Signs and symptoms of fever in babies and children

How can you tell if your child has a fever? What if your baby also has earache or diarrhea? Expert advice from family GP Dr Simon Latham plus parents' experiences

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It can be really worrying when you suspect your baby or child may have a fever. Yet fevers in babies and young children are much more common than you might think. According to a 2007 report published in the Royal College of Obstetricians and Gynaecologists Press¹, and funded by the NHS to produce guidelines for NICE:

  • more than 60% of parents with children aged between 6 months and 5 years say their child has a fever at some point
  • nearly 40% of parents with a child under 6 months reported their child had experienced a fever

What exactly is a fever and what causes it?

In more common language, a ‘fever’ means your baby or child has a particularly high temperature, and this is often (though not always) your baby’s or child’s natural response to fighting an infection.

A normal temperature for a baby is about 36.4C. A  fever is defined as when your baby or child’s temperature is at 38C or above,  explains Dr Simon Latham, a GP in Altrincham and medical officer at Push Doctor.

Many things can cause a fever in children, including common childhood illnesses like chicken pox and tonsillitis.

“It can also be caused by infections such as colds or chest or urinary tract infections,” explains Dr Latham. “It can even occur if a baby or child overheats (on a hot day, for example) or after a vaccination.”

What are the signs and symptoms of a fever?

Many of the mums on our forum talk about their own experiences of their little ones having a fever, with obvious signs being hot skin / a raised temperature when they measure it with a thermometer.

“I just had a really rough night with Spencer, he was sick everywhere and burning-up,” says mum pixie_woo. “I took his temperature and it was 38.4 degrees.”

Alongside a fever your child may have other symptoms such as earache, runny nose, or diarrhea. Of course things like earache can be really difficult to know about, especially if your little one doesn’t yet talk.

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“Symptoms of an earache include your baby pulling at their ears and becoming irritable,” says Dr Latham.

“With a runny nose you may notice mucus running from the nostrils and diarrhea might mean loose stools and your baby or child needing to go more often than usual. The poo may be yellow or green in colour as well.”

For Lucy-H , her baby’s high temperature was indeed a sign of an ear infection: “Aaron’s last round of 40+ temperature turned out to be an ear infection,” she says.

“Besides feeling hot to the touch, your child may be more tired than usual, irritable and off their food and drink,” explains Dr Latham.

They may also feel or look sweaty and clammy and perhaps have flushed cheeks.

When loopyloo80uk’s baby woke up crying at 5am recently, there were clear signs that her baby had a fever. “I could feel she was really hot. She had never felt that hot to touch before. Her head, back, tummy and neck all felt hot.”

How can I tell if my child is dehydrated with a fever?

Dehydration can happen in children with a fever because of vomiting / diarrhea, or because they just don’t want to drink anything.

“Signs that the child may be becoming dehydrated include fewer wet nappies or, in older children, passing urine less often,” says Dr Latham.

“If the child is becoming drowsy or their mouth is dry they may be not taking in or keeping hold of enough fluids.”

Keep a close eye, do your best to get them to sip liquids and, again, if you are worried – then contact a doctor.

What should I use to check my child’s temperature – and how often should I check it?

A digital thermometer is the best way to check your child’s temperature, if you can afford to invest in one, as they’re generally more accurate than any other kind.

“You can measure the temperature of a child of any age using a digital thermometer in the armpit or (if they are over 4 weeks old) an infra-red tympanic (ear) thermometer can be used instead,” says Dr Latham.

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And one tip is to wait until your baby’s napping, as Fragsjones found out: “I sent my hubby out to buy a digital ear thermometer as I was sick of trying to get a reading off my basic one…

“It’s well  worth the money as I get an accurate reading and I can take his temperature whilst he’s asleep – which I’ve done a lot!”

How often you check on them is up to you – but worthwhile keeping a close eye on it, especially if you are worried.

Mum Trying4babyM says: “In terms of frequency, maybe take it every couple of hours, then before bed at night and at any other time that they look flushed, feel warm or are generally not acting like themselves.”

When should I worry about a fever?

No one wants their baby to be under the weather, but most of the time you will be able to treat your child at home.

Many of ours mum opt for over-the-counter fever-reducing medicines specifically designed for babies and children, to try and bring the temperature down.

And thankfully, in lots of cases, the high temperature reduces fairly quickly.

DawnG recalls an incident with her little one recently: “I had to collect him from the childminder’s early because he’d been sick and had a bit of a temperature.

“When we got home he was sick again, but soon perked up after that. He’s been fine today, just a little bit clingy.”

“But if your child is under 3 months of age and they have a temperature they should always be assessed by a doctor straight away,” says Dr Latham.

Other signs that a child with a fever may be seriously unwell are:

  • fast breathing (more than 60 breaths a minute)
  • blue or very pale skin
  • unresponsiveness
  • an unusual cry
  • sucking in of the chest when breathing
  • making grunting sounds.
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“A rash that does not fade when pressed (non-blanching) could be a sign of meningococcal disease. If the child has any of these signs they need to be assessed by a doctor immediately.”

When should I see a doctor with my child’s fever?

“If the temperature goes on for more than 5 days you should also make sure you see a doctor,” says Dr Latham.

As with a lot of parenting, going with your gut instinct is really important. There is no point sitting at home worrying by yourself.

As weekender says, you are the parent so will know if your little one isn’t quite right.

“My daughter rarely gets high temperatures so I worry when she does. I think mummy instinct tells you if you should worry or not,” she says.

If in doubt it is always better to see a professional. “If you are worried you should take your child to be seen by a doctor straight away,” agrees Dr Latham. “And if your level of concern isn’t quite as urgent you could always call NHS 111 for advice.”

¹ Source: Feverish illness in children assessment and initial management in children younger than 5 years, Clinical Guideline May 2007. Produced by National Collaborating Centre for Women’s and Children’s Health. Commissioned by the National Institute for Health and Clinical Excellence. Published by Royal College of Obstetricians & Gynaecologists Press

This article is sponsored by Nurofen for Children Orange Baby. Contains ibuprofen. Pain and fever relief. From 3 months (and over 5kg). Always read the label. RB-M-00997

If your child has asthma please do not give them this product unless you’ve first consulted with a doctor.

Please note that Dr Simon Latham does not endorse any brands

Pics: Getty

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