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Fever / High Temperature

Fever is extremely common in children and usually suggests that your child has an infection. It's really important that you measure your child's temperature accurately - you should use a digital thermometer (under the the armpit (axillary) for children 5 years and younger, and in the mouth for children over 5 years of age). The other option is to use an in the ear thermometer (tympanic), although these should not be used in babies below a month of age.

  • 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).
  • Fever is common in babies up to 48 hours after receiving immunisations - it is OK to give paracetamol after the MenB vaccine without seeking medical advice if your baby is otherwise well.
  • Occasionally, children with fever can have a seizure/fit. This is called a febrile convulsion and most commonly occurs in children aged between 6 months and 3 years. They generally occur on day 1 of the fever, and in most cases have no long term effects.
  • 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.

Click here for an Operation Ouch video on fever that you and your child can watch together.

Watch a local GP and health visitor talking about what they would look out for in a child with a fever:

How to take a temperature

When should you worry?

You need urgent help.

Go to the nearest Hospital Emergency (A&E) Department or phone 999

If your child has any of the following:

  • Becomes pale, mottled and feels abnormally cold to touch
  • Has blue lips
  • Severe breathing difficulty - to breathless to talk or eat/drink
  • Has a fit/ seizure
  • Becomes extremely agitated (crying inconsolably despite distraction), confused or very lethargic (difficult to wake)
  • Develops a rash that does not disappear with pressure (the ‘Glass Test’)
  • 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)

You need to contact a doctor or nurse today.

Please ring your GP surgery or call NHS 111 - dial 111

We recognise that during the current COVID-19 crisis, at peak times, access to a health care professional may be delayed. 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 your child has any of the following:

  • Is finding it hard to breathe
  • Seems dehydrated (sunken eyes, drowsy or not passed urine for 12 hours)
  • 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
  • Swelling of a limb or joint
  • Too painful for your child to stand
  • Has a swollen eye
  • Complaining of severe pain that is not improving with painkillers
  • 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 or more for more than 5 days
  • Is getting worse or if you are worried

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

If your child has any symptoms suggestive of COVID-19 (high temperature; new continuous cough - coughing a lot, for more than an hour or 3 or more coughing episodes in 24 hours; or loss of taste/smell) then arrange for your child to be tested via the NHS testing website or by calling 119.

If none of the above features are present

If your child has any other symptoms associated with their fever, such as sore throat, cough, earache, diarrhoea and vomiting or tummy ache, look for information about specific things to look out for - click here

Additional advice is also available to young families for coping with crying of well babies – click here.

What should you do?

  • To make your child more comfortable, you may want to lower their temperature using paracetamol (calpol) and/or ibuprofen. Use one and if your child has not improved 2-3 hours later you may want to try giving the other medicine. However, remember that fever is a normal response that may help the body to fight infection and paracetamol/ibuprofen will not get rid of it entirely.
  • 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.

Download 'Fever' advice sheet for children under 5 years of age

Download 'Fever' advice sheet for children over 5 years of age

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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.
  • The chart below shows how long fever lasts in a child with viral infections. The faces represent 10 children who have seen their GP with a viral infection. Green faces are those children whose fever has recovered within that time period.

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The diagrams above are taken from www.whenshouldiworry.com

Where should you seek help?

For wear and tear, minor trips and everything in between.

Self-care

You can treat your child's very minor illnesses and injuries at home.

Some illnesses can be treated in your own home with support and advice from the services listed when required, using the recommended medicines and getting plenty of rest.

Sound advice

Children can recover from illness quickly but also can become more poorly quickly; it is important to seek further advice if a child's condition gets worse.

For information on common childhood illnesses go to What is wrong with my child?

Pharmacists are experts in many aspects of healthcare and can offer advice on a wide range of long-term conditions and common illnesses such as coughs, colds and stomach upsets. You don’t need an appointment and many have private consultation areas, so they are a good first port of call. Your pharmacist will say if you need further medical attention.

Sound advice

  1. Visit a pharmacy if your child is ill, but does not need to see a GP.
  2. Remember that if your child's condition gets worse, you should seek further medical advice immediately.
  3. Help your child to understand - watch this video with them about going to the pharmacy.

For information on common childhood illnesses go to What is wrong with my child?

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.

Contacting the School Nurse

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.

GPs assess, treat and manage a whole range of health problems. They also provide health education, give vaccinations and carry out simple surgical procedures. Your GP will arrange a referral to a hospital specialist should you need it.

Sound Advice

You have a choice of service:

  1. Doctors/GPs can treat many illnesses that do not warrant a visit to A&E.
  2. Help your child to understand – watch this video with them about visiting the GP or going to a walk in centre

For information on common childhood illnesses go to What is wrong with my child?

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.

Sound advice

  1. Many visits to A&E and calls to 999 could be resolved by any other NHS services.
  2. If your child's condition is not critical, choose another service to get them the best possible treatment.
  3. Help your child to understand – watch this video with them about going to A&E or riding in an ambulance

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