A high temperature, or fever is very common in children. It is the way the body responds to any number of infections both minor and serious. This information is designed to tell you what to look for, when you should be concerned and when to seek help.
Useful facts
What is fever? Fever is a raised body temperature above the normal daily variation, which usually suggests an underlying infection. A high temperature is 38°C or higher.
Fever is common Around 3 out of 10 pre-school children will develop one or more episode of fever every year.
Fever is often ‘normal’ Mild feverish illness is a normal part of childhood – a natural, healthy and harmless response by the immune system to help the body fight infection.
Common causes Common causes of fever include the common cold, ear infections, stomach bugs (gastroenteritis), throat- and travel-related infections.
Serious causes In rare cases, severe infections, such as pneumonia or meningitis, are the main cause of a fever.
Children under 6 months Any child under 6 months of age with a fever must be assessed by a health professional.
What can I expect to happen?
In most cases, a fever is caused by a common, harmless illness which gets better by itself. Your child is unlikely to need antibiotics.
Duration: A fever should not last longer than 5 days.
Your child is unlikely to be seriously unwell if they:
• Behaviour: Respond normally to you, seem content, wake easily and stay awake and has a normal cry
• Hydration: Have moist lips and tongue and normal skin and eyes
• Skin colour: Their skin and tongue are their usual colour
• Other signs: Have none of the signs and symptoms listed in the sections on “when to seek medical help”
Rarely, more serious medical problems may cause fever in children. Always speak to 111 (or NHS24 in Scotland / Phone First Service in NI) or to your child’s GP if their health gets worse or if you have concerns about looking after your child at home. Your pharmacist can also help with advice.
Treatment
Remember that you can ask a member of your pharmacy team for advice.
Medication You can give either paracetamol or ibuprofen if your child is unwell or appears distressed.
Neither should be given routinely just to reduce body temperature or to prevent fits.
If you’ve given paracetamol and they still have a high temperature after 1 hour, you could try giving them ibuprofen.
If this helps to bring down their temperature carry on giving them ibuprofen instead of paracetamol. Do not continue alternating without advice. See your doctor if you’ve tried both paracetamol and ibuprofen and they have not helped.
Always follow the manufacturer’s instructions.
- Do not give paracetamol to a child under 2 months.
- Do not give ibuprofen to a child under 3 months or under 5kg or to children with asthma.
- Never give Aspirin to children under 16.
What can I do to help my child now and in the future?
Checking your child’s temperature if you have a thermometer: Under 4 weeks old, use an electronic thermometer in the armpit. In children aged between 4 weeks and 5 years, use either an electronic or chemical dot thermometer in her/his armpit, or an infra-red tympanic (ear) thermometer in the ear canal.
If you haven’t got a thermometer, use your judgement as to whether your child feels abnormally hot and therefore has a high temperature. Your child might feel hotter than usual to the touch on the forehead, back or tummy, is sweaty or clammy or has red cheeks.
Clothing Avoid over, or under-dressing your feverish child.
Heating and cooling Keep your heating down. Keep the room well ventilated. Tepid sponging of children is not recommended.
Fluids Offer your child regular fluids. If you’re breastfeeding, offer as many feeds as she/he will take.
School or nursery It is best to keep feverish children away from nursery or school.
Body checks Check your child 2-3 times at night for signs of serious illness (see red boxes below).
Make sure your child is up to date with their vaccinations. Let a health professional know if vaccinations are missed or delayed.
When should I seek medical attention for my child?
Contact your child’s surgery or call 111 in England and Wales, the Phone First Service in NI or NHS24 in Scotland NOW if your child has any of these:.
High fever If your child is 3-6 months old and has a temperature of 38°C or more or you think they have a high temperature.
Vomiting Your child vomits repeatedly, or brings up dark-green vomit.
Skin colour Your child’s skin, lips or tongue are pale.
Rash You notice a new rash that fades when a tumbler is pressed against it.
Behaviour Your child doesn’t respond , wakes with difficulty, is less active, doesn’t smile or feed poorly or is not their usual self and you are worried.
Breathing Your child breathes much faster than usual and their nostrils flare.
Hydration Your child is not drinking and not passing much urine. Nappies stay dry, her/his mouth and eyes appear dry.
Duration Your child’s fever has persisted for 5 or more days.
Other signs Your child also can’t walk for some reason, has developed a swelling or new lump in a limb or joint or has attacks of shivering or you notice any other unusual symptoms and signs that you can’t explain, or your child is less well than when you previously sought advice.
Go to A+E if your child has a temperature and any of these symptoms:
High fever If your child is 3 months old or less and has a temperature you have measured of 38°C or more or you think they have a high temperature.
Skin colour Your child’s skin, lips or tongue are mottled, ashen, pale or blue.
Behaviour Your child does not respond, does not wake, or falls asleep again if woken or has a high pitched or continuous cry or is very agitated or confused.
Breathing Your child breathes much faster than usual, makes a grunting sound when they are breathing, and the skin between the ribs or the area just below the rib cage moves in and out during breaths.
Hydration If your child has a dry mouth, if you pinch the skin on the back of your child’s hand and it does not return to normal quickly or, in babies, the soft spot on the top of the head (the fontanelle) is sunken or bulges.
Rash You notice a new rash that doesn’t fade on pressure (press a tumbler against the rash to see if it disappears).
Other signs Your child has a stiff neck, is bothered by light, has cold hands or feet or has had a fit or seizure for the first time (can’t stop shaking).
Where can I find out more?
A member of your pharmacy team can help you assess your child’s symptoms, or visit the NHS website in your country for advice:
Could it be coronavirus?
It is still important to be mindful about coronavirus (COVID-19) symptoms, which are the same for adults and children and can include a high temperature. Many symptoms are similar to those of colds and flu. For more information click here.
