Managing fevers and febrile
convulsions
Information for patients, parents and guardians
A fever (high temperature) is very common in babies and children. Most fevers are caused by an
infection and children often have fevers with minor illnesses such as colds.
What is a high temperature?
• In children less than three months old a temperature of more than 38°C or (100.4°F)
• In children more than three months old a temperature of more than 38.5°C (101.3°F)
How to take your child’s temperature
The best way to take your child’s temperature is using a digital or chemical dot thermometer under
the armpit.
Does a fever mean my child is very ill?
Although it can be scary when your child’s temperature rises, fever itself causes no harm and can
actually be a good thing, as it’s often the body’s way of fighting off infection. In most cases a fever
should only be treated if it's causing discomfort.
A higher temperature is not always a sign of a more severe infection. It should be considered with
other factors relating to how well the child is, such as drowsiness, difficulty breathing and how much
they are drinking. It is also possible for children to have severe infections without a fever.
Causes of a fever
Most fevers in children are caused by a viral infection and the child will start to get better in a few days
without any treatment.
In some cases a fever may be the sign of a more serious infection which may be viral, bacterial or
caused by other infections.
The doctors and nurses will look for any clear signs of infection or reason for the fever. They will look
for a rash, check your child’s ears and throat and a sample of urine may be collected. Sometimes a
blood test may be required.
In most children, if there are no signs of a severe infection it will mean that a viral illness is causing
the fever.
Managing a fever
Follow this advice to manage your child’s fever and to help them feel more comfortable:
• It’s important for your child to drink small amounts of fluid (preferably water), little and often to
prevent them from getting dehydrated (not enough fluid).
• Ice lollies or jelly may be a good way of getting your child to take fluid if they don’t want to drink.
• Make sure your child is dressed comfortably, so that they aren't too cold or too hot.
• Do not sponge your child down with water as this can make them shiver and add to
their discomfort.
Pain relief
The current National Institute for Clinical Excellence (NICE) guidelines say that medicines should not
be given if the only reason is to reduce a temperature. You can give paracetamol and ibuprofen if your
child is distressed or in pain, following the instructions on the packet. Try not to give paracetamol and
ibuprofen at the same time. If you try one and it does not work, wait until it's time for your child to
have their next dose before trying the other one.
You should seek medical advice if your child:
• seems to be getting worse
• has a rash that does not go away when pressure is applied or a glass pressed over it
• is not taking enough fluids
• has excessive drowsiness or tiredness
• has a fever that lasts more than five days
• has other symptoms that you are concerned about
• has a febrile convulsion (see information on the next page)
Febrile convulsions
These are fits (seizures) that sometimes happen in young children when they have a fever. They look
frightening but are usually harmless.
Febrile convulsions happen in children aged six months to six years old and around 3% of children
(1 in 30) will have one febrile convulsion in their lifetime. Febrile convulsions can affect any child,
but occur more commonly if another close family member has had one or if the child has had
one before.
Most last for only a few minutes and do not need treatment. Children who have had a simple febrile
convulsion will be awake and acting normally within one hour of the convulsion finishing.
A third of children who have had a febrile convulsion will have more. Having a febrile convulsion does
not mean that your child has epilepsy.
What to do if your child has a febrile convulsion
• Lay them on their side, with their face turned sideways. This helps to keep the airways clear.
• Make sure they are in a safe area and cannot hurt themselves.
• Do not try to hold them still or stop the jerking movements.
• Do not put anything in their mouth.
• If the convulsion lasts for more than five minutes, dial 999.
If this is your child’s first febrile convulsion they should be seen by a doctor. If this is the second one (or
your child has had several), they do not necessarily have to see a doctor, but should do so if you have
any concerns.
There is no treatment or medicine that will prevent a febrile convulsion happening.
If you have any questions or concerns please contact
The paediatric assessment unit: 023 8120 3744
If you need a translation of this document, an interpreter or a version in
large print, Braille or on audio tape, please telephone 023 8120 4688 for help.
www.uhs.nhs.uk/childrenshospital
Version 3. Published March 2015. Due for review date March 2018. 2015-948(3)