Fever

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Fever is very common in children.

A child has a fever when their temperature is 38°C (100°F) or higher.

If your child is over 6 months old how high their temperature is does not tell you how sick they are. A child can have a very high temperature from a mild illness, or a low fever from a serious illness. What is more important is how your child looks and behaves compared with normal.

When your child has a fever check on them regularly during the day and night. Follow the Red-Amber-Green advice on the back on this leaflet to know when you should get medical help for your child.

What causes a fever in children?

Viral illnesses are more common than bacterial infections.

Symptoms of viral illnesses can include:

  • runny nose
  • sore throat
  • cough
  • diarrhoea and vomiting

If several people are also unwell in the same household, this also suggests a viral infection (as they are easily spread).

Most viral infection get better on their own with time. Antibiotics do not work against viruses.

Fever can also be common for up to 48 hours after childhood immunisations.

How do I check my child’s temperature?

  • If your child is under 1 year old, check their temperature with a thermometer under their armpit.
  • If they are over 1 year old, you can use an ‘in-ear” thermometer
other-sectorsArtboard 1 How to take your baby's temperature

How can I look after my child?

  • Give your child plenty of drinks so they do not become dehydrated.
  • If your child is vomiting (being sick), give them small amounts of drinks but more often. This should be milk (breast or formula) if your baby is under 6 months old. If your child is older than 6 months and is not eating, make sure they have some drinks containing sugar. For example you can mix half water with half apple juice.
  • Do not put too many blankets or clothes on your child
  • Do not use cold or tepid sponging, and do not blow fans directly at your child. This may make them shiver and make them feel worse.

What medicines can I use to help?

  • If your child is distressed or feeling unwell because of their fever, you can use paracetamol or ibuprofen to help them feel better.
  • These can be taken at the same time or at different times throughout the day.
  • Always read the instructions on the medicine bottle to make sure you give the right amount at the right time.
  • Some children should not have ibuprofen. For example, children with chickenpox. If you are unsure whether to give your child ibuprofen you can ask your pharmacist, GP or call NHS 111.
  • Never give aspirin to a child.

When should I worry?

🔴 RED: You need urgent help. Go to your nearest accident & emergency department or call 999

  • Breathing very fast or too out of breath to talk, eat or drink
  • Struggling to breathe, including drawing in of the ribs, or noisy breathing (stridor or grunting)
  • Blueness around the lips, any pauses in breathing lasting more than 10 seconds
  • Is pale, mottled or feels unusually cool to touch
  • Difficult to wake, very sleepy or confused
  • Has a fit (seizure), or makes any abnormal movements of their arms, legs or face
  • Irritability (unable to settle with distraction such as toys, TV, food, even after their fever has settled down)
  • Unable to comfortably move neck, intolerance of bright light
  • Any child under 3-months of age with a temperature of 38 or above (unless fever in the 48 hours following vaccinations and no other associated red or amber flags)
  • Has a rash that does not disappear with pressure (perform the glass test)

What is the glass test?

If a rash does not fade under a glass, it can be a sign of sepsis (sometimes called septicaemia or blood poisoning) caused by meningitis and you should call 999 straight away.

🟠 Orange: You need to contact a medical professional today. Contact your GP practice or NHS 111

  • Temperature of 38°C or above for more than 5-days and is not getting better
  • Is 3-6 months old with a temperature of 39°C or above
  • If your child is shivering with fevers (rigors)
  • Breathing a bit faster than usual or working harder to breathe even when their fever has settled down
  • Seems dehydrated ((sunken eyes, drowsy or no urine passed for 12 hours)
  • Is more drowsy than usual (excessively sleepy) or very irritable (you cannot calm them down), particularly if persisting when the fever settles down
  • Swelling or redness to a limb or a joint (hips, knees, ankles, elbows), or new limp and/or difficulty with weight bearing
  • Getting worse and you are worried
  • Complaining of severe pain that does not improve with painkillers
  • Severe tummy pain that does not improve with painkillers

NHS 111 can help if you think your child needs medical help right now. You can get help from NHS 111:

By using 111 online (if your child is 5 years old or older)

By calling 111 – you can ask for an interpreter

By Text Relay – call 18001 111 using text relay, 24 hours a day

By using signvideo.co.uk/nhs111 if you need British Sign Language

🟢 GREEN: If none of the above features are present.

  • If none of the above red or amber symptoms are present you can continue caring for your child at home
  • Continue to regularly check on your child. Children who are unwell and have a high temperature should stay at home. They can return to school or childcare once they no longer have a high temperature and they are well enough to attend.
  • If your child has a long-term condition or disability and you are worried, please contact your regular team or follow any personalised plans that they have given to you.