What To Do If Your Child Has A Fever by Dr Zeshan Qureshi

Fever is very common in children, especially in younger children, and is a common source of parental anxiety. It is not an illness in and of itself but rather it’s usually the body’s response to fighting infections.

Fever stimulates the body’s immune system to fight and kill the cause of an infection.

In children, normal body temperature is around 36.4°C however, this can vary between children.

A high temperature is usually considered above 38°C.

Temperatures can make children very uncomfortable. They are associated with sweating, reduced feeding, and a change in behaviour (your child may be quieter and/or not interact as much).

There are lots of causes of high temperature in children. Some can be severe, but most are self–limiting.  A few common examples include:

• Colds
• Ear infections
• Throat infections
• Chicken pox
• Tummy bugs
• Vaccinations
• Bacterial infections (pneumonia, kidney infections, meningitis, sepsis)
• Monitor your child’s temperature with a thermometer (you can usually buy these from a local pharmacy)

Where they can be placed, depends on age:

• <4 weeks: armpit
• 4 weeks to 5 years: armpit or ear
• >5 years: armpit, ear or mouth

You can give paracetamol to help with the temperature. This does not mean that your child will get rid of the infection any faster but it can however, reduce the pain and discomfort associated with the fever.

You must make sure to keep a record of how much paracetamol your child has had and the exact times that you and any other caregivers have given it.

This is very important to ensure that you are not giving more than the recommend amount, which can make your child unwell.

If you are worried that you might have given your child too much paracetamol, please seek medical advice urgently.

While most fever is short-lived, it’s important to be aware of ‘red flags’ related to serious illness.

These include:

• Children under 3 months with any temperature, or 3-6 months with a temperature over 39°C
• Non-blanching rash
• Fits
• Dehydration – reduced feeding and wet nappies, dry lips, eyes, or mouth, sunken eyes
• Blue, pale or blotchy skin
• Persistent fever over 5 days
• Change in behaviour or sound of cry (high-pitched or inconsolable)
• Difficulty breathing – including making unusual sounds and seeing ribs sucking in
• Anything that worries you

Fever and COVID-19

In the current climate, there is a possibility that your child’s fever may be due to a viral illness such as coronavirus. However, coronavirus (COVID-19) is uncommon and tends to be less serious in children.

Symptoms to look out for include:

• Loss of sense of taste or smell
• Continuous cough
• A high temperature
• If your child has one of these symptoms, it is important to get a PCR test. If you are worried and you are not sure what to do, then please ring NHS 111 helpline

Febrile Seizures

Some children can develop fits from fever (also known as febrile seizures). During a febrile seizure, your child may shake or twitch or they may lose consciousness and become floppy or stiff.

During the fit, monitor your child closely. Febrile seizures tend to last around 4-5 minutes and stop without needing any treatment. Once the fit has finished, check your child is breathing and put the child in the recovery position. Your child will likely be tired and upset following the fit.

If your child has never had a fit before, seek urgent medical help. Additionally, if the fit is unusual, you have any worries, or the fit is lasting longer than 5 minutes, call an ambulance immediately. Otherwise, if the fit has already stopped, and you have no other concerns, please inform your general practitioner as soon as possible.

If your child has a febrile seizure, there is a chance that they could have another seizure in the future however, children usually outgrow these. It is important to note that febrile seizures do not mean that your child has epilepsy and does not require continuous anti-seizure medication.

Fever following vaccinations

It’s important that your baby has their immunisations at the right age – the first ones are given at 8 weeks old.

As with all medicines, the vaccinations may have side effects but don’t worry these side effects are usually mild and short-lived. Check with each individual vaccine but for example the majorities of babies get a fever after the MenB vaccine. Look out for warning signs as with any case of fever, and if there are any concerns, seek immediate medical advice.

Resources for more information:

https://www.nhs.uk/conditions/fever-in-children/

https://patient.info/childrens-health/fever-in-children-high-temperature

https://www.nhs.uk/conditions/coronavirus-covid-19/symptoms/coronavirus-in-children/

https://www.nhs.uk/conditions/vaccinations/why-vaccination-is-safe-and-important/