Fever in children: Home treatment and when to see a doctor

Fever is one of the most common reasons parents take their children to see a doctor. It can be scary to see your little one feeling unwell, but fever is often the body’s way of fighting off infections. I will answer some of the most frequently asked questions about fever in children so you can feel more confident managing it at home and know when to seek medical help.

What is a fever, and why does it happen?

A fever occurs when your child’s body temperature rises above the normal range (usually above 37.5 °C). It’s not an illness itself but a sign that the body is working hard to fight off an infection, like a cold, flu, or ear infection.

Think of fever as your child’s immune system turning up the heat to make it harder for germs to survive. While it can be uncomfortable, fever is usually a good sign that the body is doing its job!

How do I take my child’s temperature accurately?

Taking your child’s temperature might seem simple, but doing it correctly is important. Here’s a quick guide: For babies under three months, use a digital thermometer in the armpit (axillary) or rectum (rectal) . Rectal temperatures are the most accurate for this age group. For child aged above three months to five years, you can use an armpit, ear (tympanic), or forehead (temporal artery) thermometer. Armpit temperatures are less accurate but safer for young children. For children above five years: you can use an oral thermometer, but ear or forehead thermometers are also fine.

Avoid using old-fashioned mercury thermometers or strip thermometers as they are less reliable.

When should I worry about my child’s fever?

Most fevers are harmless and go away on their own. However, there are some “red flags” to watch out for. 

Age matters: If your baby is under three months old and has a fever (even a mild one), call your doctor immediately. Young babies are more vulnerable to serious infections. 

High fever: A fever above 39°C (102.2°F) can be concerning, especially if it doesn’t come down with medication. 

Duration of fever: If the fever lasts more than three days, it’s time to see a doctor. 

Other symptoms accompanying the fever: Watch for signs like difficulty breathing, a stiff neck, a rash that doesn’t fade when pressed, or your child is unusually sleepy or irritable.

If you’re ever unsure, trust your instincts and call your paediatrician.

How can I make my child feel better at home?

Keep them hydrated: Fever can lead to dehydration, so offer plenty of fluids like water, diluted juice, or oral rehydration solutions. For babies, continue breastfeeding or formula feeding.

Dress them lightly: Overdressing can trap heat and make the fever worse. A light layer of clothing and a thin blanket are usually enough.

Use fever-reducing medication: Paracetamol (acetaminophen) or ibuprofen can help lower the fever and ease discomfort. Always follow the dosing instructions on the label or as advised by your doctor.

Lukewarm sponge baths: If your child is very uncomfortable, you can gently sponge them with lukewarm water. Avoid cold water or ice baths as these can make them shiver and raise their temperature further.

Should I wake up my child to give them fever medicine?

It’s usually not necessary to awaken a sleeping child to give them medication. Sleep is important for recovery, and if your child is resting comfortably, it’s okay to let them sleep. However, if they’re very unwell or have a history of febrile seizures, your doctor may advise otherwise.

Can fever cause seizures?

Febrile seizures are scary but relatively common in children aged between six months and five years. Seizures happen when a child’s temperature rises quickly, not necessarily because it’s very high. During a seizure, your child may shake, lose consciousness, or roll their eyes.

If this happens, stay calm, place your child on their side to prevent them from choking, don’t put anything in their mouth, and time the seizure - most last less than five minutes.

After the seizure, call your doctor. While febrile seizures are usually harmless, it’s important to rule out other causes.

When should I take my child to the doctor?

Here’s a quick checklist of when to seek medical advice:

•    Your child is under three months old with any fever.

•    The fever lasts more than three days.

•    Your child has a high fever (above 39°C or 102.2°F) that doesn’t respond to medication.

•    They have other symptoms like a rash, vomiting, diarrhoea, or difficulty breathing.

•    Your child seems unusually sleepy, irritable, or unwell.

Remember, you know your child best. If something doesn’t feel right, don’t hesitate to call your doctor.

Can I prevent my child from getting a fever?

While you can’t prevent all fevers, you can reduce the risk of infections that cause them:

Vaccinate: Keep your child up to date on immunisations to protect against serious illnesses.

Practise good hygiene: Teach your child to wash their hands regularly and cover their mouth when they cough or sneeze.

Avoid sick contacts: Try to keep your child away from people who are unwell, especially if they’re very young.

What’s the biggest mistake parents make when managing fever?

One common mistake is over-treating the fever. Remember, fever is a symptom, not the problem itself. Focus on keeping your child comfortable rather than trying to bring the temperature down to normal. Overusing medication or bundling your child up too much can do more harm than good.

When in doubt, ask!

Fever can be stressful for parents, but with the right knowledge, you can handle it like a pro. Keep an eye on your child’s symptoms, trust your instincts, and don’t hesitate to reach out to your paediatrician if you’re worried.

Your child’s health is a team effort, and we are here to support you every step of the way. Stay calm, stay informed, and remember—most fevers are just a sign that your little one’s body is doing its job!

Dr Quek is a general paediatrician at Aga Khan University Hospital, Nairobi