Fever / High Temperature
Fever is very common in children and can happen when your child has an infection. Most children get better quickly with no treatment.
Please see Red-Amber-Green tables for advice on when and where to seek care for your child.
- Viral infections are far more common than bacterial infections.
- Symptoms such as runny nose, cough, wheeze, sore throat, red eyes and diarrhoea are more likely with a viral infection. If several people are unwell in the same home, this also suggests a viral infection (because viral infections are easily spread).
- Most viral infections get better on their own and do not need antibiotics. Antibiotics can cause side effects such as rash and diarrhoea and can increase the risk of them developing antibiotic resistance.
- How your child is compared to their usual self is more important than what the temperature is.
- Fever is common in babies up to 48 hours after immunisations - it is OK to give paracetamol after the MenB vaccine if your baby is otherwise well.
- Occasionally, children with fever can have a seizure / fit. This is called a febrile convulsion and most often happens in children aged between 6 months and 3 years.
When should you worry?
If your child has any of the following:
- Is under 3 months of age with a temperature more than 38°C or under 36°C (unless fever in the 48 hours following vaccinations and no other red or amber features)
- Breathing very fast, too breathless to talk, eat or drink
- Working hard to breathe, drawing in of the muscles below the ribs, or noisy breathing (grunting)
- Breathing that stops or pauses
- Is pale, blue, mottled or feels unusually cold to touch
- Difficult to wake up, very sleepy or confused
- Weak, high-pitched cry or can’t be settled
- Has a fit (seizure)
- Has a rash that does not disappear with pressure (perform the glass test)
You need urgent help.
Go to the nearest Hospital Emergency (A&E) Department or call 999 - dial 999.
If your child has any of the following:
- Is 3-6 months old with a temperature 39°C or above (unless fever in the 48 hours following vaccinations and no other red or amber features)
- Temperature of 38°C or above for more than 5 days or shivering with fever (rigors)
- Temperature less than 36°C in those over 3 months
- Breathing a bit faster than normal or working a bit harder to breathe
- Dry skin, lips or tongue
- Not had a wee or wet nappy in last 8 hours
- Poor feeding in babies (less than half of their usual amount)
- Irritable (Unable to settle them with toys, TV, food or hugs even after their fever has come down)
- Swelling of a limb or joint
- Not using or putting weight on an arm, leg, hand or foot
- Complaining of severe pain that is not improving with painkillers
- Has had chickenpox in the past few days and is now getting worse with a high fever or spreading red rash
- Getting worse and you are worried
You need to contact a doctor or nurse today.
Please contact your GP surgery or call NHS 111 - dial 111.
If symptoms persist for 4 hours or more and you have not been able to speak to either a member of staff from your GP practice or to NHS 111 staff, recheck that your child has not developed any red features.
If none of the above features are present
- Watch them closely for any change and look out for any red or amber symptoms
- If your child has any other symptoms associated with their fever, you may want to look at the information on sore throat, cough, earache, diarrhoea and vomiting or tummy ache or our other pathways
- Additional advice is also available to young families for coping with crying of well babies
- If your child has a long term condition or disability and you are worried please contact your regular team or follow any plans that they have given you
Self care
Continue providing your child’s care at home. If you are still concerned about your child, speak to your health visitor, local pharmacist or call NHS 111– dial 111. Keep monitoring your child for red and amber features and seek help if they develop
Children and young people who are unwell and have a high temperature should stay at home. They can go back to school, college or childcare when they no longer have a high temperature, and they are well enough to attend.
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Advice and Guidance
Self care and Prevention
Keep checking your child for red and amber signs and seek help if they are there.
- Fever is a normal response that helps your child’s body to fight an infection
- If your child seems unsettled or uncomfortable, you may wish to give your child paracetamol or ibuprofen.
- 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.
- If you have given your child one of these medicines and they are still uncomfortable 2 hours later you could try the other medicine.
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.
- It can be normal for the temperature to go back up when the medicine wears off.
- Avoid tepid sponging your child. It doesn’t actually reduce your child’s temperature and may cause your child to shiver.
- Encourage them to drink plenty of fluids.
- If a rash appears, do the glass test.
- 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 assessed by your GP.
- The chart below shows how long fever lasts in a child with viral infections. The faces represent 10 children who have been assessed by their GP with a viral infection. Green faces are those children whose fever has recovered within that time period.
• 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.
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