In brief
Fever may accompany infection, and safe home care focuses on the child’s comfort, fluids and general condition [22].
Practical tips for parents
- Offer fluids suitable for your child’s age and watch for signs of dehydration [22].
- Give a fever reducer only at the dose and method specified by the doctor or the approved leaflet for your child’s weight [11, 22].
When should you seek medical help?
Note: This content is for awareness and is not a substitute for consulting a pediatrician.
Treat your child, not the number
When your child’s temperature rises, don’t rely on the thermometer reading alone; look at:
- Their activity.
- Whether they look tired.
- Whether they are taking fluids.
Note: This does not apply to an infant under three months, whose fever, especially at 38 degrees Celsius, requires urgent contact with the doctor.
When is a fever dangerous?
Signs in your child’s fever that cannot wait:
- Fever in an infant under 3 months: see the doctor immediately.
- Difficulty breathing: including fast or shallow breathing.
- Severe lethargy: difficulty waking the child, low activity.
- Seizures or a stiff neck: signs that need urgent medical care.
- Severe paleness or bluish skin: especially the lips or nails.
Note: These signs require urgent medical assessment, and the information here is for awareness and is not a substitute for a medical examination.
What is fever and how do we measure it?
A temperature of 38 degrees Celsius or higher counts as fever. Use a digital thermometer, and don’t rely on touching the forehead or body to estimate temperature. The right way to measure depends on the child’s age, so ask your pediatrician which is best for your child, and tell the doctor the reading and method when you call.
Why does the temperature rise?
Fever is not a disease in itself; it is a sign that the body is reacting to something, and its most common cause in children is a simple viral infection. The aim of home care is your child’s comfort, not bringing the number down to normal at any cost [22].
Home care for a child older than 3 months who looks well
- Dress them in light clothing and don’t bundle them in many layers, and keep the room at a moderate temperature [19].
- Encourage them to drink small, frequent amounts, and keep breastfeeding infants [22].
- Let them rest, and don’t force food.
- Don’t use cold compresses, cold baths or alcohol rubs; they don’t help and may harm [19].
- If your child seems distressed or in pain, the doctor may prescribe a fever reducer suitable for their age and weight; the aim is their comfort, not just lowering the number [19, 22]. Follow the doctor’s or the label’s instructions, and don’t give more than one medicine without the doctor’s guidance.
- Don’t give aspirin to children to lower a fever [22].
Infants under 3 months
Any rise in the temperature of an infant under three months (38 degrees Celsius or higher) calls for an urgent call to the doctor or a trip to the emergency room, even if they look well. And don’t give them any medicine before contacting the doctor. Serious bacterial infections are harder to detect at this age, so the infant is assessed carefully, and the assessment may include laboratory tests [23, 26].
How do we assess your child? Don’t rely on the number alone
Your child’s activity, breathing, drinking and skin color matter more than the number. Watch for the following [19]:
- Activity: Do they play and interact, or seem listless or hard to wake?
- Breathing: Fast or difficult breathing, or unusual sounds.
- Hydration: Drinking enough, passing urine as usual, and a moist mouth.
- Skin: Severe paleness, a bluish color, or a rash.
Signs that need urgent assessment at any age
- Difficulty breathing, fast breathing or bluish lips [19].
- A rash that doesn’t fade when pressed [19].
- A stiff neck or a bulging soft spot (fontanelle) in an infant [19].
- Severe lethargy, difficulty waking, or constant crying that can’t be soothed [19].
- Signs of dehydration: dry mouth, passing little urine, no tears [19].
- A seizure with fever, especially if it is the first; see the febrile seizures article.
- Fever lasting 5 days or more, or returning after going down [19].
Common mistakes
- Relying on touching the forehead instead of a thermometer.
- Bundling the child in many layers to make them sweat.
- Cold compresses or alcohol.
- Giving an antibiotic without a prescription; most childhood fevers are viral and antibiotics don’t treat them.
- Doubling the medicine or combining more than one medicine without the doctor’s guidance.
Frequently asked questions
What is the most important thing to know about fever?
Fever may accompany infection, and safe home care focuses on the child’s comfort, fluids and general condition.
What practical tips are there for parents about fever?
Offer fluids suitable for your child’s age and watch for signs of dehydration. Give a fever reducer only at the dose and method specified by the doctor or the approved leaflet for your child’s weight.
When should I seek medical help for fever?
Fever in an infant under three months, especially at 38 degrees Celsius, requires urgent contact with the doctor. Seek urgent assessment for difficulty breathing, a worrying rash or signs of dehydration.
Should I always bring the temperature down?
No. A high temperature in itself doesn’t mean danger; what matters is the child’s condition, activity and drinking. And if they are distressed, the doctor may prescribe a suitable medicine for their comfort [19, 22].
How long can a fever last?
Many viral fevers clear within days, but a fever lasting 5 days or more, or returning after going down, is a reason to see the doctor [19].
Does fever happen after vaccination?
A mild fever can occur after some vaccinations within a day or two. See the doctor if the temperature rises a lot or your child seems unwell.
Does this article replace consulting a doctor?
This content is for awareness and does not replace consulting a pediatrician.
References
- Jaber RM, Alnshash BM, Qasem NW. Infectious Diseases in Children. 2020:1-18. DOI: 10.1007/978-1-4939-0779-3_150-1
- National Institute for Health and Care Excellence. Fever in under 5s: assessment and initial management (NG143). 2019. nice.org.uk/guidance/ng143
- Sullivan JE, Farrar HC; Section on Clinical Pharmacology and Therapeutics; Committee on Drugs. Fever and antipyretic use in children. Pediatrics. 2011;127(3):580-587. DOI: 10.1542/peds.2010-3852
- Grief MM, Yamamoto LG. Approach to the Febrile Infant (<3 Months).. Pediatric Emergency Care. 2023;39(11):875-879. DOI: 10.1097/pec.0000000000003064
- Pantell RH, Roberts KB, Adams WG, Dreyer BP, Kuppermann N, O’Leary ST, et al. Evaluation and Management of Well-Appearing Febrile Infants 8 to 60 Days Old.. Pediatrics. 2021;148(2). DOI: 10.1542/PEDS.2021-052228
This information is general awareness and is not a substitute for a medical examination. If your child has symptoms, consult the doctor.
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