Fever in children: how do I care for my child, and when should we get help?
A temperature of 38.0 °C or higher usually counts as a fever (1177, NHS). Fever is one of the body's ways of fighting infection, and how your child is otherwise matters more than the number (1177). Most children with fever do not need care: let them rest, give them more to drink than usual, and dress them so they are comfortable (1177). Fever-reducing medicine can help if your child is miserable or uncomfortable, at the dose on the package (1177, NHS). Contact a health centre if the fever lasts more than four days. Get help at once if your child seems very ill, will not drink, or has a temperature of 41.0 °C or higher, and call 112 for a first febrile seizure (1177).
| Question | What applies | Source |
|---|---|---|
| What counts as a fever? | 38.0 °C or higher. Most people have a body temperature between 36 and 37.8 °C | 1177, NHS |
| Is the number the most important thing? | No. How your child is otherwise matters most | 1177 |
| How long does it usually last? | The temperature usually returns to normal within 1 to 4 days | NHS |
| How do I measure it? | With a thermometer. 1177 says ear or bottom gives the most reliable result; the NHS describes a digital thermometer in the armpit | 1177, NHS |
| Most important at home? | Rest and plenty to drink, more than usual | 1177, AAP |
| Fever-reducing medicine? | Only if needed, for example if your child is miserable, will not eat or drink or cannot settle. Follow the dose on the package. No acetylsalicylic acid (aspirin) under 18 | 1177, NHS |
| When to contact a health centre? | If the fever has lasted more than four days | 1177 |
| Back to school? | When your child has been fever-free for a day without fever-reducing medicine and has the energy for a full day | 1177 |
What is a fever?
Fever is one of the body's ways of defending itself against infections caused by viruses or bacteria. Children get fevers easily, but that does not have to mean they are very ill (1177). Fever is common with viral infections such as colds, coughs and sore throats (1177).
- The limit: a temperature of 38.0 °C or higher usually counts as a fever (1177, NHS). Body temperature also varies over the day: it is usually lowest at night and highest in the afternoon (1177).
- Common signs: your child feels warm, is tired, upset or grumpy, sleeps more or less than usual, or does not want to eat or drink as usual. They may shiver as the temperature rises and sweat as it falls (1177).
- Seeing things: some children become briefly confused with a fever and may see, hear or feel things that are not there. 1177 says this can feel unpleasant but is not harmful and usually passes after a while.
- Taking the temperature: feeling the forehead is not always enough (AAP). Use a thermometer; 1177 says measuring in the ear or bottom gives the most reliable result, and the NHS describes a digital thermometer in the armpit. If your child has just had a bath or been wrapped in a blanket, wait a few minutes and try again (NHS).
Caring for your child at home
Most children with a fever do not need care. The fever itself is not harmful; it is the cause of the fever that may need care (1177). Children with a fever need rest and time to recover (1177).
- Rest, but not necessarily in bed: help your child take it easy, and let them decide how much they want to be up (1177). Keep them company (1177).
- Drinks first: give your child more to drink than usual, otherwise they can easily become dehydrated (1177). A fever makes a child lose fluids more quickly (AAP).
- Food they like: offer things your child likes to eat and drink. It is OK if they eat less than usual for a few days (1177).
- Dress for comfort: take off clothes or covers if your child is too warm, and add a layer or a blanket if they are shivering (1177, AAP). Do not wrap them in too many clothes or bedclothes (NHS).
- No cold sponging: do not sponge your child down to cool them (NHS). Ice packs, sponging and alcohol baths are no longer recommended (AAP).
- Check regularly: look in on your child regularly, including during the night (NHS).
Fever-reducing medicine
Fever helps the body fight infection, so there is no need to treat a fever in a child who is otherwise doing well (1177).
- When it helps: you can give over-the-counter fever-reducing medicine if your child is miserable, does not want to eat or drink, or finds it hard to settle in the evening (1177). The NHS mentions paracetamol or ibuprofen if your child is distressed or uncomfortable.
- The right dose: read the package leaflet (1177) and check the packaging to make sure the medicine is suitable for your child. Ask a pharmacist if you are not sure (NHS).
- Not aspirin: children and young people under 18 should not take medicines with acetylsalicylic acid for fever (1177).
- Do not alternate ibuprofen and paracetamol unless a doctor or nurse tells you to (NHS).
- Ibuprofen is not for everyone: do not give it to a child who has chickenpox or is dehydrated, or to a child with asthma unless a doctor has recommended it (NHS).
- Antibiotics can help if the infection is caused by bacteria, but not if it is caused by a virus (1177).
Febrile seizures and school
- Febrile seizures: some children have seizures when they have a fever, but most children never do. It can look frightening, but it is not harmful (1177). If it is the first time, call 112 (1177).
- Back to school: your child can go back when they have the energy for a whole day with others and have been fever-free for a day without fever-reducing medicine (1177). Read more in our guide to sick days and school.
- Fewer infections: fever cannot be prevented, but you can lower the risk of infections: wash hands often, sneeze and cough into the elbow, try not to touch the nose and eyes, and spend lots of time outdoors, also in winter (1177).
Try this week
- Check that you have a working thermometer at home and know where it is (AAP).
- Read the package leaflet for the fever-reducing medicine you have at home now, before anyone is ill, and check the dose for your child's weight or age.
- Put a water bottle by the bed when someone in the family has a fever, and offer a drink every time you look in.
When to get help
Contact a health centre or out-of-hours clinic if your child has had a fever for more than four days. If they are closed, you can wait until they open (1177). Also get advice if the medicine is not helping or you are worried (NHS), or if your child still seems ill once the fever has come down or seems to be getting worse (AAP).
Seek care at once at a health centre or out-of-hours clinic, or at A&E if you cannot reach them, if your child has a fever and (1177):
- has a temperature of 41.0 °C or higher
- seems very ill, is in a lot of pain somewhere or cries and cannot be comforted
- will not drink at all or shows signs of dehydration, such as a dry mouth or peeing less than usual
- has been in a tropical country and gets a headache or aches in the body
The AAP also lists a stiff neck, severe headache, severe sore throat, severe ear pain, an unexplained rash, repeated vomiting or diarrhoea, and a weak immune system as reasons to call a doctor right away. Fever is judged a little differently depending on the child's age, and stricter rules apply to babies (1177).
Call 112 if your child has a febrile seizure for the first time (1177). The NHS also lists these as emergency signs: a stiff neck, a rash that does not fade when you press a glass against it, being bothered by light, unusually cold hands and feet, blue, grey, pale or blotchy skin or lips, being drowsy and hard to wake, being very agitated or confused, difficulty breathing or breathing very fast, and not responding as usual. Call 1177 for medical advice or help finding the right clinic. See also when to seek care for your child.
This guide is general information, not medical advice for your child.