FEVERWhat is a fever?
Fever occurs when the body’s normal temperature of 36-37°C rises to 37.5° C in a baby or toddler. It’s usually a sign that your child’s unwell. The younger the child, the more sensitive their temperature control and the less mature their immune system, meaning they’re more likely to develop a fever.


What causes a fever?
A fever develops when the white blood cells that fight off the bacteria or virus send out proteins called pyrogens. The pyrogens raise the temperature in an attempt to destroy the invading infection. In that sense, it’s a sign that the body’s working well.

Are babies and toddlers affected differently?
In babies the most common causes of a fever are:
•Cold or cough
• Flu
•Rubella (German measles)
•First immunisations

The symptoms of a fever in a baby are:
•Irritability and crying
•Flushed cheeks
•Fast breathing
A raised temperature in a baby with no other symptoms isn’t usually serious and can be treated with infant paracetamol in children over three months old. But if the baby is also pale and listless, you should seek advice quickly.

In toddlers the most common causes of a fever may also include:
•Ear infection or flu
•Kidney infection
•Scarlet fever

Symptoms of a fever in a toddler include:
•Flushed face
•Shivery body

How do I take my baby’s or toddler’s temperature?
A forehead temperature strip is the easiest way. Place the strip on your child’s forehead for 15 seconds and watch the colour change – usually green for normal and red for a fever. A digital thermometer placed under the armpit will give a more accurate reading.
To check your baby or toddler’s temperature if you haven’t got a thermometer, feel his tummy and the back of his neck.

How do I treat a child or baby's fever?
Although the temperature has risen for a reason, you need to take steps to bring it down:
Medical advice has changed in the last few years and doctors now do not recommend undressing or cooling the skin externally with tepid water. Instead:
•Ensure your child is re-hydrated and offered the breast or bottle – or water for a toddler. This is important to prevent a fit. If your child is finding it difficult to drink give him just a few drops of liquid at a time to prevent his stomach rejecting it
•Give a dose of infant paracetamol if your child’s over two months old. Over three months, you can also offer ibuprofen which is thought to work slightly faster

When do I call the doctor?
You need to get medical attention if:
•Your baby is under three months old and has a fever over 37.5°C
•A fever in a three to six-month-old baby doesn’t reduce after one dose of infant paracetamol
•Your baby is pale or floppy. This could indicate dehydration or something more serious such as meningitis or encephalitis
•A fever in an older baby or toddler lasts longer than 24-48 hours and there’s no obvious cause
•A baby or child of any age has a temperature of 39°C or more.

Using Paracetamol and Ibuprofen

Both paracetamol and ibuprofen have a proven safety record for use on infants. Make sure you use the children's version of the medicine, however, and follow the guidelines for dosage. Paracetamol is often recommended by doctors after your baby's first jabs at around two months, while ibuprofen is considered safe from three months. Paracetamol works for up to six hours while ibuprofen can work for up to 8. There's no evidence that combining the two has any real benefit.

Doctors also recommend that you use a medicine spoon or measuring syringe (which usually come with the medicine or can be picked up in your pharmacy). Ordinary teaspoons can vary in size and could affect the dosage.

Click through to the next page for information on fits and febrile convulsions which can be caused by fever and high temperature.

FITSWhat causes fits & febrile Convulsions

Febrile convulsions and fits are the same thing. They are caused by a sharp increase in temperature so are more likely when your child has fever or virus. Though fairly common they can be quite scary to witness. Between the ages of 6 months and 4 years about 1 in 20 children are affected. The fits are generally harmless but it is good to recognise signs of more serious cases.

What are the symptoms of fits?

• Loss of conciousness
• Body & limbs stiffen
• Shaking: Limbs may jerk uncontrollably while head and eyes may fall back
• skin goes pale or has a blue-ish tinge
• After a few minutes, the attack stops, your child's colour should return to normal and he should regain conciousness (this varies from child to child)

What to do when your child's fit is over

• Try to take down your child's temperature with child paracetamol or ibuprofen
• Lie your child on his side or in the recovery position if you know it
• Do not put anything in your child's mouth as biting the tongue is rare

When do fits need medical attention?

• All episodes of fits should be reported to you doctor to check whether it was caused by a fever from a virus or something more serious
• If your child suffers prolongued or frequent fits in succession, call an ambulance
• After a child has a fit for the first time, he should be admitted to hospital


Anti-convulsion medications can be given if your child is prone to febrile convulsions but the risk drops to almost nothing after the age of 5.