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Fever
Your childs average body temperature is about 37C. If your
childs temperature is higher than 38C for 24 hours or more,
she probably has a fever. A fever is a sign of illness.

Causes of fever and high temperature in children

Fever is not an illness in itself, but is the sign of an illness.

Children get fevers for all kinds of reasons. Most fevers and the illnesses that
cause them last only a few days. But sometimes a fever will last much
longer, and might be the sign of an underlying chronic or long-term illness
or disease.

Infections are by far the most common cause of fever in children. In general, fever is natures response
to infection, and can actually help the body fight infection.

Most of these infections are caused by viruses, which are responsible for colds and upper respiratory
infections, as well as the common infectious diseases of childhood, such as chickenpox. These infections
dont last long and usually dont need to be treated.

Some infections are caused by bacteria, and need treatment with antibiotics. These include certain ear
and throat infections, urinary tract infections, pneumonia, blood infections and meningitis. A very sore
throat with a fever can be caused by streptococcus. If it isnt treated with antibiotics, this infection can lead
to rheumatic fever or heart damage.

There are other less common causes of fever. These include allergic reactions to drugs or vaccines,
chronic joint inflammation, some tumours and gastrointestinal diseases, like gastroenteritis.

Fever symptoms

During the course of each day, body temperature goes up and down by up to one degree. Its usually
lowest in the early hours of the morning, and highest in the late afternoon and early evening.

A fever or high temperature might come on slowly and rise over a few days, or it might rise very quickly.
The height of a fever, and how quickly it comes on, usually doesnt have anything to do with the illness
that causes it.

Fever in itself is rarely harmful. But the high temperature might make your child feel uncomfortable he
might have chills or shivering when his temperature is rising, and might sweat when its falling. Sometimes
he might become mildly dehydrated if hes losing a lot of fluid from the fever and not replacing it.

Febrile convulsions are seizures that happen because of fever. They occur in about 4% of children
between the ages of six months and five years. Children outgrow febrile convulsions by the age of 4-5
years. Febrile convulsions have no long-term consequences, but you should talk to your doctor about
them.

Sometimes your child might appear flushed, and her skin might feel warm, but her core
(inner body) temperature will be quite normal. This can happen when your child has a cold

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 or has done some hard physical activity. It can also happen on a very hot day.

When to see your doctor about fever and high temperature

Babies under three months of age who develop a fever must be seen by a doctor immediately, because
its harder to tell if they have a serious underlying illness.

In children under 12 months, fever might be a sign of a more significant illness, and you do need to seek
medical advice.

In children over 12 months, seek medical attention if your child:

looks sicker than before more pale, lethargic and weak

has trouble breathing
becomes drowsy
refuses to drink, and is weeing less often (if your baby has fewer than half the usual number of
wet nappies, see a doctor)
complains of a stiff neck, persistent headache or light hurting his eyes
vomits persistently, or has frequent bouts of diarrhoea
doesnt improve in 48 hours
suffers pain
has a fever above 40C
is causing you to worry for any other reason.

Fever treatment

A fever will run its course regardless of treatment. Fever is a result of the bodys attempt to fight
an infection. Your childs temperature will return to normal when the infection or other cause of the fever
has completely gone.

In older children, treat the fever only if you feel its making your child uncomfortable, irritable or so
lethargic that she cant drink enough fluids.

Generally, children handle fever well, but you can do a few things to make your child more comfortable:

Dress your child in light clothing.

Give your child frequent small amounts of clear fluids, like water, to drink. If your child isnt
hungry, thats OK. The most important thing is to make sure hes drinking enough to avoid
dehydration. If your child is under six months old you should breastfeed often and/or give
cooled boiled water.
Give your child liquid paracetamol in the correct and recommended dose. Giving your child
more than the recommended dose can cause liver damage. Its important not to give fever-
lowering medication too often or for prolonged periods, because it can cause side effects.

Cool baths, sponging and fans can actually make your child more uncomfortable.

You must not give your child aspirin for any reason. Aspirin can make your child
susceptible to Reyes syndrome, a rare but potentially fatal illness. It can also cause serious
illness or even death in children with chickenpox or flu symptoms.

Taking your childs temperature

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You might want to take your childs temperature if your child is:

unwell and feels warmer than usual

irritable and crying
more sleepy than usual
in pain
refusing to drink, or vomiting.

Using a thermometer is the best way to check your childs temperature. Feeling your childs skin
temperature (for example, by putting your hand to her forehead) isnt always a reliable way of diagnosing
a fever.

There are several different methods for taking a childs temperature using a thermometer:

orally putting a digital thermometer in your childs mouth under the tongue
rectally putting the thermometer a little way into your babys rectum
axillary putting the thermometer under your childs armpit
aurally putting a digital ear thermometer into your childs ear, which can be a little inaccurate
superficially wiping a device called a temporal artery thermometer across your childs
forehead.

Your GP or child and family health nurse nurse can also show you how to take your childs temperature
with a thermometer.

Oral temperatures
Its hard to take an oral temperature if your child is under five years because he might not cooperate. If
your child has a blocked nose because of a cold, he might find it hard to breathe with his mouth closed.

To take an oral temperature:

Wait five minutes after your child has had a hot or cold drink (or it will affect the temperature).
Place the thermometer well under one side of your childs tongue.
Have your child hold it in place with her lips, not her teeth, and tell her to breathe through her
nose.
Wait until the thermometer beeps before taking a reading.

Oral readings can be around half a degree lower than body temperature.

Rectal temperatures
Rectal thermometers are best used for babies and young children under 12 months (older children will
probably protest loudly!). Rectal readings are most reliable for babies under three months.

Taking a rectal temperature is often difficult, especially when your baby is very active the thermometer
can slide out of the rectum, or the tip of the thermometer might damage the lining of the rectum.

Place the tip of a digital thermometer just inside your childs anus and wait for it to beep before taking a
reading.

Armpit temperatures
Taking your childs temperature under the armpit is usually the safest method, especially in young
children. Unfortunately, its also the least accurate method.

Place the thermometer in your childs armpit and close his arm, holding his elbow against his body. Wait
for the thermometer to beep before taking a reading.

Armpit readings can record a temperature up to 1 degree lower than the actual body temperature.

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 Mercury thermometers can poison a child if they break. If youre using a mercury
thermometer, consider replacing it with one of the thermometers below.

Thermometer types

Ear thermometers (infrared tympanic thermometers)

These are quick and easy to use. Your doctor or nurse can show you how to place the thermometer in your
childs ear canal, so you get a reasonably accurate reading.

You put a plastic cover over the tip of the thermometer and put the tip gently just inside your childs ear
canal, until the thermometer beeps.

Its accurate to within about a degree, as long as the ear canal doesnt have too much wax in it.

Temporal artery thermometers

These are the simplest thermometers to use. The thermometer is scanned across your childs forehead. An
advantage of these thermometers is that you can check a sleeping child without waking her.

Pacifier thermometers
These are good if your child already uses a pacifier. Infants or toddlers who dont use pacifiers will usually
resist a pacifier thermometer, so something else might be easier to use.

Other types
One type of thermometer involves a plastic strip that you put on your child's forehead to get a digital
reading of your childs temperature. This system isnt very accurate at best, it can give you only a rough
guide to your childs temperature.

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More to explore
Signs of serious childhood illness

Last updated or reviewed

04-11-2016

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