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Fever in children


Expert reviewer, Dr Adrian Raby, General Practitioner
Next review due September 2022

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.

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 fever 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’s fever, and when to get medical help.

Symptoms of fever in children

If your child has a fever, they will have a body temperature of 38°C 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 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

You should 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 have swollen joints, arms or legs
  • they’re less active than usual
  • their fever has lasted for five days or more
  • they can’t put weight on one or both legs, or they don’t seem to be using their arms or legs

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 more about febrile seizures, and what to do if your child has one, in the FAQ section below.

Diagnosis of fever in children

You can see whether your child has a fever by checking their temperature using 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.

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 ones listed above instead.


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 anyone who has, 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 sample. Your GP may also refer your child to a paediatrician (a doctor who specialises in children’s health) for more tests.

Treatment of fever in children

A 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.

But in some cases, 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 behaviour and any other symptoms.

Self-help

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.

If your GP believes your child has a bacterial infection, they may prescribe a course of antibiotics.

Causes of fever in children

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

Children can also develop a fever as a symptom of other health conditions. For example, some autoimmune conditions like Still’s disease, some cancers, and liver and kidney disease may all cause a fever.

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?’

 

Frequently asked questions

  • Your child can lose a lot of fluid if they have a fever, so it's important to check for signs of dehydration.

    When your child or baby is dehydrated, they may:

    • seem and look generally unwell
    • be irritable or restless
    • pee less
    • have sunken eyes and not produce any tears if they cry
    • have a dry mouth
    • have sunken fontanelles – the soft spots on the top and back of their head

    Give your child something to drink regularly if they have a fever. If you’re breastfeeding, try to continue feeding your baby. Contact your GP for advice if you’re concerned.

  • Yes, immunisation can sometimes cause a mild fever. Some vaccines – for example, tetanus – can cause a fever within a few hours. Others, such as the MMR vaccine, may lead to fever seven to 10 days later.

    When your child has the vaccine, ask what you should to do if a fever does develop. You can give your child paracetamol or ibuprofen to treat any discomfort or fever. If your child is well, it’s best not to give these medicines to prevent a fever because they may affect how well the immunisations work. An exception is the meningitis B immunisation for children under one. If your child has this vaccine, you’ll be given information about giving them liquid paracetamol to reduce the chance of a fever.

  • Febrile seizures or convulsions are fits caused by a high temperature. They happen in younger children, usually between six months and five years old. During a febrile seizure, part or all of your child's body shakes or twitches. Your child could also lose consciousness.

    Although febrile seizures rarely last longer than a few minutes, they can be very frightening. Try to stay calm and don’t restrain your child, but try to make them as safe as possible, using your hands or a cushion to protect their head. If they’re in a place where they may get hurt, move them to somewhere safe if you can. Don’t put anything in their mouth.

    Febrile seizures usually last just a few minutes and stop without needing any treatment. But if the seizure lasts for longer than five minutes, call for an ambulance. If the seizure lasts for less than five minutes, call 111 or contact your GP.

    When the seizure is over, make sure your child is breathing properly and put them on their side in the recovery position until they fully wake up. For information on how to do this, see the first aid advice from St John Ambulance in Related information.

    Around one in three children who have a febrile seizure will go on to have another. Although febrile seizures can be frightening, most children recover well with no lasting health problems.


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Related information

    • Assessment of fever in children. BMJ Best Practice. bestpractice.bmj.com, last reviewed July 2019
    • Feverish children – management. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised December 2018
    • Fever in under 5s: assessment and initial management. National Institute for Health and Care Excellence (NICE). www.nice.org.uk, last updated August 2017
    • Ill and feverish child. Patient. patient.info/doctor, last edited 30 August 2018
    • Fever in under 5s. Quality statement. National Institute for Health and Care Excellence (NICE). www.nice.org.uk, published July 2014
    • Fever in infants and children. The MSD Manuals. www.msdmanuals.com, last full review/revision July 2018
    • Meningitis. Patient. patient.info/doctor, last edited 25 July 2019
    • Personal communication, Dr Adrian Raby, General Practitioner, 11 August 2019
    • Pediatric febrile seizures. Medscape. emedicine.medscape.com, updated 9 November 2018
    • Child health. Oxford handbook of general practice. Oxford Medicine Online. oxfordmedicine.com, published April 2014
    • Dehydration in children. Patient. patient.info/doctor, last edited 13 May 2019
    • Green book. GOV.UK. assets.publishing.service.gov.uk, published 20 March 2013
    • Immunizations – childhood. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised February 2018
    • Febrile seizure. BMJ Best Practice. bestpractice.bmj.com, last reviewed July 2019
    • Febrile convulsions. Patient. patient.info/doctor, last edited 25 Jun 2015
    • Febrile seizure. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised November 2018
  • Reviewed by Rachael Mayfield-Blake, Freelance Health Editor, September 2019
    Expert reviewer, Dr Adrian Raby, General Practitioner
    Next review due September 2022



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