Fever in Young Children

What is a fever?

A fever is an increase in your child’s body temperature. Fever in children is common although it can cause anxiety for parents and carers, particularly when body temperature is above 38oC. However, for infants over six months of age, the height of the temperature or the length of time your child has a fever may not be helpful when working out how ill your child is.

Most children recover quickly and without problems. In a small proportion of children the fever may not improve or the child’s health may worsen. This may sometimes be a sign of a serious illness or infection.

Working out the cause of the fever

The doctor or nurse will have asked you questions about your child’s health and symptoms. They usually also ask about the health of other family members or contacts to try to work out the cause of your child’s fever.

The doctor or nurse examines your child to rule out serious illness. They check your child’s temperature, heart rate and breathing rate. They also look for dehydration. The doctor / nurse may have asked for a urine sample because a urinary tract infection is a common cause of fever in children. Unlike adults, very young children may not show the typical symptoms of a urine infection and fever may be the only sign.

In most cases other tests, e.g. blood tests / x-rays, will not be needed. If the doctor / nurse thinks that other tests would be helpful they should explain these tests and the reasons for doing them.

Sometimes the doctor / nurse will not have found a reason for your child’s fever. Based on the assessment they will decide how best to care for your child. Most children can be cared for at home. Some children will need a period of observation in hospital.

Caring for your child at home

• Antipyretics (medicines to reduce fever): It is okay to give your child paracetamol or ibuprofen if they have a fever and are distressed or unwell. Do not give ibuprofen if you are concerned that your child may be dehydrated (or if they have another medical condition for which ibuprofen is not advised).

These medicines can help lower your child’s temperature and make your child feel more comfortable. However, they do not treat the cause of the fever. Paracetamol and ibuprofen should not be given at the same time, but if you want to use one medicine and it does not work or the effects wear off before it is time for the next dose of that medicine, you may wish to consider using the other. Always check the instructions on the bottle or packet. Your healthcare professional can also give you advice and tell you about the recommended dose of medicine to use:

Paracetamol dose:
Ibuprofen dose:

• Offer your child regular drinks (if you are breastfeeding then breast milk is best).
• Do not over or under dress your child.
• Do not sponge your child with water. This does not help to reduce fever.
• Look for signs that your child may be dehydrated. Symptoms of dehydration include dry mouth, no tears, sunken eyes, sunken fontanelle (the soft spot on a baby’s head) and reduced urine output.
• Encourage your child to drink more fluids if they are dehydrated, and seek further advice if you are worried.
• Look for any non-blanching rash. If your child has a rash, do the tumbler test. Press a glass tumbler firmly against the rash. If you see the spots through the glass and they do not fade, this is a ‘non-blanching’ rash. If this type of rash is present seek medical advice immediately.
• Check on your child during the night.
• Keep your child away from school or nursery while they have a fever and notify them of your child’s absence.

Seeking further advice

If you have been given ‘open access’ then within the specified time period (e.g. 24 hours) you may call Kingfisher Ward for further advice. A card / letter with the appropriate telephone number(s) will be provided.

Otherwise seek help from either your GP, Dorset Emergency Care Service, NHS Helpline (dial 111), or A&E (or call an ambulance if it is an emergency).

You should seek further advice if:

• Your child develops a non-blanching rash
• Your child has a fit
• Your child’s health gets worse
• Your child shows signs of dehydration
• The fever lasts more than five days
• You are more worried than when you last received advice
• You have concerns about looking after your child at home.

Further information

Further useful information and advice can be found at https://www.what0-18.nhs.uk/parentscarers/worried-your-child-unwell/fever-high-temperature

About this leaflet

Author: Dr Julie Doherty, Paediatric Consultant
Written: March, 2018
Approved: April, 2018
Review date: April, 2021
Edition: v1

If you have feedback regarding the accuracy of the information contained in this leaflet, or if you would like a list of references used to develop this leaflet, please email patientinformation.leaflets@dchft.nhs.uk