Fever (high temperature) in babies and toddlers (2024)

A fever is the body's way of fighting infections. It may be due to viral or bacterial infections or some routine immunisations. A high temperature won't harm your baby, but it needs urgent medical care in babies under six months, especially those under three months. Fever may come along with other symptoms, such as trouble breathing, diarrhoea, cold, cough, vomiting, rashes, earache or seizures. To help your baby recover, keep her hydrated and comfortable and follow your doctor's advice on medication and care.

What is a fever?

A fever is a higher-than-normal body temperature. It's a sign of an infection or illness, but it's not an illness in itself. It's a response to inflammation and means that the body's immune system is responding to a virus or bacteria, for example.

The elevated temperature makes it difficult for bacteria or viruses to survive and helps the body to fight infections more effectively. A fever also tells the body to make more white blood cells and antibodies to clear the infection.

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A fever usually isn't harmful and will eventually go away on its own, when the underlying cause is diagnosed and treated.

What temperature is considered a fever in babies and children?

Normal body temperature is between 96.8 degrees F (36 degrees C) and 98.6 degrees C (37 degrees C), but this can vary by a few points of a degree from child to child.

If your baby's temperature is higher than normal, she has a fever.

Bear in mind that babies' temperatures, like adults, can rise slightly for many reasons, from physical exertion to a warm bath to being overdressed.

What are the signs that my baby has fever?

You can usually tell if your baby has fever just by touching her. Her skin will feel hotter than usual. You can feel her forehead, or if she’s younger than three months, feel her tummy or back. She may feel clammy and sweaty.

Also see how your baby is acting. If she has fever she may be:

  • crankier and fussier than usual
  • drowsy with flushed cheeks
  • less active and interested in her surrounding and play
  • more clingy
  • having poor sleep
  • refusing feeds

If you notice these signs, check her temperature with a thermometer to be sure.

What causes fever in babies and children?

Many conditions can cause a fever, including inflammatory conditions and immune responses. Viral and bacterial illnesses can also cause fever. The most common illnesses that cause fever include:

  • viral flu
  • colds
  • ear infection
  • sore throat and coughs
  • bronchiolitis, croup and whooping cough
  • kidney or urinary tract infections (UTIs)
  • stomach flu (gasteroenteritis)
  • mosquito-borne diseases, such as dengue fever, malaria or chikungunya
  • a virus that causes a rash, such as chickenpox or roseola
  • illnesses such as meningitis, tonsillitis, typhoid, jaundice or covid-19
  • heat stroke
  • sepsis, also known as septicaemia, or blood poisoning, is a very serious and life-threatening infection.

Some childhood vaccines (such as DTaP or MMR) can sometimes cause a fever as the body mounts an immune response. Your doctor will advise you on what to look out for after your baby has had her immunisations.

You may have heard that teething can cause a fever. However, there's no scientific evidence confirming that teething causes fevers, though many parents report fevers in their teething babies and toddlers.

When is fever dangerous in babies and young children?

If your baby has a fever along with other symptoms, this could be a sign of a more severe illness. Take your baby to the emergency department of the nearest hospital if your child:

  • Is under three months old and doesn't want to feed. This includes breastfeeds or bottle feeds.
  • Is particularly sleepy or drowsy. Older children may also appear confused and suddenly unable to walk.
  • Is unable to wake up easily or is unconscious.
  • Develops an unusually weak and high-pitched cry.
  • Has signs of respiratory distress (grunting, flaring nostrils, sucking in the skin above the collarbone or between or below the ribs, consistently fast breathing, whistling or wheezing while breathing).
  • Has sunken fontanelles (the soft spots on her head), along with other symptoms, including dry lips, no tears, and fewer wet nappies than usual. These can be signs of dehydration.
  • Has an unexplained rash or blotchy skin.
  • Has blue lips, tongue, or nails.
  • Has cold hands or feet
  • Has a stiff neck.

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Some infections, though rare, can be life-threatening if untreated. They include:

  • Meningitis, an infection in the membranes that surround the brain and spinal cord.
  • Sepsis, an infection of the blood.
  • Pneumonia, an inflammation of the lungs, usually caused by an infection.

Again, fever is common, normal, and a sign your little one's body is doing what it's designed to do when faced with inflammation. But, if you have any concerns about your baby's health, no matter what her age, get medical advice.

When should I call my doctor if my baby has fever?

When in doubt, call your doctor. But, generally, a lot depends on your baby's age. A fever is more of a worry if your baby is under six months old, and it's an emergency in babies under three months.

It's fairly unusual for young babies to develop a high temperature, so this can be a warning sign that something is wrong.

See your doctor straight away if your baby is:

  • under three months and has a temperature of 100.4 degrees F (38 degrees C) or more

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  • three to six months and has a temperature of 102.2 degrees F (38.8 degrees C) or more

But if your baby is older than six months, her temperature doesn't always give the whole picture of how sick she is. It's generally fine to let the fever run its course, and many fevers resolve quickly and on their own.

At this age, if your baby has a fever but otherwise seems unaffected and is playing and feeding as usual, you don't need to worry. But you still need to closely watch her to check if she's getting better. Also, look out for any worrying symptoms such as breathing difficulty, falling appetite, drowsiness and loss of interest in her surroundings.

Always ask your doctor for additional guidance. For example, your doctor may suggest calling right away if your baby's fever reaches 104 degrees F (40 degrees C), or if the fever lasts for more than 24 hours, regardless of symptoms.

Know these seven surprising things about fever and trust your instincts. If your instinct tells you that your baby is unwell no matter how old she is, you're probably right.

What is the best way to take a baby's temperature?

If your baby has a fever, it's best to use a thermometer. Don’t rely on touch alone.

For proper treatment, it's essential to know precisely what your baby's temperature is, and, a thermometer will give you an accurate reading.

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You don’t need to buy an expensive thermometer. A digital thermometer is probably the best one to have in your first-aid box. Tuck the thermometer in your baby’s armpit, with her arm down by her side. The thermometer will beep when it's ready to be read.

See our slideshow to know more about how to take your baby's temperature and the pros and cons of different thermometers.

Keep the following in mind when checking your child's temperature:

  • Don't take your baby's temperature just after a bath or if she has been snugly wrapped up for a while. If your baby is already warm, this can affect the reading. Wait 20 minutes before taking her temperature.
  • No matter which thermometer you use, always read the manufacturer's instructions. This will help you understand how to use it, what precautions to take and how clean it (before and after use).
  • If you have a multi-use digital thermometer that can be used orally, rectally or under the armpit, designate it for just one area to avoid spreading bacteria and germs. Don't use it once for taking the fever rectally and the next time, orally. It's best to have separate thermometers for each area, and each should be clearly marked to avoid any mix-ups.

If you're not sure you've taken your baby's temperature accurately, or you're worried about her, speak to your doctor.

What medicine should I give for my child's fever?

Doctors recommend infant paracetamol in most cases where a baby is uncomfortable or upset.

However, be sure not to give your baby medicine before talking to a doctor – it can be dangerous to give your baby the wrong dosage, and medication can mask your baby's symptoms, making it hard for the doctor to provide appropriate care.

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When your doctor prescribes the medicine and required dosage, keep the following in mind:

Always give the correct dose of the fever medicine to your child

The correct dosage for your child is determined by her weight, not her age.

Your doctor will be able to help you calculate the right dosage. Always use the measuring cup that comes with the medicine to give your child exactly the right amount.

Don't give fever-reducing medicine more often than recommended

Always follow your paediatrician's advice on the dosage timings.

Some medicines may need to be given every four hours, others six-hourly. There is also a maximum number of doses you shouldn’t cross in a 24-hour period.

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Make a note on your phone or a chart of when your baby has her medicine. You can also set an alarm on your phone to track the timing of her next dose.

Never give your child aspirin

Aspirin can make a child more susceptible to Reye's syndrome, a rare but potentially fatal disorder.

If your child has an illness such as dengue fever, or if your doctor suspects that dengue might be the cause of her symptoms, he will recommend you don't give your baby ibuprofen or meftal. These can lower the platelets in her blood, and increase the risk of bleeding.

Also, don't give your baby or young child over-the-counter cough and cold medicine or herbal remedies without checking with your doctor first.

Some of these products aren’t suitable for babies and young children. Some of these could also mask symptoms, cause interactions with other medicines, or harm your child's health.

What else can I do to treat my baby’s temperature at home?

In addition to the medicines advised by your doctor, you also take these steps to treat your baby’s fever and keep her comfortable:

  • Give your baby lots of drinks to make sure she is well-hydrated. Offer her extra breastfeeds if she's exclusively breastfed. If she's on formula milk, give her extra cooled boiled water.
  • If your baby is old enough for solids, don't worry if she doesn't want to eat too much. Offer small, light meals often to keep her energy levels up.
  • Your baby will need to rest while she's ill, so help her to relax and doze. Read her stories, and keep any games quiet and low-key.
  • Don’t over-wrap your baby. Sheets and lightweight blankets are cooler than quilts or duvets, and you can remove them when necessary.
  • Remove layers of clothing so your child can lose heat more easily through her skin. Dress her in one light layer and keep her head uncovered. If she's shivering, give her an additional layer until she's warm again.
  • Sponge your baby's face, neck, arms and legs with lukewarm water to bring down the fever. Don't use cold water. It can make your child shiver and cause her body temperature to rise.
  • Keep the fan or AC at a low setting. This will circulate the air in the room rather than blowing directly on your child and keep her from getting too cold.
  • Make a note of your baby's temperature every time you check it. This will help you keep a track of how she's doing, and will also be useful information for your baby's doctor.
  • Keep your baby away from her crèche or daycare until she's better.

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What causes febrile seizures (convulsions) in children?

A high temperature, usually from an infection, can sometimes trigger febrile seizures, also known as febrile convulsions or fits. "Febrile" means relating to a fever.

Febrile seizures are most common between the ages of six months and five years, with a peak at around 18 months. However, most children will never have a febrile convulsion.

However, febrile convulsions can sometimes run in families. Your baby is more likely to have a febrile convulsion if a close member of the family has had them.

What to do if your baby has a febrile seizure

In most cases, the seizures are harmless, but that doesn't make it any less terrifying if your child's having one. Your child may roll her eyes, drool, or vomit. Her limbs may become stiff, and her body may twitch or jerk.

Although a convulsion may seem like it's going on for ages, it usually lasts between three and six minutes.

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If your baby has a seizure, here's what to do:

  • Try to stay calm.
  • Note the time the fit started.
  • Don’t restrain her in any way during the seizure.
  • Cushion your baby's head with your hands or something soft, so she doesn't hurt herself.
  • Clear anything hard or heavy out of the way, or move her to a safer space on the floor, if needed.
  • If you have someone with you, and it's safely possible to do so, ask them to film your baby's convulsion. This can help doctors with diagnosis later.

A febrile seizure is usually limited and not dangerous, but it's important for your child's doctor to evaluate the cause of the fever.

Take your baby to the hospital emergency if:

  • She has a febrile seizure for the first time.
  • It's not the first time she's had a seizure, but it hasn't stopped after five minutes.
  • She has additional symptoms along with the seizure, such as breathing problems, vomiting, extreme sleepiness and a stiff neck.

If your baby has been previously diagnosed as having febrile convulsions, you may not need emergency help. Call your doctor right away for advice, though.

A big worry for many parents is that their baby may develop epilepsy after a febrile convulsion. The risk of this happening is small, but it is slightly raised if your baby has had a complex seizure.

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What are complex febrile seizures?

Sometimes, seizures are more complicated, lasting longer than 15 minutes. These are called complex febrile convulsions. Complex seizures may:

  • affect one part of your baby’s body
  • happen more than once within 24 hours
  • happen a few times while your baby's illness runs its course
  • take longer than an hour to recover from

Your paediatrician will recommend additional tests and further observation if your baby or child has a complex febrile convulsion.

The likelihood is that your baby will be fine, even after a complex seizure.

Why does my child's fever keep coming back even with medicine?

Fever-reducing medicine temporarily reduces body temperature, but it doesn't address the cause of the inflammation in the body.

So, your child may run a fever until her body is clear of the infection, if that's the cause. This can take at least two or three days. Your doctor may want to see your child again if the fever lasts longer than three days.

If your child's fever lasts more than three days, she may be fighting a bacterial infection, which will need evaluation and possibly treatment with antibiotics.

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Some infections, such as the flu, can last five to seven days. And if your child is being treated with antibiotics to fight a bacterial infection, it may take 48 hours for their temperature to fall.

Whatever the case, don’t hesitate to check with your doctor for more help and advice.

My child has fever but no other symptoms. Should I be worried?

When a child has a fever that isn't accompanied by symptoms such as a runny nose, a cough, vomiting, or diarrhoea, figuring out what's wrong can be difficult.

Many viral and severe infections can cause a fever without typical symptoms.

You're the best judge of when something is wrong. If you're concerned about what's happening with your child's temperature, it's best to check with your baby's doctor.

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हिंदी में पढ़ें: शिशुओं और बच्चों में बुखार

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Fever (high temperature) in babies and toddlers (2024)
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