One of the scarier things about being a parent is that when your child’s temperature spikes dramatically, there’s not really a set rulebook you can follow.
And after last year’s terrifying Strep A updates, coupled with the fact kids tend to pick up every bug under the sun before they start school, the worry many parents feel when their child gets a fever is understandable.
According to paediatric doctor Dr Kiran Rahim, a fever is one of the most common issues issues paediatricians see in kids. The expert said “there is a lot of worry and misunderstanding” surrounding them.
“Lots of parents have health anxiety when it comes to their children and I totally get it,” she wrote in an Instagram post. So why do kids get fevers? And when do parents need to seek medical help for them?
What is a fever?
A high temperature, or fever, is usually considered to be 38°C or above, while a ‘normal’ temperature in babies and children is about 36.4°C, but this can vary.
“The vast majority of fevers occur in response to viral infections. When a virus or bacteria gets inside your body, your immune system signals your brain to make your body hotter,” Dr Rahim explained.
The brain will then do two things, she said. Firstly, it makes the body shiver. And secondly, it causes the hairs on the body to stand up and stops any heat from being lost by directing blood away from the hands and feet. This is why children can often feel cool when they have a fever.
Fevers are technically a good thing – they help us fight infection by making it easier for our immune systems to kick in and making it harder for bacteria and viruses to multiply and spread.
If your child has a fever, they will usually feel hotter to touch on their back and chest. They might also seem sweaty and generally look or feel unwell.
What to do if your child has a fever
Fevers can be pretty terrifying for parents – especially if you randomly check your child’s temperature in the middle of the night and find it’s spiking at 39°C.
But Dr Rahim warned that having a good, working thermometer makes a huge difference here, as some types of thermometer don’t give particularly accurate readings.
For children under five, she recommends a digital thermometer placed in their armpits to get the best reading. For children over five, you can use a digital thermometer in their mouth.
“You can also use inner ear thermometers, but these are not as accurate and often give false readings,” she said.
Dr Laurence Gerlis, founder of Samedaydoctor, told HuffPost UK that if your child’s temperature goes above 37.5°C, the first action should be to cool the child down by removing excess blankets and clothing.
“The temptation to put covers on a febrile child must be resisted as it just makes things worse even if the child feels cold,” he said.
The NHS advises against fully undressing your child or sponging them down to cool them, and Dr Rahim agrees, saying “research tells us that neither [cool baths or wet sponges] are helpful in bringing down the fever”.
If your child is distressed or unwell, you can give them paracetamol or ibuprofen – but make sure you give them the correct dose suited to their age. And also check that they’re OK to have the medication – a pharmacist or doctor can advise accordingly.
“If the temperature rises above 38°C, then one can consider alternating paracetamol with ibuprofen every two hours,” suggested Dr Gerlis.
Alternating the doses is key here. The NHS advises against giving your child ibuprofen and paracetamol at the same time, unless a GP tells you to.
Dr Rahim suggested you can use both safely, but advised to alternate doses because if you are using both, “errors are more likely”.
If you do end up using both on the advice of a doctor, she recommends writing down the time you gave each medicine.
Research suggests ibuprofen is slightly better at treating fever and pain, but paracetamol works well too, according to the paediatric doctor. “If your child is not drinking as much, then ibuprofen should not be used for more than 48 hours,” she advised.
A lot of the time, the cause behind your child’s temperature is a viral infection and you can monitor it at home and they’ll get better within a few days. Signs of viral illnesses typically include a runny nose, coughing, sore throat, tummy pain, diarrhoea and vomiting.
When to call your GP or NHS 111
Dr Rahim said sometimes it can be hard for parents to listen to their instinct (especially during those 3am checks) so she shared a helpful checklist of things parents can look out for that would warrant further medical help.
If you answer ‘yes’ to any of the questions below, she advises seeking medical help:
- Is your baby less than 3 months old and has a fever over 38°C?
- Is their breathing persistently abnormal? Are there any additional sounds such as wheeze?
- Are they irritable/sleepier/more confused than normal and not their usual self?
- Are they eating/drinking less than 50% of their normal intake?
- Are they complaining of a headache/stiff neck or keeping very still?
- Are they complaining about how bright it is?
- Are they passing urine less than normal or have had less than two wet nappies in 12 hours?
- Are they complaining of a lot of pain despite medicine?
- Is there a limp or swelling in their joints?
- Have they had a fever for five or more consecutive days?
Most fevers will settle within 48 hours, but any persisting fever beyond that should lead to you seeking medical advice, either by the GP or NHS111, Dr Gerlis suggested.
“Coughing can be quite common in viral or bacterial infections, but if this persists beyond 48 hours medical advice should also be sought,” he added.
The higher the fever, the more serious the illness?
Dr Rahim suggested this is a myth and, actually, the most important factor in all of this is how your child is, rather than the number on the thermometer.
“It is important to look and observe your child,” she said. “Most children can be managed safely at home with observation and some TLC.”