Fever in children under 5 years (1)

Fever in children under 5 years

This advice is intended for parents/carers taking their child home after consulting a doctor. Your doctor may recommend different treatments depending on your child's condition.

This is discharge advice for carers of children younger than 5 years who have a fever where we may not know the cause.

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About fever in children

Fever is extremely common in children and usually suggests that your child has an infection
Your child has a fever if their temperature is over 38°C. The most accurate way of measuring your child’s temperature is with a digital thermometer
Viral infections are far more common than bacterial infections. Symptoms such as runny nose, cough, wheeze, sore throat, red eyes and diarrhoea are more suggestive of a viral infection than a bacterial infection. If a number of people are unwell in the same household, this also suggests a viral infection (because viral infections are easily spread)
Viral infections tend to get better on their own and do not need treatment with antibiotics

How can I look after my child?

Offer them simple food and regular drinks. If your baby is breastfed, continue breast feeding
If they are vomiting, offer small frequent drinks as this is more likely to stay down
Do not try to control your child’s temperature with tepid sponging or fans
Keep an eye on your child day and night and follow the guidance overleaf
If a rash appears do 'the Glass Test' (see guidance below)
Fever is common in babies up to 48 hours after receiving immunisations - consider giving regular paracetamol. If your child is due their vaccinations, postpone until after their fever has improved
If you need to keep your child away from nursery or school while they are unwell and have a fever please notify the nursery or school

Using medicines to help

Consider giving paracetamol or ibuprofen for comfort
Use one and if your child has not improved 2-3 hours later you may want to try giving the other medicine
Carefully read the instructions on the medicine for dose and frequency. Although both are very safe when used correctly, they may be harmful if too large a dose is given, or if given too often
You could ask your local pharmacist for more advice about medicines
In general, we do not recommend cough medicines

The Glass Test

Do the ‘glass test’ if your child has a rash. Press a glass tumbler firmly against the rash. If you can see the spots through the glass and they do not fade as you press the glass onto the skin then this is called a ‘non-blanching rash’.

If you see this type of rash, seek medical advice immediately.

The rash is harder to see on dark skin so check paler areas, such as palms of the hands, soles of the feet and tummy.

(Photo courtesy of the Meningitis Research Foundation 2013)

When should I get help?

Advice for parents and carers of children younger than 5 years

If your child has any of the following:

Becomes pale, mottled and feels abnormally cold to touch
Is going blue around the lips
Severe breathing difficulty - too breathless to talk / eat or drink
Has a fit / seizure
Becomes extremely agitated (crying inconsolably despite distraction), confused or very lethargic (difficult to wake)
Develops a rash that does not disappear with pressure (see 'The Glass Test’ above)
Is under 1 month of age with a temperature of 38°C / 100.4°F or above

You need urgent help.

Go to the nearest Hospital Emergency Department or phone 999

If your child has any of the following:

Is finding it hard to breath
Seems dehydrated (sunken eyes, drowsy or no urine passed for 12 hours)
Is becoming drowsy (excessively sleepy) or irritable (unable to settle them with toys, TV, food or picking up) – especially if they remain drowsy or irritable despite their fever coming down
Has extreme shivering or complains of muscle pain
Is between 1-3 months of age with a temperature of 38°C / 100°F or above; or 3-6 months of age with a temperature of 39°C / 102.2°F or above (but fever is common in babies up to 2 days after they receive vaccinations).
Continues to have a fever of 38.0°C or above for more than 5 days
Seems to be getting worse or if you are worried

You need to contact a doctor or nurse today.

Please ring your GP surgery or call NHS 111 - dial 111

If none of the above features are present.

Self care

Continue providing your child’s care at home. If you are still concerned about your child, contact your GP or call NHS 111 – dial 111

Content adapted with permission from the what0-18.nhs.uk resource produced by the Healthier Together initiative