Fever / high temperature
Fever is extremely common in children and usually suggests your child has an infection.
If you use a thermometer to measure your child’s temperature, it’s really important that you do it accurately. You should use a digital thermometer (under the armpit for children aged five years and younger, and in the mouth for children aged over five years). The other option is to use an in-ear thermometer (tympanic), although these should not be used in babies below one month old.
- Viral infections are far more common than bacterial infections.
- Symptoms such as runny nose, cough, wheeze, sore throat, red eyes and diarrhoea are more likely to indicate a viral infection than a bacterial infection. If a number of people are unwell in the same household, this also suggests a viral infection (viral infections are easily spread).
- Fever is common in babies up to 48 hours after receiving immunisations. It is OK to give paracetamol after the meningitis B (MenB) vaccine without seeking medical advice if your baby is otherwise well.
- Occasionally, children with fever can have a seizure or fit. This is called a febrile convulsion and most commonly occurs in children aged between six months and three years. They generally occur on day one of the fever, and in most cases have no long-term effects.
- Viral infections tend to get better on their own and do not need treatment with antibiotics. Antibiotics may actually cause side effects such as rash and diarrhoea and can increase the risk of your child developing antibiotic resistance.
Check if your child has any red symptoms:
- Your child 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 or seizure.
- Becomes extremely agitated (crying inconsolably despite distraction), confused or very lethargic (difficult to wake).
- Has a stiff neck (cannot bend their neck to touch their chin to their chest).
- Develops a rash that does not disappear with pressure (the ‘Glass Test’).
- Is under three 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) – how to take your child’s temperature.
Actions to take if your child has any red symptoms
- Your child may require emergency treatment.
- You should call 999 or take them to your NEAREST Emergency Department where they can be assessed.
If there are no red symptoms, check if your child has any amber symptoms:
- Your child is finding it hard to breathe.
- Seems dehydrated (sunken eyes, drowsy or not passed any urine for 12 hours).
- Is becoming drowsy (excessively sleepy) or irritable (unable to settle them with cuddles, toys, TV or snacks) – especially if they remain drowsy or irritable despite their fever coming down.
- Extreme shivering or complains of muscle pain.
- Is three to six months of age with a temperature of 39°C / 102.2°F or above (please note fever is common in babies up to two days after they receive vaccinations) – how to take your child’s temperature.
- Continues to have a fever of 38.0°C or more for more than five days.
- Is getting worse or if you are worried.
Options if your child has any amber symptoms
Your child does not need to be taken to the Emergency Department immediately, but you should seek medical advice today.
- ring your GP surgery during their usual opening hours
- contact the out of hours GP if the surgery is closed
If symptoms continue for four hours or more and you have not been able to speak to your GP or the out of hours GP, consider going to your nearest Emergency Department.
If your child develops any of the red symptoms above, go to your nearest Emergency Department.
If no red or amber symptoms are present:
- your child does not seem to have any symptoms of serious illness or injury
- you can get general advice on the NI Direct website or from your local pharmacy
If your child develops any of the red or amber symptoms above, follow the advice in these sections.
How you can help manage your child’s fever at home
- Please see the comprehensive NI Direct information on fever in children.
- If your child is distressed, you may want to lower their temperature using paracetamol (Calpol) and / or ibuprofen (Nurofen). Use one medication and if your child has not improved two or three hours later, you may want to try the other one. However, remember that fever is a normal response that may help the body fight infection and paracetamol / ibuprofen will not get rid of it entirely.
- Avoid sponging your child with cold water – it doesn’t actually reduce your child’s temperature and may cause your child to shiver.
- Encourage your child to drink plenty of fluids.
- Click here for advice on fever in children under five years of age.
- Click here for advice if your child is older than five years.
- Fever caused by a viral infection will usually start to improve within two or three days.
- If your child’s fever lasts for more than five days, arrange an appointment with your GP.
- If it is non-urgent, speak to your local pharmacist or health visitor.
- Alternatively, you can contact your GP practice and a qualified member of the clinical team will check whether your child needs to be seen urgently. Out of hours GP details are available here.
- You should only call 999 or go your nearest Emergency Department in critical or life-threatening situations.
- See our section: How does the Children’s Emergency Department Work?