DOES YOUR CHILD HAVE A FEVER?
It is always worrying when your child is not well, and especially when they
have a fever. This leaflet is designed to help you decide whether or not your
child needs to be seen by a doctor, or when home care and paracetamol will
suffice.
What is a fever?
Normally, our temperature is kept at a constant level by lots of automatic
adjustments in our body. Fever is a higher than normal body temperature,
which can be due to all sorts of reasons. The body increases the amount of
blood flowing through the skin by widening tiny blood vessels. This allows
excess heat to escape. Sweating helps, because heat escapes when sweat
evaporates. If necessary we can generate more heat by shivering. This
results in your child feeling hot to the touch.
Fever helps the body fight infections by stimulating natural defence
mechanisms. The body tries to create extra heat so that the bug cannot
survive. Having a temperature helps you fight illness.
Reducing a fever can help make a child feel more comfortable but it is not
possible, or desirable, to try to bring the temperature back to normal
completely while they are fighting off an infection. The part of the human
brain that controls body temperature is not fully developed in children. This
means that a child’s temperature may rise and fall very quickly and the child is
sensitive to the temperature of his or her surroundings.
What causes high temperatures?

Is it a viral infection?
o
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What about bacterial infections?
o
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This is very common. Viral infections cause many common
illnesses such as colds, coughs, 'flu, diarrhoea, tonsillitis, or ear
infections etc. Measles, mumps and chicken pox can also result
in a high temperature. Sometimes virus infections cause more
serious illnesses.
Less common, but can cause high temperatures. Bacterial
infections can cause serious illnesses such as pneumonia and
meningitis.
Do clothes have any effect?
o Occasionally, a high temperature can happen if a young child
(especially newborn) is overdressed in a hot environment
because they can't regulate their own body temperature.

My baby’s teeth are coming through!
o
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Teething may also cause a slight rise in body temperature.
Can immunisation cause it?
o
Babies and children can sometimes get a fever within 48 hours
of being vaccinated. This is normal and usually a minor side
effect of no consequence. It shows that they are responding to
the vaccine.
Help! My child has a fever!
Most bouts of fever are not serious, and the temperature usually reduces. It is
very common to see a child happily playing an hour or so later when their
temperature has come down. They may not be entirely back to normal, but it
is reassuring if a child improves with the drop in temperature.
Signs & symptoms that reassure you and generally suggest a self-limiting
illness include:

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Your child behaves much as normal and looks well
There are a few other minor symptoms such as runny nose or sore
throat
The fever improves with paracetamol or similar medicine
Your child is eating and drinking as normal
(See Appendix: ‘Self-limiting Illnesses’)
WARNING SIGNS: Seek medical help if your child:

Looks very unwell, drowsy or is difficult to wake

Continually refuses fluids

Develops breathing problems

Starts fitting (convulsions) (febrile convulsions are not epilepsy – they
are part of the way the body deals with high temperature – if it goes on
for longer than 4-5mins, call an ambulance)

Vomits continuously, inconsolably cries, or has just had an operation

Develops a rash that doesn’t go away on pressing or neck stiffness, or
complains that light hurts their eyes
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Develops pains or headaches which get worse

Paracetamol or ibuprofen does not improve the fever

Is under 1 month of age – he/she definitely needs to be seen. Your
doctor may recommend he/she be seen by the paediatricians in the
hospital

Has recently had chemotherapy or is on treatment to suppress the
immune system
It is important to seek advice if your child does not improve or has any other
symptoms that worry you. A health professional can offer to assess what the
likely cause is and what, if any, treatment is appropriate. If in any doubt, you
can also get advice from NHS Direct:
0845 46 47
This is a 24hr advice line where experienced nurses can help you decide
whether your child needs to be seen urgently.
http://www.nhsdirect.nhs.uk
Can I treat it at home?
Yes! If you are unsure that your child has a fever, read your child's
temperature first (see Appendix: ‘Taking your child’s temperature’). However,
once you know your child has a fever, it is not necessary to re-check or
monitor their temperature. This only causes more anxiety and distress,
because temperatures can vary greatly over their course. Simple measures
can help your child to feel better quickly, while their body deals with the fever:

Give paracetamol or ibuprofen
o You can buy these in liquid form for children. They come in
various brand names. An alternative is to give soluble
paracetamol in a drink. The dose varies by age – read
instructions on the packet/information leaflets carefully.

Give lots of cool drinks
o This helps to lower the temperature and prevents dehydration. If
your child is vomiting, taking little sips and often is effective.

DO NOT wrap up your child – If they are hot, take clothes off the
child
o As long as the room is normal 'room temperature'.

DO NOT ‘cold-sponge’ your child
o Used to be popular, but now not advised. It is thought that cold
water narrows blood vessels in the skin, reducing heat loss from
deeper parts of the body, which then raises the child’s fever
even more. Many children don’t like this treatment either!
Some people use a fan to cool a child. Again, this may not be a good idea if
the fanned air is too cold. However, a gentle flow of air in a room which is
'room temperature' may be helpful. Perhaps just open the window, or use a
fan on the other side of the room to keep the air circulating.
Useful websites for further information:
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www.ridgeway-surgery.co.uk
www.netdoctor.co.uk
www.patient.co.uk
www.nhsdirect.nhs.uk
www.bupa.co.uk
APPENDIX
Taking your child’s temperature
A normal temperature is between 36-36.8ºC (96.8-98.24ºF). In children, any
temperature of 38°C (100.4°F) or above is considered high and is classed as
a fever.
1. Digital display thermometers can give a good reading of your child’s
temperature within seconds. The thermometer needs to be placed in
the child's armpit, directly against the skin, while holding the arm gently
against the chest for around 2 minutes. (The reading will be 0.5°C
lower than it would be if the temperature was measured in the mouth).
2. Some thermometers can be used in the ear, using a clean cover over
the tip of the probe each time, to prevent transferring any infection.
These are more expensive, but produce a reading in seconds.
3. Forehead strips are also available, but give a rough estimate to your
child’s temperature.
4. Tempadots – disposable heat-sensitive plastic strips placed under the
tongue.
Ask your pharmacist for various ways to check your child’s temperature.
Self-limiting illnesses
The following are approximate time periods that self-limiting illnesses last:


Colds & sore throat – 1 week
Diarrhoea & vomiting – 2 weeks
25% of children have a fever lasting for longer than a week – this is a variant
of normal, and as long as your child looks well and is taking fluids, then it is
not a cause for concern.