Child fever: when to see a doctor and when it's safe to wait

Fever is one of the most common reasons parents bring children to Toongabbie Doctors, and one of the most common causes of a sleepless night. A raised temperature is the body's normal response to infection and, on its own, is rarely harmful. What matters is how your child looks and behaves, and whether any warning signs are present.

What counts as a fever

A temperature of 38°C or higher is a fever. The number itself is less important than how your child is: a child with 39.5°C who is drinking, playing between doses of paracetamol and settling to sleep is usually less concerning than a child with 38.2°C who is floppy, pale and refusing fluids.

Managing fever at home

• Offer fluids often: breastmilk, formula, water or oral rehydration solution. Small sips frequently are fine.
• Dress your child lightly and keep the room comfortable. Do not bundle them up or use cold baths.
• Paracetamol or ibuprofen can be given for discomfort, at the dose on the packet for your child's weight. Ibuprofen is not for babies under three months or children who are dehydrated.
• Let them rest, and keep them home from school or childcare until the fever has gone for 24 hours.

Fever medicines are for comfort, not to "bring the number down". A child who is happy with a temperature does not need them.

See a GP today if your child

• Is under three months old with any fever
• Has had a fever for more than 48 hours, or it keeps returning
• Is drinking much less than usual or has fewer wet nappies
• Has ear pain, a sore throat with difficulty swallowing, or pain passing urine
• Has a rash, especially one that appeared with the fever
• Is unusually drowsy or irritable, or you are worried

We keep same-day appointments for unwell children. Call (02) 7813 6000 from 8am and tell reception your child has a fever.

Call 000 or go to emergency if your child

• Is hard to wake, limp or unresponsive
• Has a rash that does not fade when you press a glass against it
• Is having trouble breathing, breathing very fast or grunting
• Has a seizure (a febrile convulsion)
• Has a stiff neck, a bulging soft spot, or is sensitive to light
• Has a fever after returning from overseas travel

Westmead Children's Hospital is our nearest paediatric emergency department. Healthdirect nurses are available 24 hours on 1800 022 222 if you are unsure.

Febrile convulsions

About one in thirty children between six months and five years will have a seizure with a fever. It is frightening to watch but usually stops within a few minutes and does not cause lasting harm. Place your child on their side on a safe surface, do not put anything in their mouth, note the time and call 000 if it lasts more than five minutes or it is the first one.

Common causes of fever in children

Most fevers in Toongabbie children are caused by viruses: colds, flu, RSV, hand-foot-and-mouth disease, roseola and gastro. Bacterial causes such as ear infections, tonsillitis, urinary tract infections and, less commonly, pneumonia need antibiotics, which is one reason a GP assessment is valuable when a fever persists. Fever is also expected for a day or two after some vaccinations, particularly the meningococcal B and MMR vaccines.

Fever after immunisation

A mild fever within 48 hours of a vaccine is a normal sign that the immune system is responding. Paracetamol before and after the meningococcal B vaccine is specifically recommended for babies to reduce fever. If a fever after immunisation is high, lasts more than two days or is accompanied by other symptoms, treat it like any other fever and see your GP.

Taking a temperature accurately

For babies under three months, a digital thermometer under the arm is the safest option. For older babies and children, an ear thermometer or a digital thermometer under the arm or in the mouth works well. Forehead strips are unreliable. The exact reading matters less than the trend and how your child looks, but it is useful to note the temperature and time when you call reception or Healthdirect.

Antibiotics and fever

Antibiotics do not treat viral infections and will not bring down a viral fever. Your GP will prescribe them only when a bacterial cause is likely, because unnecessary antibiotics cause side effects and contribute to resistance. If your child is prescribed antibiotics, finish the course even when they feel better.

After the fever

Most childhood fevers are viral and settle within two to three days. If your child is recovering slowly, has a lingering cough or you would like reassurance, book a bulk billed appointment with Dr Shirazi, who focuses on children's health.