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Fever in children

A child's body temperature is usually between 36.5°C and 37.5°C. A fever is a temperature above 38°C . Fever isn't an illness in itself; it’s thought to be part of your body's natural response to a viral or bacterial infection.

Symptoms of fever in children 

A child with a fever may:

  • feel tired
  • look pale
  • have a poor appetite
  • be irritable
  • have a headache or other aches and pains
  • feel generally unwell.

Fever can occasionally be a sign of a serious infection. Contact your GP immediately or take your child to hospital if they:

  • are under three months of age
  • are unusually sleepy or difficult to wake up
  • have bluish or mottled skin
  • have cold hands and feet
  • have a weaker than usual, high pitched cry or won’t stop crying
  • have difficulty breathing or are breathing very quickly
  • have a stiff neck
  • are vomiting
  • develop a rash that doesn’t disappear when pressed
  • have a fit.

Contact your GP if your child’s fever lasts longer than five days. Always seek medical advice if your child develops a fever soon after an operation or soon after travelling overseas.

Febrile convulsions

In some children a sudden increase in body temperature can lead to seizures (or fits) which are called febrile convulsions. During a febrile convulsion, part or all of your child's body may shake and twitch and your child’s eyes may roll back in their head. Febrile convulsions can be frightening and can last for up to six minutes, but your child is likely to make a full recovery. However, they may seem confused immediately after the convulsion ends, and you should take them to see your doctor or to your local hospital.

Causes of fever in children 

Fevers are common in young children. They are usually caused by viral infections that go away on their own, such as the common cold. Sometimes a fever can be caused by something more severe, such as an ear, bladder or kidney infection. On rare occasions a fever can be a sign of a serious illness such as a severe bacterial infection of the blood (septicaemia), urinary tract, lung (pneumonia) or brain (meningitis).

Occasionally, your child may develop a fever as a symptom of a specific condition rather than as a result of an infection. For example, certain blood disorders and autoimmune disorders may cause a fever. In this case, the fever lasts for longer than one associated with an infection.

Fever can also be a side effect of some childhood immunisations.

Diagnosis of fever in children 

You can take your child’s temperature using a digital or glass thermometer. Mercury thermometers are no longer recommended because there’s a risk that the thermometer could break and release its poisonous mercury into your child's body.

To take your child’s temperature by mouth, place the thermometer under your child’s tongue for two to three minutes.

You may find it easier to take the temperature from your child’s armpit if they find it difficult to keep a thermometer in their mouth. However, bear in mind that these measurements are less accurate as the armpit is slightly cooler. To take your child’s temperature this way, place the thermometer under his or her armpit, directly against the skin, and hold your child’s arm gently against the chest.

You can also take a child’s temperature:

  • rectally – by carefully inserting a thermometer a little way into the baby's rectum
  • aurally - with a digital ear thermometer, though this can be a little inaccurate
  • superficially – using a new product called a temporal artery thermometer which is swiped across your child's forehead to get a reading.

Your doctor, pharmacist or maternal and child health nurse can give you advice on taking your child’s temperature with these methods and on using these different thermometers.

Seeing your doctor 

If your child has a temperature over 38°C or if you’re concerned, contact your GP. Your doctor will ask about your child's symptoms and can advise whether further examination is needed. If necessary, your child’s temperature will be taken, heart rate and breathing will be measured and your doctor may also ask about your child’s medical history.

It may help if you keep a record of your child's temperature and other symptoms so that you can give clear information to your GP. There is likely to be a clear cause for your child’s fever, so no further tests may be required. However, if your child’s fever lasts longer than a few days and/or the cause isn’t clear, your GP may also take a blood sample and/or a urine sample.

If your GP is concerned about your child’s symptoms, he or she may be referred to a paediatrician (a doctor who specialises in children’s health) and, very rarely, your GP may ask for emergency medical help.

Treatment of fever in children 

Usually your child's fever will be caused by a viral infection and will get better on its own. Monitor your child's fever by regularly checking their temperature.

A fever is part of the body’s natural response to infection and can often be left to run its course provided your child is drinking enough and is otherwise well. If your child is having trouble drinking though, trying to reduce their temperature may help. Maintaining fluid intake is important in preventing your child from becoming dehydrated, which can lead to more serious problems. As a guide, your child's urine should be pale yellow – if it's darker, drinking more fluids should be encouraged.

Keep your child away from school or day care while they have a fever.

Medicines

If your child is particularly distressed, try offering paracetamol or ibuprofen to reduce their temperature. You can buy these medicines that are suitable for children from a pharmacy without a prescription. If the first medicine you try doesn’t help, you can try the other one later. Don’t give your child paracetamol and ibuprofen together without the advice of your doctor or pharmacist.

Don’t give your child these medicines to prevent a febrile convulsion.

Children under the age of 16 shouldn’t be given or take aspirin as it can lead to a serious condition called Reye’s syndrome that affects the brain and liver.

Always read the accompanying consumer medicines information leaflet and if you have any questions, ask your pharmacist for advice.

If your child has a bacterial infection, your GP may also prescribe a course of antibiotics.

Further Information 

The Meningitis Centre

1800 250 223

www.meningitis.com.au

Sources 

Clinical Knowledge Summaries. Febrile seizure. [online] London: National Institutes for Health and Clinical Excellence. 2008 [last updated Sept 2008, accessed 1 Jul 2011] Available from: http://www.cks.nhs.uk/febrile_seizure

Merck Manuals Online Medical Dictionary. Fever. [online] Whitehouse Station, NJ: Merck, Sharp and Dohme Corp. [Last updated Dec 2009, accessed 1 Jul 2011] Available from: http://www.merckmanuals.com/professional/sec15/ch178/ch178e.html

National Institute for Health and Clinical Excellence (NICE). Feverish illness in children - assessment and initial management in children younger than 5 years. [online] 2007 [Last reviewed Jan 2011, accessed 1 Jul 2011] Available from: http://guidance.nice.org.uk/CG47

National Institute of Neurological Disorders and Stroke (NINDS). Febrile seizures factsheet. [online] Bethseda, MD: NINDS. [Last updated 28 Jun 2011, accessed 1 Jul 2011] Available from: http://www.ninds.nih.gov/disorders/febrile_seizures/detail_febrile_seizures.htm

Oberklaid F Kaminsky L. Fever. [online]  Raising Children Network (Australia) Limited. May 2006 [accessed 1 Jul 2011] Available from: http://raisingchildren.net.au/articles/fever_a.html

Pearce C Curtis N. Fever in children. Australian Family Physician. 2005; 34(9): 769-771.

The Royal Children’s Hospital, Melbourne. Fever in children. [online] Melbourne, VIC; Royal Children’s Hospital, Melbourne. 2000 [last updated Apr 2008, accessed 1 Jul 2011] Available from: http://www.rch.org.au/kidsinfo/factsheets.cfm?doc_id=5200

When the child has a fever. Drug Ther Bull. 2008; 46: 17–21.

Disclaimer
This information has been developed and reviewed for Bupa by health professionals. To the best of their knowledge it is current and based on reputable sources of medical research. It should be used as a guide only and should not be relied upon as a substitute for professional medical or other health professional advice.

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