Kids Health Info - Fever

• Fever is when the temperature of the body rises to above 38°C. A normal temperature range for a child is usually up to 38°C.
• Fever is usually a sign of infection in the body. Fever is often caused by a virus and sometimes by bacteria. Viral infections are far more common and do not need antibiotics. Antibiotics do not cure viruses. Bacterial infections are treated with antibiotics.
• A high fever does not necessarily mean your child has a serious illness. The fever seen in common childhood infections is not harmful, and in fact it helps the body's immune system fight off the infection. 
• There is no advantage to lowering your child's fever except for comfort. 
• Treat your child by making them more comfortable; give clear fluids (eg. water, diluted fruit juice) and paracetamol if the fever is making your child miserable.
• Fever is a way the body fights infection, and your child's temperature will return to normal when the infection has completely gone.
• Fever is not known to cause damage to the brain or other organs.

Febrile convulsions

A few children can have convulsions ('a fit') when they have a fever. This may happen if your child's temperature goes up suddenly. Sometimes a convulsion happens when parents don't actually know their child has a fever. Febrile convulsions are not common and do not usually cause any long term health effects.  See factsheet on Febrile convulsions.

Taking your child's temperature

You may want to take your child's temperature if they are:

• Unwell and feel hot
• Irritable, crying
• More sleepy than usual
• Vomiting or refusing to drink
• In pain.

There are three ways to take a child's temperature

1. Under the arm - for all children.
2. Under the tongue - only for older children.
3. Ear (tympanic) - for children of all ages. It can be difficult to use and may not be accurate.

Different thermometers have different instructions to follow to make sure you get an accurate reading.  Ask your Maternal and Child Health Nurse, doctor or chemist to show you how to use your thermometer - before you need it.

Plastic tape thermometers used on the forehead are not reliable.

Treatment

See your doctor if your child has the following symptoms with their fever.

• Complaining of a stiff neck or light hurting their eyes.
• Vomiting and refusing to drink much.
• Rash.
• More sleepy than usual.
• Problems with breathing.
• If your child is in pain.

Also see your doctor if:

• Your child is under three months and has a fever. .

At home care

Treat your child at home by making them more comfortable.

• Dress your child in enough clothing so that they are not shivering.
• Tepid sponging (sponging with slightly warm water) and fanning children with fevers is not recommended.
• Give your child frequent small drinks of clear fluid (eg. water, diluted fruit juice or cordial). If your child is less than six months old give extra cooled boiled water, breast feeds, or bottles.
• Do not worry if your child refuses to eat at this time.
• Watch your child for signs that their illness is getting worse.

About paracetamol 

• Paracetamol is also known as Panadol, Tempra, Dymadon and Tylenol.
• If your child seems well and is happy, there is no need to treat a fever with paracetamol.
• If the fever is above 38.5ºC and your child is miserable or has other symptoms such as a sore throat, they may be given paracetamol. Follow the correct dose on the medicine instructions.
• Panadol may not make the fever go away but the aim is to make the child feel better.
• Paracetamol is a common ingredient in a number of medicines for illnesses such as colds and flu. Make sure that when giving paracetamol for fever that your child has not had one of these cold and flu medicines in the last 4 hours.
• Paracetamol  can be given every four hours as directed on the bottle. No more than four doses should be given in each 24 hours. Do not give for more than 2 days without seeing your doctor.

When to come back

Bring your child back to the Royal Children's Hospital emergency department or to see your own GP if they: 

• look more sick than before
• have not improved in 48 hours

Key points to remember

• The normal temperature range is up to 38ºC.
• Fevers are common in children.
• If your child seems well and is happy there is no need to treat a fever. 
• If your child is under 3 months and has a fever above 38º C, take them to the doctor to be checked.
• If your child is miserable, treatment is needed to comfort your child.  Give clear fluids and paracetamol.  The response of the fever to treatment does not matter.
• Watch your child for signs of the illness getting worse. 

* Information extracted from RCH.