What a fever is and why it happens
A fever is a temperature of 38°C (100.4°F) or higher, and in children it is very common. A fever is not an illness in itself but a sign that the body is responding to something, most often an infection — usually a minor viral illness such as a cold. Raising body temperature is part of how the immune system fights infection, which is why fever so often accompanies everyday childhood illnesses.
For most children, a fever is not harmful in itself and settles as the underlying illness passes. An important principle for parents is that how high the temperature is matters less than how the child seems and behaves. A child with a mild fever who is very unwell needs more attention than a child with a higher reading who is alert, drinking and reasonably content. This is why the warning signs below matter more than the number on the thermometer — with one key exception: very young babies.
Caring for a feverish child at home
Most fevers in children can be managed at home while the illness runs its course. The main aims are to keep the child comfortable, well hydrated, and to watch how they are doing. Helpful steps include:
- •Offer plenty of fluids regularly to prevent dehydration (breast milk or formula for babies)
- •Keep the child comfortable — not too hot or too cold; do not over-wrap them
- •Let them rest, but they do not have to stay in bed if they don't want to
- •Children's paracetamol or ibuprofen can help if the child is distressed or uncomfortable — follow the dose for their age and weight
- •Check on them regularly, including during the night
- •Keep them off nursery or school while feverish, and until they are well enough
What not to do, and medicine cautions
A few common instincts can do more harm than good. Do not try to cool a child by sponging them with cold water or using cold baths, and do not under- or over-dress them to force the temperature down — keeping them comfortable is the goal, not rapidly lowering the number. Fever-reducing medicines are for easing discomfort, not for getting the temperature to a particular figure, so there is no need to use them if the child is otherwise comfortable.
With medicines, some important cautions apply. Give children's paracetamol or ibuprofen only as directed for the child's age and weight, and do not give both at the same time unless a doctor or pharmacist advises it. Never give aspirin to a child under 16. If you are ever unsure about which medicine, what dose, or whether to give anything at all, a pharmacist or doctor can advise — and for a very young baby, always seek advice before giving fever medicines.
Babies and when fever is urgent
Age matters a great deal with fever. In very young babies, a fever needs prompt medical attention because serious infections can be harder to spot and progress quickly. A fever in a baby under 3 months (a temperature of 38°C or above) should always be treated as needing urgent medical advice, and a fever in a baby aged 3 to 6 months also warrants a lower threshold for seeking advice. For these youngest children, do not wait to see how things develop — get medical advice.
For children of any age, certain warning signs mean a fever needs urgent or emergency assessment regardless of the exact temperature. These are covered in the guidance below and include things like a rash that does not fade under pressure, difficulty breathing, a stiff neck, a fit (seizure), unusual drowsiness or difficulty waking, or a child who seems seriously unwell. Trust your instincts as a parent — if your child seems very unwell or you are worried, seek help.
It is also worth knowing about febrile seizures, which can occur in some young children with a fever. They are frightening to witness but are usually brief and not typically harmful in themselves; however, a child having a seizure needs to be assessed, and a first seizure, or one lasting more than five minutes, needs emergency help. Reassuringly, the great majority of childhood fevers are due to minor infections and resolve with simple home care — the guidance here is about knowing the smaller number of situations that need prompt attention.