Childhood Fever

Your child has been assessed by an ED Clinician and they feel it is safe to discharge your child home. This leaflet is a guide to help you managing your child at home. 

How do I know if my child has a temperature? 

You may wish to take your child's temperature if they are: 

• Unwell and feel hot. 

• Irritable and crying. 

• More sleepy than usual. 

• Vomiting or refusing to drink. 

• In pain. 

You can take your child's temperature using: 

• A thermometer in their ear (above 1 month). 

• A thermometer under their tongue (above 5 years). 

• A thermometer underneath their arm (all ages). 

Forehead thermometers are NOT recommended as they are not reliable. 

A temperature above 38°C is considered high and is classed as a fever. 

Why does my child have a temperature? 

Fever is a common occurrence in children and is a way the body fights infection. The fever itself is not harmful. There is no advantage to lowering your child's fever, except for comfort. 

Fever is a sign of infection in the body - viral infections are more common and do not require antibiotics. Antibiotics do not cure viruses. Only bacterial infections are treated with antibiotics. 

What can I do to make my child more comfortable? 

Although the fever is not harmful it may make your child miserable. You can help to lower your child's fever by: 

1) Skin exposure 

• Allow your child to lose heat through their skin. If your child feels hot then take most, but not all, of their clothes off. DO NOT wrap them up, even if they complain of feeling cold. 

• Keep the room ventilated. 

• If you have an electric fan this will help to keep the room cool. Do not place it so that it is blowing directly onto your child. 

• Tepid sponging or bathing is NOT recommended. 

2) Giving fluids 

• Encourage your child to have frequent small amounts of clear fluids. If your child is less than 6 months give extra breastfeeds, cooled boiled water or bottles. 

• Do not worry if your child refuses to eat at this time. 

GIVING MEDICATION 

If your child seems well and happy, there is no need to treat the fever with medication. 

However, if your child is miserable with the fever: 

• Consider giving your child Paracetamol (age appropriate dose). If there is no response within 2-3 hours consider age appropriate dose of Ibuprofen (unless there is a medical reason they cannot take ibuprofen). 

• Paracetamol can be given every 4 hours up to a maximum of 4 doses in each 24 hour period. Please note that paracetamol is a common ingredient in a number of other medicines for illnesses such as colds, flu and cough. Make sure when giving paracetamol for fever that your child has not received any other medicine containing paracetamol in the previous 4 hours. 

• Ibuprofen can be given 3 times a day. 

• DO NOT give either or both for more than 2 days without seeing your doctor. 

• DO NOT give children with a fever Aspirin. 

It is important that if your child has been given antibiotics that you make sure that they finish the course even if they seem to be completely better. 

When should I seek medical attention? 

We recommend you see a doctor if your child has any of the following: 

• Is 0-3 months and has a temperature above 38°C. 

• Is older than 3 months and has 2 temperature of 39°C or more. 

• A The fever lasts more than 5 days. 

• Your child's temperature does not come down despite giving paracetamol and/or buprofen. 

• Has an obvious or unusual high pitched cry. * Complaining of a headache which does not settle with paracetamol. 

• Complaining of a stiff neck. 

• Unable to keep eyes open in daylight or complains of light hurting their eyes. 

• Vomiting and not keeping any fluids down or refusing to drink. 

• A rash. 

• More sleepy than usual, confused or obviously less active than usual. 

• Your child has a fit or starts to twitch or shake. 

• General health gets worse/you are worried 

Febrile Convulsions 

Febrile convulsions are fits that occasionally occur in children between 6 months and 6 years who have a high fever. They can be worrying for parents but do not usually cause any long term harm. 

There is nothing you can do to predict or prevent a febrile convulsion but knowing what to do if it happens may help you and your child. During such an episode please: 

• Try to remain calm and stay with your child. 

• Place your child on the floor or bed on their left side. 

• Make sure you do not put anything into their mouth. 

• Try to watch exactly what happens so that you can describe it later or record this on your phone.. 

• Time how long the convulsion lasts. 

• Seek medical advice immediately either from your GP or NHS 24 (Tel 111). 

Call 999 if: 

• The fit lasts longer than 4 minutes. 

• The child has a second seizure before fully recovering from the first seizure. 

• The child does not wake up within 5 minutes of the first seizure. 

• They experience difficulty breathing. 

If your child becomes unresponsive. 

If your child becomes blue. 

If your child is finding it hard to breathe. 

If your child has a fit. 

Your child needs urgent help, please phone 999 or go straight to A&E 

• If your child's health gets worse or if you are worried. 

• If your child is not drinking. 

• If your child is passing less urine than usual, 

• If your child has signs of dehydration including dry mouth, sunken eyes, no tears, sunken soft spot on babies head. drowsiness and generally seems more unwell. 

• If your child's fever lasts longer than 5 days. 

YOU NEED to see a NURSE/ DOCTOR today. Please ring your GP surgery/ Health Visitor 

• If you have concerns about looking after your child at home. 

Please phone 111 or arrange to see your GP/Health Visitor today