Healthy Early Years
A parent’s guide from birth to five
Fever

Fever

Part of the body’s natural response

A child with a significant fever will have a body temperature above 38°C. Your child may also feel tired, look pale, have a poor appetite, be irritable, have a headache or other aches and pains and feel generally unwell. Take the temperature from the armpit, using an electronic thermometer (don’t use in the mouth of under 5s) or use an ear thermometer. Remember that measurements from under the arm are less accurate as the armpit is slightly cooler.

A fever is part of the body’s natural response to fight infection and can often be left to run its course provided your child is drinking enough and is otherwise well. If your child is having trouble drinking, trying to reduce their temperature may help with this. This is important to prevent your child from becoming dehydrated, which can cause kidney problems. Your child’s urine should be pale yellow - if it is darker, your child needs to drink more fluids.

Fevers are common in young children. They are usually caused by viral infections and clear up without treatment. However, a fever can occasionally be a sign of a more serious illness such as a severe bacterial infection of the blood (septicaemia), urinary tract infection, pneumonia or meningitis.

You should also contact your GP if fever symptoms are not improving after 48 hours. Check your child during the night.

Always seek medical advice if your child develops a fever soon after an operation, or soon after travelling abroad.

GP

GP says

When looking after a feverish child at home you should:

  • Get the child to drink more (where a baby or child is breastfed the most appropriate fluid is breast milk).

  • Look for signs of dehydration: reduced wet nappies, dry mouth, sunken eyes, no tears, poor overall appearance, sunken soft spot on baby’s head.

  • If your child is dehydrated contact your GP or call 111.

  • Know how to identify a meningitis rash (see meningitis).

  • Check child during the night.

Source: NICE, Feverish illness in children/2013

Young babies

Always contact your GP or NHS 111 if your child:

  • Is under three months of age and has a temperature of 38°C or above.

  • Is between three and six months of age and has a temperature of 39°C or above.

  • Is over six months and shows other signs of being unwell - for example, they are floppy and drowsy or you are concerned about them.

Older children

A little fever isn’t usually a worry for an older child. Contact your GP if your child seems unusually ill, has a high temperature which doesn’t come down or is having difficulty breathing. With older children it’s not so much the temperature to look out for but the other symptoms. It’s important to encourage your child to drink as much fluid as possible. Water is best.

How can I regulate my baby's temperature?

 

To help reduce temperature:

  • Undress to nappy/pants.

  • Keep room at a comfortable temperature (18°C).

  • Encourage your child to drink more (even little amounts often).

  • Give sugar-free paracetamol or ibuprofen in the correct recommended dose for your child (see packaging).

Febrile convulsions

A febrile seizure or convulsion is a fit that can happen when a child has a fever. They often occur during the first day of a fever. However, there appears to be no connection between the extent of your child’s fever and the start of a seizure. Seizures can occur even if your child has a mild fever. You should take your child to A&E or call 999 for an ambulance if:

  • Your child is having a fit for the first time.

  • The seizure lasts longer than five minutes and shows no signs of stopping.

  • You suspect the seizure is being caused by another serious illness, for example meningitis.

  • Your child is having breathing difficulties.

If your child has previously had febrile seizures, it's recommended that you telephone your GP or call NHS 111 for advice. While febrile seizures may be frightening, most are harmless and don't pose a threat to a child’s health. See the video above.

1

My toddler is hot and grumpy.

2

Have you tried infant paracetamol? Have you made sure they are drinking as usual?

3

If their temperature remains over 38°C and doesn’t come down, contact your GP.