Most fevers (high temperatures) in children are not serious and are due to the common infections of childhood such as coughs, colds and other viral infections. However, sometimes a fever is a symptom of a serious infection. If your child has a fever, give them lots to drink. It is not always necessary to give them paracetamol or ibuprofen, unless they are distressed or very unwell. Also, check for signs of dehydration (low body fluid) and serious illness (details below). Seek medical help if you are concerned.
A fever can make a child feel uncomfortable and irritable. The following are things that you can do that may bring the temperature down and make your child feel more comfortable:
Note: do not give both paracetamol and ibuprofen at the same time. However, on occasions, if a fever is difficult to control then, for each time a medicine dose is given, a doctor or nurse may advise alternating one of these medicines with the other. It is best only to do this alternating dose regime after assessment by a doctor or nurse.
Note: do not use ibuprofen for:
Do not cold-sponge a child who has a fever. This used to be popular, but it is now not advised. This is because the blood vessels under the skin become narrower (constrict) if the water is too cold. This reduces heat loss, and can trap heat in deeper parts of the body. The child may then get worse. Many children also find cold-sponging uncomfortable.
Some people use a fan to cool a child. Again, this may not be a good idea if the fanned air is too cold. However, a gentle flow of air in a room which is room temperature may be helpful. Perhaps just open the window, or use a fan on the other side of the room to keep the air circulating.
A fever caused by any illness may contribute to dehydration. The fever itself can cause more sweating, and some children who become irritable with a fever do not drink as much as they might need. In particular, dehydration can develop more quickly in a child who is vomiting or has a lot of diarrhoea. Encourage your child to have plenty to drink if they have a fever. Signs of dehydration include: a dry mouth, no tears, sunken eyes, drowsiness, and generally becoming more unwell. Seek medical help if you suspect that your child is becoming dehydrated.
A child with a fever may look quite unwell. He or she may be flushed and irritable. However, most bouts of fever are not caused by serious illness, and the temperature often comes down quickly. It is quite common to see a child happily playing an hour or so later when their temperature has come down and they have had a good drink. They will not be entirely back to normal, but it is reassuring if a child improves with the drop in temperature.
If a child has a serious infection they will usually get worse despite efforts to bring their temperature down. In addition, they may have other worrying symptoms. For example, breathing problems, drowsiness, convulsions, pains, or headaches which become worse. But - use your instincts. If you think a child is getting worse for any reason, or is developing a serious infection, then get medical help. Note: you should check on your child 2-3 times in the night if they have a fever, to make sure they are not developing a serious infection.
Two of the most serious infections are meningitis and septicaemia (blood infection). These are uncommon, and the vast majority of children with a fever do not have these infections (or other serious infections). However, meningitis and septicaemia need urgent treatment if they develop. Therefore, the following gives a guide as to symptoms to look out for.
Many children (and adults) who develop meningitis or septicaemia have 'nonspecific' symptoms at first, such as just feeling or looking generally unwell. However, three symptoms that commonly develop early on - often before the more classic symptoms listed later - are:
The rash that may occur is red or purple. Small spots develop at first and may occur in groups anywhere on the body. They often grow to become blotchy and look like little bruises. One or two may develop at first but many may then appear in different parts of the body. The spots/blotches do not fade when pressed (unlike many other rashes). To check for this, do the tumbler test. Place a clear glass (tumbler) firmly on one of the spots or blotches. If the spot/blotch does not fade and you can still see it through the glass, get medical help immediately. (Note: a rash does not occur in all cases of meningitis and septicaemia but can be quite characteristic when it does occur.)
The symptoms often develop quickly, over a few hours or so. They can occur in any order, and not all may occur. Sometimes symptoms develop more slowly, over a few days. The symptoms may suggest a less serious illness at first such as flu. But, even if you think it was flu to start with, if symptoms become worse then it may be meningitis or septicaemia.
Most fevers are due to infections that are not serious and do not last long. But, see a doctor if a child does not improve within a few days, or has any worrying symptom.
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