Fever

This article explains fever, the signs and symptoms in children and some great tips on how to manage fever at home.

What is fever?

A fever is a raised body temperature (its medical name is pyrexia).

Normal temperature is 36 – 37ºc so fever is a temperature above this range, although it is significant when it is higher than 38°c and dangerous when it is above 40°c.

When fever occurs it is as though the body has changed its thermostat –

it attempts to raise its own temperature by increasing the heart rate and shivering. Fever is usually a sign of infection, which can be bacterial or viral. A mild fever may also occur after a child’s vaccinations.

What are the signs and symptoms of fever?

When a child has a high temperature they will generally feel hot and sweaty, be unable to sleep properly and will not want to eat – although they will be thirsty and it is vital to encourage your child to drink plenty of fluids.

Fever can be diagnosed at home using a thermometer, or by feeling your child’s forehead or chest and comparing it to your own. It is important to find out what is causing the fever, as the underlying illness may require treatment.

What is the treatment for fever?

Most childhood fevers can be managed at home (see below for ‘What can I do?”) – but sometimes it is important to call the doctor:

• When the temperature is very high as there may be an infection that needs treatment
• In a baby less than 3 months old, with a temperature over 38ºc
• When the child is extremely sleepy
• When they are refusing fluids
• If there are any other symptoms you are worried about, such as a rash, headache, or if they are breathless, limp or have a stiff neck

Is a temperature of 38°C too high?

Unless the temperature becomes very high (above 40°C) fever is not usually harmful.

Very rarely young children under 5 may have a febrile seizure (fit) as the result of fever.

• If this happens lay the child on their side and stay with them while they recover.
• If it is the first time, take the child to hospital.
• After any febrile convulsion you should seek medical advice to discuss the possible cause and the child’s recovery.

How to check if your child has a fever

Checking your child’s temperature can be done in several ways:

• Feel your child’s forehead with the palm of your hand or cheek to see if it feels hot (they may also look flushed and sweaty)
• A normal temperature is around 36.5 – 37º c in children. An armpit temperature reading is about 0.5 ºc lower
• An ear or forehead sensor thermometer is easier to use with a restless child, but must be checked a couple of times to ensure readings are correct
• A digital thermometer with a reading from the mouth is much more accurate, although many children (especially when not feeling well) struggle to hold the thermometer under their tongues for long enough to get a reading.

Useful tips to keep your child comfortable during a fever

• Ensure your child keeps sipping water
• Use cool, cotton pyjamas and bed clothes
• If very hot, strip the child to a single layer of light clothing
• If your child is old enough, give them ice cubes or ice blocks to suck
• Children can be given medication to reduce fever: paracetamol syrup is usually recommended for children – carefully following the instructions on the bottle, as the dose will change according to your child’s weight. Never exceed the recommended dosage.
• Let your child’s hands rest in a basin of lukewarm water
• Rest a cool flannel on the back of their neck, or on their forehead.

If you are worried your child’s temperature is persisting, is getting too high, or that your child is becoming dehydrated or drowsy, contact your doctor immediately.

For more expert health advice, see our Common childhood illnesses section.