What is fever (high temperature)?
In infants and toddlers, fever is defined as a temperature of 38.0 Celsius or higher. Usually, a fever indicates an underlying infection. Our body’s natural response to infection is to raise its temperature. The theory is that the higher temperature may prevent the replication of the causative bacteria or virus, whilst simultaneously enhancing the body’s immune response. We must also be aware that high temperature can be due to non-infectious conditions, but these are less common and our team are highly experienced at looking for clues to differentiate the potential causes.
Importantly, the temperature alone is not the only thing to consider. There are several other clues that you, as a parent, can assess to help decide if your child needs a doctor’s assessment. Whilst we are always available to see you and your children, we are aware children don’t all love doctors. Often the child is happier at home and we can save your time and their tears!
How do I check their temperature?
This is very important as incorrectly measured temperature can either be falsely reassuring or cause unnecessary anxiety. In this age group, the best ways are either:
- Electronic armpit thermometer
- Infra-red in-ear thermometer
Oral (under the tongue) and rectal thermometers are no longer seen as the best options and should not be used.
If you don’t have a thermometer to hand but feel your child is hot, that is also a valid concern we will never ignore. However, we encourage all families to have an age-appropriate thermometer in the house. These are widely available in pharmacies and online.
How can I bring the fever down?
DO:
- Give either paracetamol (Calpol) or ibuprofen (Nurofen) to begin with. Bear in mind, most children can have paracetamol safely, but some cannot have ibuprofen. If you are unsure, please discuss with our team. Both are widely available as liquids, and the dose is age-dependant and written clearly on the packaging.
- Recheck the temperature after 30-45 minutes. If the initial medication does not bring the temperature down, it is safe to give the other. Whilst not harmful to give both medications simultaneously, it is not advisable to do so as alternating the medications allows you to keep a second option available if your child remains feverish or unwell before the next dose is due.
- Dress the child appropriately for the weather. Do not strip down or over-layer.
Do NOT
- Give aspirin unless explicitly advised to do so, which is incredibly rare. Aspirin in under-16s can cause a life-threatening illness (Reye’s syndrome).
- Use a tepid sponge to lower the temperature.
Should I still bring the fever down if it’s helping fight infection?
A common question, but important for a few reasons.
- A fever makes you feel rotten. A child with a fever will be unhappy, low in energy and unlikely to want to eat or drink. Bringing the fever down should make them happier. If they are not drinking, they risk becoming dehydrated and acutely unwell, potentially needing admission to hospital. By bringing the fever down, you give them a chance to feel slightly more ‘normal’, drink a bit more and hopefully not become dehydrated.
- Sadly, children risk suffering ‘febrile seizure’, a fit, secondary to a high temperature. Thankfully, most children make a good recovery following such an event, but it is certainly something we strive to avoid. Often, these occur when the temperature rises rapidly, rather than being related to a set thermometer reading, so they can be difficult to prevent or predict. However, certainly acting quickly at the first sign of a fever will certainly help reduce the risk.
When should I worry and who should I contact?
| Red flags | Amber flags |
|---|---|
| If your notice any one of these, you must phone an ambulance or present to your nearest Accident & Emergency: | If your notice any one of these, contact a doctor to be seen urgently (the same day): |
|
|
When should I monitor my child at home?
Most fevers in young children can be safely managed at home. This is usually appropriate if your child remains alert, is drinking fluids, passing urine, and has none of the red or amber flags listed above.
How can I keep track of their temperature, nappies and medication timings?
When your child is unwell and you are tired from caring for them (amongst other responsibilities), it can be impossible to remember when they last went for a wee or had a medication. There are many apps that can help you keep on top of things and they are incredibly useful to accurately paint a picture for the doctor. A widely used, freely available application is ‘Huckleberry’. Parents and carers can share a profile and use it to accurately track things (and even set medication reminders). With plenty on your plate already, it’s one less thing to worry about.
What else can I do to help my child recover?
- Encourage fluids little and often – water, juice, whatever they will take!
- Check them frequently, including overnight if they are requiring regular medication to lower their temperature during the day.
- Keep them away from daycare/nursery until they no longer have a fever.
Above all, trust your instincts. You know your child best, and if something doesn’t feel right, it’s always worth seeking advice.
Fever is extremely common in young children and, in most cases, settles with simple care at home. However, our team is always here to support you — whether you need reassurance, advice, or a same-day appointment.
About the author
MBBS BSc (Hons) MSc MFSEM MRCGP
“It’s a rare privilege to be trusted with people’s lives — and here at Sloane Street Surgery, I’m grateful to have the time to truly get to know my patients and their needs.”
I enjoy all areas of general practice and the variety it brings, caring for patients of all ages and their families. I have a particular interest in musculoskeletal health, preventative medicine, and the role exercise can play in recovery and long-term wellbeing.
