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Fever in children

Expert reviewer, Dr Adrian Raby, General Practitioner
Next review due December 2024

The normal body temperature of children varies from child to child and goes up and down naturally throughout the day. But fever in children is when their temperature is 38°C (100.4°F) or higher. The medical name for fever is pyrexia.

A baby reaching for a toy

About fever in children

Fever is very common, especially in young children. Each year, around three in 10 parents seek health advice because their child has a fever. When your child is ill and has a fever, it can be upsetting and worrying but there are things you can do to help them feel better.

A high temperature (fever) in children is usually caused by an infection of some kind, and often gets better on its own. But it can sometimes be a sign of a more serious infection. So, it’s important to know how to manage and treat your child when they have a fever, and when to get medical help.

Causes of fever in children

There are many conditions that can cause a fever in children. Most fevers in children are caused by viral infections, and some are caused by bacterial infections. These can include coughs, colds, flu and other viral infections, and throat, ear, chest and urine infections. Less often, a fever can be a sign of a serious illness such as meningitis or sepsis.

Children can also develop a fever as a symptom of other health conditions, including some autoimmune conditions. An autoimmune condition is when your immune system attacks your healthy body tissues. Familial dysautonomia, some cancers, liver disease and kidney disease may all cause a fever. But these causes are rare.

Children can also get a fever as a side-effect of some immunisations. For more information, see the FAQ: Could my child have a fever after being immunised?

Symptoms of fever in children

If your child has a fever, they’ll have a body temperature of 38°C (100.4°F) or higher. They may feel or look generally unwell and may not be as active and engaged as usual. They may not want to eat or drink.

Your child’s temperature alone isn’t always a sign of how serious their illness is. Sometimes, minor illnesses can cause a very high temperature, whereas some serious infections can cause only a small rise in temperature. As well as your child’s high temperature, you may notice other symptoms of an infection such as:

  • diarrhoea and vomiting
  • earache or your child may clutch at their ears
  • a cough, runny nose or wheezy breathing
  • a rash

Getting medical advice or help

If your child has a high temperature or fever, they may need to go to a hospital for treatment. You should get medical help straightaway by taking your child to accident and emergency or calling an ambulance if they:

  • are less than three months old and have a temperature of 38°C (100.4°F) or above
  • have bluish, pale or mottled skin
  • have a weak, high-pitched cry or won’t stop crying
  • have difficulty breathing or are breathing very quickly or noisily
  • have a stiff neck
  • shy away from bright lights
  • develop a rash that doesn’t disappear when you press on it
  • don’t respond to you in the usual way – for example, your baby doesn’t smile when you smile
  • are dehydrated – see the FAQ below for symptoms of dehydration

Seek urgent medical advice from your GP or out-of-hours service if:

  • you think they’re getting worse instead of better
  • they’re shivering
  • they’re unusually sleepy or difficult to wake up
  • they’re less active than usual
  • their fever has lasted for five days or more
  • they have swollen joints, arms or legs
  • they can’t put weight on one or both legs, or they don’t seem to be using their arms or legs
  • they don’t pee as much as normal
  • they are not feeding or eating as normal

In some children, a high fever can lead to fits called febrile seizures or convulsions. If this happens, your child can lose consciousness and twitch and shake for several minutes. You can find out what to do if your child has a febrile seizure, in the FAQ section.

Diagnosis of fever in children

You can tell if your child has a fever by checking their temperature with a thermometer. You can do this yourself at home.

  • If your child is younger than four weeks old, use an electronic thermometer to take their temperature under their arm (in their armpit).
  • For children between a month and five years, you can measure temperature under their arm or in their ear using an electronic thermometer.
  • You can use a digital mouth thermometer for children aged over five (as well as the methods for younger children).

Follow the instructions that come with the thermometer to make sure you get an accurate reading.

Thermometers that measure temperature on a child’s forehead can be unreliable. It is better to use one of the types listed above.


At the doctor’s

If you go to see your GP, they’ll ask about your child's symptoms and medical history and examine them. If you’ve travelled abroad recently or had contact with someone who has been unwell with a fever, let your GP know. They’ll take your child’s temperature and check their heart rate. Your GP might check for other signs of infection by examining your child’s ears, throat and tummy (abdomen), and by listening to their breathing.

There may be an obvious cause for your child’s fever, so they may not need to have further tests. But if it isn’t clear, your GP may ask for a urine (pee) sample. Your GP may also refer your child to a paediatrician (a doctor who specialises in children’s health) for more tests.

Self-help for fever in children

Fever is part of the body’s natural response to infection, so sometimes it doesn’t need to be treated, as long as your child isn’t distressed.

Offer your child something to drink regularly to prevent them getting dehydrated. If you’re breastfeeding your child, you can carry on as normal. For information on how you can tell if your child is dehydrated, see the FAQ: How can I tell if my child is dehydrated?

Although it’s important that your child doesn’t overheat, take care to ensure they aren’t underdressed either. Don’t actively try to cool your child – for example, with tepid sponging or a cold bath. It’s unlikely to work, it can be distressing for your child, and it may cause them to start shivering.

While your child has a fever, it’s best to keep them away from school or nursery. Keep an eye on them and check them during the night too.

Medicines

If your child has a fever and they’re uncomfortable or distressed, you can give them paracetamol or ibuprofen. Don’t give these medicines just to bring down their temperature if your child is otherwise well.

If you try paracetamol and it doesn’t seem to work, you can try ibuprofen instead and vice versa. Don’t give both medicines at once though.

Make sure you keep a note of how much paracetamol or ibuprofen your child has had and when you’ve given it. This will help to make sure you don’t accidentally give them more than the recommended amount.

You can buy medicines for children from a pharmacy without a prescription. Always read the patient information leaflet that comes with your child’s medicine and if you have any questions, ask your pharmacist for advice.

Treatment of fever in children

A high fever in children is often caused by a viral infection and will get better on its own. So, to treat your child’s fever, you may just need to keep them comfortable and wait for them to get better (see our section on self-help). But sometimes, a fever can be the sign of a more serious illness. That’s why it’s important to keep an eye out for any changes in your child’s behaviour and any other symptoms.

If your GP believes your child has a bacterial infection, they may prescribe a course of antibiotics to treat the cause of the fever. And if your child’s doctor identifies the cause of the fever, they’ll treat this if possible.

Common childhood viruses

In this podcast, Specialist Health Editor, Alice Windsor, is joined by Bupa GP, Dr Samantha Wild, to discuss common childhood viruses. They discuss why children pick up so many viruses and illnesses during childhood, how to manage them and when to seek medical advice. They also discuss the implications of the pandemic on general immunity and if the vaccination programme will extend to children.

Frequently asked questions



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Related information

  • Discover other helpful websites

    • Assessment of fever in children. BMJ Best Practice. bestpractice.bmj.com, last reviewed 23 October 2021
    • Fever in infants and children. MSD Manuals. msdmanuals.com, last full review/revision June 2020
    • Ill and feverish child. Patient. patient.info, last edited 18 February 2020
    • Fever in under 5s: assessment and initial management. National Institute for Health and Care Excellence (NICE), November 2019. nice.org.uk
    • Meningitis. Patient. patient.info, last edited 25 July 2019
    • Febrile convulsions. Patient. patient.info, last edited 13 December 2020
    • Feverish children – management. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised December 2018
    • Ibuprofen. NICE British National Formulary for Children. bnfc.nice.org.uk, last updated 10 November 2021
    • Paracetamol. NICE British National Formulary for Children. bnfc.nice.org.uk, last updated 10 November 2021
    • Fever. NICE British National Formulary for Children. bnfc.nice.org.uk, last updated 10 November 2021
    • Green book. GOV.UK. gov.uk, last updated 27 November 2020
  • Reviewed by Rachael Mayfield-Blake, Freelance Health Editor, December 2021
    Expert reviewer, Dr Adrian Raby, General Practitioner
    Next review due December 2024

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