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Emergency department advice for the care of children with fever

What is fever?

Normal body temperature is around 37C. A raised body temperature is often a sign of infection and is common in children when they are unwell.

A fever is a raised temperature of 38C or higher and is best measured using a digital thermometer if possible.

Your child may feel hot and sweaty and look shivery and flushed. Fever is the body’s normal response to fighting an infection.

Infections caused by viruses are more common than bacterial infections. Viruses often also cause a runny nose, cough or sore throat. Viruses get better on their own and don’t need antibiotics.

The temperature usually returns to normal within 3 to 4 days.

Fever is common after vaccinations in the first 1 to 2 days.

What can I do to help my child?

  • Offer and encourage regular fluids
  • Do not over or under dress your child
  • Give paracetamol (if over 3 months of age) or ibuprofen (if over 6 months of age) if your child is distressed or unwell.

Do not give both paracetamol or ibuprofen at the same time but consider the other medicine if the child does not respond to the first medicine after 30 to 60 minutes.

    • Paracetamol (Calpol) can be given every 4 hours
      • Do not give more than 4 doses in 24 hours
    • Ibuprofen can be given every 6 hours
      • Do not give more than 3 doses in 24 hours
    • Follow the dosing instructions on the bottle of your medicine – the doses change as children get older, so make sure you’re giving the right amount.
  • More information on paracetamol and ibuprofen can be found here: Paracetamol and Ibuprofen.
  • Keep your child away from school or nursery while unwell
  • Consider whether you need to get a COVID-19 test for your child
  • Check on your child regularly
  • Look for a rash
  • Look for signs of dehydration which include:
    • going 10 hours without passing urine or fewer wet nappies
    • sleepy or floppy child
    • sunken eyes
    • changed breathing, either faster or slower and deeper
    • dry mouth, tongue and lips or no tears
    • soft spot in the top of babies head is sunken more than usual
    • when the skin is pinched gently it stays up for a second or two

Seek further medical advice if

  • Your child has a fit. Fits caused by fever are called febrile convulsions
  • Your child develops a rash which does not disappear under the pressure of a glass (see picture below)
  • You feel your child is getting worse
  • Your child is under 3 months with a fever over 38C
  • Fever lasts more than 5 days
  • Your child shows signs of dehydration
  • You are distressed or concerned that you cannot look after your child

Medical advice can be sought by calling NHS 111, seeking help from your local pharmacist (if non-urgent) or contacting your GP.

A rash that doesn’t fade when a glass is pressed firmly on the skin is more worrying. Seek medical advice urgently.

Rash shown under a glass

More advice on fever in childhood can be found here:

Fever / High Temperature :: Healthier Together (sybhealthiertogether.nhs.uk)

High temperature (fever) in children – NHS (www.nhs.uk)

Download to print in other languages

For print-ready versions in other languages, please use the downloads below:

Arabic – Feverish child

Mandarin – Feverish child

Polish – Feverish child

Slovak – Feverish child

Somali – Feverish child

Urdu – Feverish child

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Please note this is a generic information sheet relating to care at Sheffield Children’s. The details in this resource may not necessarily reflect treatment at other hospitals. This information is not intended as a substitute for professional medical care. Always follow your healthcare professionals’ instructions. If this resource relates to medicines, please read it alongside the medicine manufacturer’s patient information leaflet. If you have specific questions about how this resource relates to your child, please ask your doctor.

Resource number: ED31

Resource Type: Article

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