Ask your local community pharmacist for advice on fever in children
Fever occurs when body temperature is above normal, generally in children this is when the body temperature goes above 37.5°C (99.5°F). A fever usually suggests that a child has an infection. Having a fever is very common and normal in childhood. It is a natural, healthy and harmless response that helps the body to fight off the infection.
Common causes include:
· Stomach bugs
· Sore throats
· Common childhood diseases like chicken pox
· Ear infections
Children can also have a fever when they are teething or following vaccinations. It is very rare that fever is due to severe infections such as pneumonia, septicaemia or meningitis, but it is possible in a very small number of cases.
Fever is common in pre-school children; however a child under six months of age with a fever should be assessed by a healthcare professional. Fever usually gets better by itself and should not last more than 5 days. In most cases the fever will be due to an infection caused by a virus. In most cases there should be no need to visit the GP for antibiotics, as antibiotics will not treat viruses. Taking antibiotics when they are not needed could cause side effects and stop them working when they really are required.
WHAT CAN I DO TO HELP?
· Take your child’s temperature
For children aged four weeks to five years old use a digital thermometer in the armpit; an in the ear thermometer or a chemical dot thermometer. If you do not have a thermometer you can use your judgment, usually by feeling your child’s forehead with the palm of your hand.
· Be aware of hot and cold
Avoid making your child too hot or too cold by over dressing or under dressing them. Keep them cool if they are hot. Keep their room cool by turning the heating down and opening a window.
· Plenty of fluids
Keep offering your child fluids like cool water to drink. If you are breastfeeding offer as many feeds as your baby will take. If your child is not thirsty try to get them to drink little and often to increase fluid levels.
· Keep a check on your child
Keep a check on your child for signs of a more serious infection, including checking their body and checking them 2-3 times during the night as well as during the day. For information on signs of a more serious infection see the section below called “When to seek medical advice straight away”.
· School or nursery
Follow the guidelines in place at your child’s school or nursery whilst they have a fever.
· Medication to reduce fever
You can give paracetamol or ibuprofen to reduce your child’s temperature if your child is distressed or appears unwell. Don’t give both at the same time (unless advised to do so by a healthcare professional), but if one doesn’t work you may want to try the other later when the next dose is due. In addition to providing pain relief they will help to reduce fever.
Always read the information leaflets provided with medication.
In November 2011 the recommended paracetamol doses for children were updated, so ensure you follow the dosing instructions included with the medicine. Do not use ibuprofen if your child is allergic to it or if ibuprofen has previously triggered an asthma attack.
WHEN SHOULD I SEE A GP?
- If your child demonstrates any symptoms of a more serious illness.
- If the fever lasts more than 24 hours with no other symptoms of infection (runny nose, sore throat, cough or earache etc.).
- If the fever lasts for five days or more.
- If your child’s health becomes worse or they have a symptom that worries you.
SEEK MEDICAL HELP STRAIGHT AWAY IF
On very rare occasions fever can be a sign of a more serious condition. You should contact your GP or health visitor straight away if you notice ANY of the following:
· High fever
In children 0-3 months old with a temperature of 38°C (101°F) or above.
In children 3-6 months old with a temperature of 39°C (102°F) or above.
If your child vomits repeatedly or if the vomit is dark green in colour.
· Fast breathing
If your child is breathing faster than normal, if their nostrils flare and if the skin between the ribs or below the ribs moves abnormally during breaths. You notice unusual breathing patterns or abnormal grunting.
· Reduced activity levels
If your child’s responses are not normal; if they are drowsy; if they are irritable; if they wake up with difficulty; if they are less active; if they don’t smile; seem confused or vacant; if they appear seriously ill or are crying in an unusual way.
If your child’s fever lasts for more than 5 days or if their fever lasts for more than 24 hours with no other symptoms of infection (runny nose, sore throat, cough or earache etc.).
If your child looks unwell or they are pale, ashen, mottled, dusky or blue especially around the lips.
If your child is not eating, if they are not drinking or if they do not pass much urine. If you notice their nappy remains dry. Signs of dehydration include dry mouth, dry eyes, no tears, sunken eyes, drowsiness and becoming increasingly unwell. In babies the soft spot on top of their head can appear sunken or can bulge.
If you notice a new rash on your child’s body. The rash is red or purple in colour; it starts as small spots, but develops in to blotches that often look like bruises. If the rash does not fade or disappear when you press a glass tumbler against it, get medical help immediately.
If your child has other signs of being unwell, for example:
- They have an unusually severe headache.
- Develop leg pains which become severe and it hurts to stand or walk.
- Excessive high-pitched unusual crying.
- They have developed a swelling in a limb or in a joint.
- They have a stiff neck.
- Their body is stiff or floppy.
- They dislike bright lights.
- They have cold limbs, hands or feet despite their fever.
- If you notice any signs or symptoms that you think are unusual or you can’t explain.
Sometimes younger children can have a fit caused by a high temperature. These are usually not serious.
- Try to stay calm and make sure your child is away from things they might hurt themselves on.
- Put your child in the recovery position if you can.
- Treating fever with paracetamol and ibuprofen will not prevent fits.
- Unless your child has previously had fits and you are confident with what to do call 999 for an ambulance immediately.
If it isn’t possible to speak to your GP or health visitor, please call the out of hours service or NHS 111 if you notice any of the above symptoms.
More information is available at:
See Fever in Children on the NHS Choices website. Available at: http://www.nhs.uk/Conditions/feverchildren/Pages/Introduction.aspx
See Fever/High Temperature in Children on the Patient.co.uk website. Available at: http://www.patient.co.uk/health/feverhigh-temperature-in-children
See the Royal College of General Pracitioners leaflet entitled When Should I Worry? Available at: http://www.whenshouldiworry.com/