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My baby has Fever / High Temperature

Fever in babies less than 90 days of age is much more likely to be due to a serious infection requiring urgent treatment compared to fever in an older child. For this reason, all children under 90 days of age with a temperature above 38°C / 100.4°F should be urgently reviewed by a healthcare professional. The only exception is if they have a fever in the 48 hours following their first set of vaccines (given at 8 weeks of age) – in this situation, it is OK to give them paracetamol without seeking medical advice if your baby is otherwise well.

 

How to take your baby’s temperature:

You should measure your baby’s temperature under their armpit. Hold their arm against their body to keep the thermometer in place for however long it says in the manufacturer's instructions – usually about 15 seconds; some digital thermometers beep when they're ready. You should not measure their temperature on the forehead as it is inaccurate. You can use an in ear thermometer from 4 weeks of age.

 

How to take a temperature

When should you worry?

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 or eat/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 (the ‘Glass Test’)
  • Is under 3 months of age with a temperature of 38°C / 100.4°F or above (unless fever in the 48 hours following vaccinations and no other red or amber features) 

You need urgent help

Go to the nearest Hospital Emergency (A&E) Department or phone 999

If your child has any of the following:

  • Is finding it hard to breath
  • Seems dehydrated (sunken eyes, drowsy or not passed urine 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
  • Is 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 / 100.4°F  or more for more than 5 days
  • Is getting worse or if you are worried

You need to contact your GP Surgery today

Please ring your GP surgery or contact NHS 111 - dial 111 or for children aged 5 years and above visit 111.nhs.uk

If none of the above features are present

Additional advice is also available to help young families cope with crying of well babies – click here.

Pharmacy/ Self care

Pharmacists can advise and treat a range of common symptoms. No appointment is needed and most pharmacies have a private consulting area. Click on this link to find a Pharmacy near to you

If you are still concerned about your child, contact NHS 111 – dial 111 or for children aged 5 years and above visit 111.nhs.uk

This guidance has been reviewed and adapted by healthcare professionals across the Black Country Integrated Care System.

What should you do?

To make your child more comfortable, you may want to lower their temperature using paracetamol and/or ibuprofen. If you've given your child ibuprofen and they're still in pain 2 hours later, you could try giving them paracetamol as well. If this works, you can alternate paracetamol and ibuprofen, giving only 1 medicine at a time.

ibuprofen and paracetamol dosing chart.png

Do not give more than the maximum daily dose of either medicine. However, remember that fever is a normal response that may help the body to fight infection and paracetamol/ibuprofen will not get rid of it entirely. Paracetamol and Ibuprofen bring down the temperature but do not treat the infection so whilst the child is unwell they will continue to get temperatures once the effects of the medication have worn off. 

Avoid sponging your child – it doesn’t actually reduce your child’s temperature and may cause your child to shiver.

Encourage them to drink plenty of fluids.

If a rash appears, do the glass test.

How long will your child’s symptoms last?

Fever caused by a viral infection tends to improve within 2 to 3 days.

If your child’s fever lasts for more than 5 days, get them seen by your GP.

The chart below shows how long fever lasts in a child with viral infections. The faces represent 10 children who have seen their GP with a viral infection. Green faces are those children whose fever has recovered within that time period.

Where should you seek help?

Health visitors are nurses or midwives who are passionate about promoting healthy lifestyles and preventing illness through the delivery of the Healthy Child Programme. They work with you through your pregnancy up until your child is ready to start school.

Health Visitors can also make referrals for you to other health professionals for example hearing or vision concerns or to the Community Paediatricians or to the child and adolescent mental health services.

Contact them by phoning your Health Visitor Team or local Children’s Centre.

Sound advice

Health visitors also provide advice, support and guidance in caring for your child, including:

  • Breastfeeding, weaning and healthy eating
  • Exercise, hygiene and safety
  • Your child’s growth and development
  • Emotional health and wellbeing, including postnatal depression
  • Safety in the home
  • Stopping smoking
  • Contraception and sexual health
  • Sleep and behaviour management (including temper tantrums!)
  • Toilet training
  • Minor illnesses

For more information watch the video: What does a health visitor do?

School nurses care for children and young people, aged 5-19, and their families, to ensure their health needs are supported within their school and community. They work closely with education staff and other agencies to support parents, carers and the children and young people, with physical and/or emotional health needs.

Contacting the School Nurse

Primary and secondary schools have an allocated school nurse – telephone your child’s school to ask for the contact details of your named school nurse.

There is also a specialist nurse who works with families who choose to educate their children at home.

Sound Advice

Before your child starts school your health visitor will meet with the school nursing team to transfer their care to the school nursing service. The school nursing team consists of a school nursing lead, specialist public health practitioners and school health staff nurses.

They all have a role in preventing disease and promoting health and wellbeing, by:-

  • encouraging healthier lifestyles
  • offering immunisations
  • giving information, advice and support to children, young people and their families
  • supporting children with complex health needs

Each member of the team has links with many other professionals who also work with children including community paediatricians, child and adolescent mental health teams, health visitors and speech and language therapists. The school health nursing service also forms part of the multi-agency services for children, young people and families where there are child protection or safeguarding issues.

If you’re not sure which NHS service you need, call 111. An adviser will ask you questions to assess your symptoms and then give you the advice you need, or direct you straightaway to the best service for you in your area.

Sound advice

Use NHS 111 if you are unsure what to do next, have any questions about a condition or treatment or require information about local health services.

For information on common childhood illnesses go to What is wrong with my child?

A&E departments provide vital care for life-threatening emergencies, such as loss of consciousness, suspected heart attacks, breathing difficulties, or severe bleeding that cannot be stopped. If you’re not sure it’s an emergency, call 111 for advice.

Sound advice

  1. Many visits to A&E and calls to 999 could be resolved by any other NHS services.
  2. If your child's condition is not critical, choose another service to get them the best possible treatment.
  3. Help your child to understand – watch this video with them about going to A&E or riding in an ambulance
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