Medicine

If you did not grow up here, your first Dutch consultation with a sick child is a shock. You describe the fever. The huisarts asks whether the child is drinking, playing, and rousable. Then they say: paracetamol if uncomfortable, plenty of fluids, come back if it changes.

No antibiotic. No cough syrup. Often no prescription of any kind.

It is a policy, not indifference

The Netherlands has among the lowest antibiotic prescribing rates in Europe, and correspondingly low rates of antibiotic resistance. That is not an accident of temperament; it is decades of deliberate primary-care guidance. Most childhood fevers, sore throats, ear infections and coughs are viral, and antibiotics do nothing to a virus except disturb the child's gut bacteria and add to the resistance problem everyone shares.

The trade-off is that you, the parent, are asked to hold more uncertainty at home than you might elsewhere. That is genuinely harder. It is also, for most illnesses, better medicine.

What is actually given, routinely

• Vitamin K. Newborns are given vitamin K after birth, and breastfed babies continue with drops, because milk supplies very little and it matters for blood clotting.
• Vitamin D. 10 micrograms a day, from the first week, up to age four — for every baby, breastfed or formula-fed, in a country with this much grey.
• Paracetamol, for discomfort and pain, dosed by weight, in suppository or liquid form. Note that the aim is a comfortable child, not a normal number on the thermometer. Fever is part of the immune response, not the illness.
• The national vaccination programme, free, opt-in in practice and very widely taken up. It is tracked in the little booklet you are given at the consultatiebureau.

Ibuprofen exists but is used more cautiously in small children, particularly if there is dehydration or chickenpox. Ask, do not assume.

What is not given

Cough and cold medicines are not recommended for young children here — the evidence for them is thin and the side effects are not. Antibiotic eye drops, ear drops and throat treatments are far less routine than in southern and eastern Europe. Anything a relative posts from abroad, check the ingredients and the age limit before it goes anywhere near your child.

When to stop waiting

The system asks for patience, but it also gives clear tripwires. Contact a doctor, or the huisartsenpost outside hours, if a baby under three months has any fever at all; if a child is unusually drowsy or floppy, or cannot be roused; if breathing is fast, laboured, or grunting; if there is a rash that does not fade under a pressed glass; if there are signs of dehydration such as very few wet nappies; if the child is in pain you cannot settle; or if your instinct simply says something is wrong. That last one is a legitimate reason and Dutch GPs treat it as one.

This post describes how the system works and is not medical advice. For anything about your own child, call your huisarts or the consultatiebureau.