Fever in Children: When to Worry and How to Care for Your Child

Few things worry parents more than a hot, unwell child. But fever itself is not an illness: it's a sign that the body is fighting an infection, usually a common virus. Most fevers settle within a few days.

What counts as a fever?

A temperature of 38°C (100.4°F) or higher is a fever.

How to measure it:

• Under 4 weeks: use an electronic thermometer in the armpit.
• Older babies and children: an armpit (digital) or ear (infrared) thermometer.
• Avoid mercury thermometers, which can break, and don't rely on touching the forehead.

How to care for a child with fever

1. Offer plenty of fluids: breast milk, formula, water, ORS, soups, coconut water. Watch for dehydration.
2. Dress them lightly and keep the room comfortably cool; don't bundle them in blankets.
3. Let them rest, but there's no need to keep them in bed if they want to play.
4. Medicines: paracetamol, or ibuprofen for children over 3 months (if they're drinking well and don't have asthma that worsens with it), can make your child more comfortable. Give the dose based on weight using the measuring device provided, and don't combine or alternate medicines unless a doctor advises.
5. Don't use cold water sponging or ice: it can cause shivering and discomfort. Lukewarm sponging may be used if your child finds it soothing.
6. Never give aspirin to children under 16: it's linked to Reye's syndrome, a rare but serious condition.

The goal of medicine is comfort, not to bring the temperature back to normal.

When to see a doctor urgently

Seek medical help the same day if your child:

• is under 3 months with a temperature of 38°C or higher
• is 3 to 6 months with a temperature of 39°C or higher
• has had a fever for more than 3 days (or 5 days in older children)
• isn't drinking well, or is passing very little urine
• has a fever along with ear pain, painful urination or a severe sore throat

Go to the emergency department or call 112 if your child:

• is very drowsy, floppy or hard to wake
• has a fit (seizure)
• has a rash that doesn't fade when you press a glass against it
• is breathing fast, grunting or struggling to breathe
• has blue, pale or blotchy skin, lips or tongue
• has a stiff neck or a bulging soft spot (in babies)
• shows signs of dehydration: no tears, dry mouth, sunken eyes

Fever in Indian seasons

During the monsoon and post monsoon months, fevers may be caused by dengue, malaria, typhoid or chikungunya. If your child has a high fever lasting more than 2 days during these seasons, see a doctor for testing.

Febrile seizures

Some children aged 6 months to 5 years have a seizure when they have a fever. It's frightening but usually harmless. Lay your child on their side, don't put anything in their mouth and time the seizure. Call for help if it lasts more than 5 minutes or if it's the first one.