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Fever / High Temperature
Fever is extremely common in children and usually suggests that your child has an infection. Your child has a fever if their temperature is over 38°C( 100.4 F). Most children recover quickly with minimal or no treatment. Useful facts regarding fever include:
Viral Infections:
- Viral infections are far more common than bacterial infections.
- Symptoms such as runny nose, cough, wheeze, sore throat, red eyes and diarrhoea are more suggestive of a viral infection than a bacterial infection. If a number of people are unwell in the same household, this also suggests a viral infection (because viral infections are easily spread).
- Viral infections tend to get better on their own and do not need treatment with antibiotics. Antibiotics may actually cause side effects such as rash and diarrhoea and can increase the risk of them developing antibiotic resistance.
Immunisations
Fever is common in babies up to 48 hours after receiving immunisations.
It is okay to give paracetamol after Men B vaccine ( 8 week vaccination) without seeking medical advise if your baby is otherwise well
Over dressing
Infants, especially newborns may get warm if they are over dressed, wrapped in a blanket or in a hot environment because they do not regulate their body temperature as well as older kids. But because fevers in newborns can be a sign of serious infection, any infant less than 3 months who has fever must be checked by a doctor.
Fits with fever
Sometimes children with fever can have a fit. This is called a febrile convulsion and most commonly occurs in children aged between 6 months to 6 years.
Most of the time, the fit stopped by themselves and last for less than 5 minutes. Call 999 if fit lasting more than 5 minutes. In most cases there are no long-term effects if self-resolving.
Most children that have a febrile fit to not go on to develop epilepsy.
How to take a temperature
It is important to take your child's temperature carefully – you should use a digital thermometer
- under the armpit for children 5 years and younger
- in the mouth for children over 5 years .
- in the ear using a special tympanic thermometer. These allow you to take temperature reading from the ear and are quick but expensive. They can be misleading if you do not put them in the ear correctly which is more likely to happen with babies because the ear holes are too small. Do not use with small babies.
For further advice on taking your child's temperature please click the link below to the NHS website on how to take a temperature
Operation Ouch - Fever
When should you worry?
If your child has any of the following:
- Is under 3 months of age with a temperature of 38°C / 100.4°F or above (unless fever in the 48 hours following vaccinations and no other red or amber features)
- Becomes pale, mottled and/or feels abnormally cold to touch
- Is going blue around the lips
- Severe breathing difficulty - too breathless to talk or eat/drink or breathing that stops or pauses
- Has a fit/ seizure
- Becomes extremely agitated (crying inconsolably despite distraction)
- Develops a rash that does not disappear with pressure (the ‘Glass Test’)
- Difficult to wake up/ sleepy or confused
You need urgent help
Go to the nearest Hospital Emergency (A&E) Department or phone 999
If your child has any of the following:
- Is 3-6 months of age with a temperature of 39°C / 102.2°F or above (but fever is common in babies up to 2 days after they receive vaccinations)
- Continues to have a fever of 38.0°C / 100.4°F or more for more than 5 days
- Breathing a bit faster than normal or working a bit harder to breathe
- Swelling of a limb or joint
- Complaining of severe pain that is not improving with painkillers
- Dry skin, lips, tongue or looking pale
- Seems dehydrated (sunken eyes, drowsy or not had a wee or wet nappy for 12 hours)
- Sleepy or not responding normally
- Crying and unsettled
- Poor feeding (babies) or not drinking (children)
- Getting worse or you are worried about them
- Is becoming drowsy (excessively sleepy) or irritable (unable to settle them with toys, TV, food or picking up) – especially if they remain drowsy or irritable despite their fever coming down
- Has extreme shivering or complains of muscle pain
- Is getting worse or if you are worried
You need to contact a doctor or nurse today
Please ring your GP surgery or call NHS 111 - dial 111
If none of the above features are present
Watch them closely for any change and look out for any red or amber symptoms
Additional advice is also available to young families for coping with crying of well babies – click here
Self care
Continue providing your child’s care at home. If you are still concerned about your child, call NHS 111 – dial 111
What should you do?
To make your child more comfortable, you may want to lower their temperature using liquid paracetamol/ ibuprofen (e.g. calpol/other brands). This should be given on the advice of a health professional in babies under 3 months of age with fever will need medical attention.
Do not give more than the maximum recommended daily dose of medicine. However, remember that fever is a normal response that may help the body to fight infection and paracetamol will not get rid of it entirely. Medicines are helpful in reducing the discomfort associated with fever.
Avoid sponging your baby with tepid water – it doesn’t actually reduce your baby's temperature and may cause hypothermia ( Low body temperature). Babies with fever should not be underdressed or overwrapped.
Encourage them to drink plenty of feeds.
Paracetamol
There are different types of paracetamol for children of different ages including 2 different strengths of syrup - infant and Six plus. Always read the dose instructions carefully. You must wait at least 4 hours between doses. Do not give more than 4 doses in 24 hours.
Ibuprofen
Ibuprofen is available in syrup and tablet form. Ibuprofen is not suitable for some children. If you are unsure whether your child can take ibuprofen, check with your pharmacist or doctor. Always read the dose instructions carefully. Don't give ibuprofen if your child has not had a wee in the last 12 hours. You must wait at least 6 hours between doses. Do not give more than 3 doses in 24 hours.
- Paracetamol and ibuprofen can be given together at the same time, although it is often best to see how your child responds to one medicine first before giving the other medicine. Take care not give more than the maximum daily dose of either medication.
- It can take 30 minutes for your child’s temperature to start to fall and for your child to start to feel better after taking paracetamol or ibuprofen.
Further information on how to give these medicines to your child can be found at medicinesforchildren.org.uk
- Encourage them to drink plenty of fluids
- If a rash appears, do the glass test
How long will your child’s symptoms last?
- Fever caused by a viral infection tends to improve within 2 to 3 days
- If your child’s fever lasts for more than 5 days, get them seen by your GP
Where should you seek help?
- If it is non-urgent, speak to your local pharmacist or health visitor.
- If your child has any of the above features, urgently see your GP. For an urgent out-of-hours GP appointment, call NHS 111.
- You should only call 999 or go your nearest A&E department in critical or life threatening situations.
Health visitors are nurses or midwives who are passionate about promoting healthy lifestyles and preventing illness through the delivery of the Healthy Child Programme. They work with you through your pregnancy up until your child is ready to start school.
Health Visitors can also make referrals for you to other health professionals for example hearing or vision concerns or to the Community Paediatricians or to the child and adolescent mental health services.
Contact them by phoning your Health Visitor Team or local Children’s Centre.
Sound advice
Health visitors also provide advice, support and guidance in caring for your child, including:
- Breastfeeding, weaning and healthy eating
- Exercise, hygiene and safety
- Your child’s growth and development
- Emotional health and wellbeing, including postnatal depression
- Safety in the home
- Stopping smoking
- Contraception and sexual health
- Sleep and behaviour management (including temper tantrums!)
- Toilet training
- Minor illnesses
For more information watch the video: What does a health visitor do?
School nurses care for children and young people, aged 5-19, and their families, to ensure their health needs are supported within their school and community. They work closely with education staff and other agencies to support parents, carers and the children and young people, with physical and/or emotional health needs.
Primary and secondary schools have an allocated school nurse – telephone your child’s school to ask for the contact details of your named school nurse.
There is also a specialist nurse who works with families who choose to educate their children at home.
Sound Advice
Before your child starts school your health visitor will meet with the school nursing team to transfer their care to the school nursing service. The school nursing team consists of a school nursing lead, specialist public health practitioners and school health staff nurses.
They all have a role in preventing disease and promoting health and wellbeing, by:-
- encouraging healthier lifestyles
- offering immunisations
- giving information, advice and support to children, young people and their families
- supporting children with complex health needs
Each member of the team has links with many other professionals who also work with children including community paediatricians, child and adolescent mental health teams, health visitors and speech and language therapists. The school health nursing service also forms part of the multi-agency services for children, young people and families where there are child protection or safeguarding issues.
If you’re not sure which NHS service you need, call 111. An adviser will ask you questions to assess your symptoms and then give you the advice you need, or direct you straightaway to the best service for you in your area.
Sound advice
Use NHS 111 if you are unsure what to do next, have any questions about a condition or treatment or require information about local health services.
For information on common childhood illnesses go to What is wrong with my child?
A&E departments provide vital care for life-threatening emergencies, such as loss of consciousness, suspected heart attacks, breathing difficulties, or severe bleeding that cannot be stopped. If you’re not sure it’s an emergency, call 111 for advice.