Fever in Children


Dealing with Fever in Children



What is Fever?


Our bodies are usually between 36.5 and 37.5 oC.  A temperature over 37.5 oC is a fever.


Is Fever Bad?


Fever is usually a sign that our immune system is battling something.  Our bodies generate a fever during infection because it helps the immune system to fight infection.

About 1 in 30 young children will experience a febrile convulsion or “fever fit” at some point, usually triggered by a very rapid rise in temperature.  While it can be scary to see your child having a convulsion, febrile convulsions are not dangerous.


Should fever be treated?


Advertisers want us to fear fever, portraying fever as a big scary monster terrifying us and our children.  But remember – in reality, fever is part of our natural immune defence.  Fever is a sign that our immune system is battling something.

It is worth remembering that fever is not “the bad guy”.  The “bad guy” is the virus or bacteria causing the infection.  Fever is a “good guy” in our fight against infection.  Infections do not attack us with fever.  Our bodies generate fever to help fight the infection.

When we take paracetamol or ibuprofen during a fever, we often feel better.   People sometimes are surprised to learn that an unfortunate side effect of paracetamol and ibuprofen is that they also reduce our fever!


When should I seek help with a fever?


In the first 12 weeks of life, any child with a fever should be assessed at an Emergency Department.  In these early weeks, the presence of a fever has a higher likelihood of indicating a potentially severe bacterial infection.

In a child over 12 weeks of age, you child should be seen by a doctor if they look unwell, or if you are concerned.

One way of remembering some of the warning signs of potentially serious illness is “ABC In Out”.


“ABC In Out”


A = Alert, Active and Interactive


You want your child to be at least intermittently playing.  You want them making good eye contact, moving around, and letting you know what they want, and yes, even what they don’t want!  If your child is lethargic, disinterested in play, and not engaged in the world around them, they are potentially very unwell and need to be reviewed.


B = Breathing


When our children are screaming, laughing, or playing in the bath tub, you might notice that their ribs jut out, and the skin forms grooves or gullies between their ribs, under their ribs, and at the base of their neck above their breast bone.  This gullying between the ribs looks a bit like the ridged appearance of corrugated iron.  It indicates an increased work of breathing, and it’s normal when your child is upset or physically active.

However, when our children are at rest, there should be no gullying, and the chest and abdomen rise together as one.

If your child is at rest, but you still see gullying between the ribs or under the ribs, it means they are working hard to breathe, and they should be reviewed.


C = Colour


There are two colours which should always prompt review: WHITE or BLUE.

If your child looks blue, it means they are not oxygenating their blood very well, and they need to be seen by a doctor as soon as possible.

Some children look a little pale during every illness. That’s something you just need to learn about your child.  However, if your child looks uncharacteristically pale or white, they need to be promptly reviewed by a doctor.


Fluid In


Most children usually drink roughly double what they need to stay hydrated.  If your child’s fluid intake drops to half of their usual intake, they are at risk of dehydration and should be reviewed by a doctor.


Fluid Out


Reduced urine output is a sign of dehydration.  For children in nappies, if your child goes 12 hours without heavily soaking at least one disposable nappy, they are probably dehydrated and should be reviewed.

Finally, if in doubt, if you don’t fall foul of ABCInOut but you are still concerned, it is still sensible to seek help and see your GP.


So remember… Fever is our friend.  It helps fight infection, and alerts us to the fact that our body is probably battling an infection.   Paracetamol or ibuprofen may help us feel better during feverish illnesses, but we should be alert to signs that should prompt us to be reviewed by a doctor.


Written by Dr Nigel Grebert


If you’re living in the Hills district and your child is not feeling well, make a doctor’s appointment with us. Head over to our medical centre in Castle Hill.

1 thought on “Fever in Children”

  1. You did not mention that babies could actually be very sick without a fever.
    I have seen really sick babies who had no fever at all and were not taken to see a Dr as the parents did not think the child was sick as he/she had no fever. What about writing something about to be aware how fast the breathing in a baby is normal -or not?

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