Fever in Children: When to Worry

A fever is usually a sign that a child’s immune system is fighting an infection, and most are caused by mild viruses. How your child looks and behaves matters more than the number on the thermometer.

Imagine your toddler waking at 2am, hot to touch and grumpy. The thermometer says 39°C. You give a dose of children’s paracetamol, offer drinks and keep a close eye. By morning he’s playing again. You also know exactly which signs would have made you call for help.

What counts as a fever?

A temperature of 38°C (100.4°F) or higher is generally considered a fever. Digital thermometers under the arm are recommended for babies under four weeks; for older children, armpit or ear thermometers are common.

Caring for a feverish child

• Offer regular drinks; breastfeed or bottle feed often for babies
• Dress them in light clothing; don’t bundle up or sponge with cold water
• Paracetamol or ibuprofen can help if they’re distressed, following the label for age and weight
• Check on them during the night
• Keep them home from nursery or school until the fever has gone

Never give aspirin to children under 16.

But when should I get help?

Seek urgent medical care if your child:

• Is under 3 months with a temperature of 38°C or more
• Is 3 to 6 months with a temperature of 39°C or more
• Has a rash that doesn’t fade when you press a glass against it
• Is floppy, very drowsy, hard to wake or has a weak, high-pitched cry
• Has fast or difficult breathing, or grunting
• Shows signs of dehydration: no wet nappies, sunken eyes, no tears
• Has a seizure, stiff neck or is in severe pain

Also see a doctor if a fever lasts more than five days, or if you’re worried. Trust your instincts; you know your child best.

Sources: NICE (Fever in under 5s), NHS (High temperature in children), American Academy of Pediatrics (HealthyChildren.org), World Health Organization.