes caused by a viral infection such as glandular fever. This diagnosis is particularly likely if your child also has a fever. Consult your doctor.

Action Your doctor will examine your child and may arrange for blood tests to establish the cause and appropriate treatment, if any. In most cases, the body fights off the infection on its own and the swelling subsides.

8 See your doctor within 24 hours

Possible causes Enlarged lymph nodes in the neck are often a symptom of a throat infection (pharyngitis) and/or an infection of the tonsils (tonsillitis).

Action Your doctor will examine your child's throat and may take a throat swab to confirm the diagnosis. He or she may prescribe antibiotics. If your child's throat is sore, follow self-help measures to soothe it (Sore throat).

9

Possible cause Your child may have an umbilical hernia, in which a part of the intestines protrudes through a weak area in the muscles of the abdominal wall near the navel. Consult your doctor.

Action Your doctor will examine your child to confirm the diagnosis. An umbilical hernia may disappear without treatment; however, in some cases, your doctor may suggest that you see a specialist to discuss an operation to repair the hernia. If the swelling becomes hard or tender, call your doctor immediately.

10

Possible cause Your child may have a type of hernia in which a section of the intestines protrudes through a weakened area in the muscles of the abdominal wall near the groin. Consult your doctor.

Action Your doctor will examine your child to determine the diagnosis. Because of the risk of the intestine becoming trapped, hernias in the groin should be repaired surgically (see Hernia repair). If a hernia becomes hard or tender, call your doctor immediately.

11

Possible cause and action A swelling in the groin area may be lymph nodes that have swollen in response to a local infection. The infection may be due to a cut, graze, or boil. If you can see no obvious cause for the swelling, such as a boil, or if it persists for longer than a few days, consult your doctor.

12

Possible causes Your child may have a boil caused by a bacterial infection or, if the swelling is itchy, he or she may have been bitten by an insect.

Action Most boils disappear on their own. If a boil has not improved in 48 hours or if your child is unwell, see your doctor, who may prescribe antibiotics or drain the pus under local anaesthetic. Insect bites usually clear up on their own.

13

Consult your doctor if you are unable to make a diagnosis from this chart.