Kids Health Information : Fever in children

Fever in children
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Fever (a high temperature) is common in children. Fever is a normal response to many illnesses, the most common being an infection in the body. Fever itself is usually not harmful – in fact, it helps the body's immune system fight off infection.
While fevers can be concerning for parents, doctors will usually be more concerned about what is causing the fever, and not what the child’s temperature is. It is more important for you to monitor any symptoms of the underlying illness, rather than the fever itself.
Signs and symptoms of fever
Your child has a fever when their temperature reads above 38°C on a thermometer.
Your child may also be:
unwell and hot to touch
irritable or crying
more sleepy than usual
vomiting or refusing to drink
shivering
in pain
If your baby is under three months and has a fever above 38°C, then you should see a doctor, even if they have no other symptoms.
Taking your child's temperature
There are a number of ways you can take a child’s temperature. Each method measures your child’s temperature in a different way, and the results can vary depending on the type of thermometer you use. Different methods include:
infrared forehead thermometer
under the arm or under the tongue with a digital, mercury or alcohol thermometer
ear (tympanic) thermometer
plastic tape thermometers used on the forehead (these are not recommended as they are not reliable).
Some thermometers are more suitable for particular age groups so you should always read and follow the manufacturer's directions to get an accurate reading. You can also ask your Maternal and Child Health Nurse, GP or pharmacist to show you how to use your thermometer. Do this before you need it.
Febrile seizures
Some children can have seizures (a 'fit') when they have a fever. These are called febrile seizures. Your child may have a febrile seizure if their temperature goes up suddenly. Sometimes, a seizure happens when parents don't actually know their child has a fever. Febrile seizures are common and do not usually cause any long term health effects. See our fact sheet
Febrile seizures.
Care at home
Infections that produce fever can be caused by different sorts of germs. Most are caused by viruses and don’t need any treatment. A few are caused by bacteria, which are treated with antibiotics. Antibiotics do not work on viruses
Lowering your child’s fever will not help treat the underlying illness more quickly.
If your child seems well and is happy, there is no need to treat a fever. If your child is miserable, there are things you can do to help them to feel more comfortable:
Give your child frequent small drinks. Many children refuse to eat when they have a fever. This is not a problem, as long as they stay hydrated
If your breastfed child is younger than six months, offer extra breastfeeds
If your formula-fed child is younger than six months, offer the usual amount of formula
If your baby is older than six months, keep breastfeeding or bottle-feeding. You can also offer your child water or oral rehydration solutions.
You might need to give your child smaller amounts of fluid, but more often.
Give your child paracetamol and/or ibuprofen if the fever is making them miserable or they have other symptoms, such as a sore throat. Carefully follow the dosage instructions on the packaging. Do not give ibuprofen to babies under three months old or to any child who is dehydrated. Never give aspirin to children. See our fact sheet
Pain relief for children.
Try wiping your child’s forehead with a sponge or facewasher soaked in slightly warm water to help cool them down. It’s important they don’t become too cold or uncomfortable when you do this. Cold baths or showers are not recommended.
Dress your child in enough clothing so that they are not too hot or cold. If your child is shivering, add another layer of clothing or a blanket until they stop.
Watch your child for signs that their illness is getting worse.
When to see a doctor
If your baby is under three months old and has a fever above 38°C, even if they have no other symptoms, then you should see a GP.
If your child is immunocompromised (has a weakened immune system) for any reason and has a fever above 38°C, you should seek immediate care from your doctor or hospital emergency department.
For all other children, take them to see a GP if their temperature is above 38°C and they have any of the following symptoms:
a stiff neck or light is hurting their eyes
vomiting and refusing to drink much
a rash
more sleepy than usual
problems with breathing
pain that doesn’t get better with pain relief medication.
Also take your child to a GP if they:
have had any fever for more than two days and there's no obvious cause
seem be getting more unwell
have had a febrile seizure
Key points to remember
A fever is when a child’s temperature is 38°C or higher
Fevers are common in children
A fever itself rarely causes harm and can help fight an infection
If your child seems well and is happy, there is no need to treat a fever.
If your child is under three months and has a fever above 38°C, take them to the doctor, even if they have no other symptoms.
Take your child to the doctor if they seem to be getting worse or have a prolonged fever
Common questions our doctors are asked
Doctors do not focus on fever in a child. They are more concerned about how your child looks and feels – if your child is not drinking, is lethargic and not themselves, or they have had a persistent fever for two or more days, that is when a doctor may try to work out what is causing the fever, and may require a blood test or urine sample.
Can teething cause a fever?
Children who are teething may have a fever of up to 38°C. However, a temperature greater than 38°C should never just be attributed to teething. It is more likely that an infection is present.
Even after pain relief, my child has a fever. Should I be worried?
Not if your child is feeling better and their other symptoms have improved. Paracetamol and ibuprofen may not make the fever go away, but the aim is to make your child feel better. If the fever has lasted for more than two days without getting better, see a doctor.
When I feel sick, my GP advises me to take aspirin. Can I also use this for my child?
Aspirin should never be given to a child to help manage their fever. It can lead to a dangerous condition called Reye syndrome. It should only be given when specifically recommended by a doctor. Paracetamol or ibuprofen can be used instead.
Developed by The Royal Children's Hospital General Medicine and Emergency departments, and Centre for Community Child Health. We acknowledge the input of RCH consumers and carers.
This information is intended to support, not replace, discussion with your doctor or healthcare professionals. The authors of these consumer health information handouts have made a considerable effort to ensure the information is accurate, up to date and easy to understand. The Royal Children's Hospital Melbourne accepts no responsibility for any inaccuracies, information perceived as misleading, or the success of any treatment regimen detailed in these handouts. Information contained in the handouts is updated regularly and therefore you should always check you are referring to the most recent version of the handout. The onus is on you, the user, to ensure that you have downloaded the most up-to-date version of a consumer health information handout.
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