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 then try to make your child
comfortable. For example, by giving them some paracetamol or ibuprofen,
and give them lots to drink. Also, check for signs of dehydration and
serious illness (details below). Seek medical help if you are concerned.
What causes a fever (high temperature)?
-
Viral infections
are the common cause. Virus infections cause many common illnesses such
as colds, coughs, 'flu, diarrhoea, etc. Sometimes virus infections
cause more serious illnesses.
-
Bacterial infections are less common than viral infections,
but also cause fevers. Bacteria are more likely to cause serious
illness such as pneumonia, urine and kidney infections, septicaemia and
meningitis.
-
Other types of infection are uncommon causes of a high temperature in the UK.
What can I do if my child has a fever?
- Make your child comfortable - details below.
- Check for signs of dehydration - details below.
- Check for signs of serious infection - details below.
- Keep your child off school or nursery until they are better.
- Seek medical help if you are concerned.
Make your child comfortable
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.
-
You can give paracetamol or ibuprofen.
Both of these medicines can lower a temperature. You can buy these
medicines in liquid form for children. They come in various brand
names. An alternative is to give soluble paracetamol in a drink. Note:
these medicines do not treat the cause of the fever. Also, do not give
both paracetamol and ibuprofen at the same time. However, it you try
one and it does not seem to work very well, you can try the other.
-
Take the clothes off the child if the room is normal 'room temperature'. It is wrong to wrap up a feverish child.
-
Give lots of to drink. This helps to prevent dehydration.
You might find that a child is more willing to have a good drink if
they are not so irritable. So, if they are not keen to drink, it may
help to give some paracetamol or ibuprofen first. Then, try them with
drinks half an hour or so later when their temperature is likely to
have come down. If breastfeeding then keep breastfeeding as breastmilk
is the best fluid. However, you can offer feeds more often to increase
amount of fluid.
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.
Look out for signs of dehydration
A fever
caused by any illness may contribute to dehydration (low body fluid).
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.
Look out for signs of serious illness
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 despite paracetamol or ibuprofen. 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 in the night if they have a fever, to make sure
they are not developing a serious infection.
Meningitis and septicaemia - what to look out for
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 of
meningitis and septicaemia to look out for.
Common early warning symptoms of meningitis and/or septicaemia
Many
children who are developing meningitis or septicaemia have
'non-specific' symptoms 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:
- Leg pains - which can become severe and prevent a child from standing or walking.
- Cold hands or feet - even if the child has a fever.
- Pale skin colour or mottled skin. In particular, pale, dusky or blue colour of the skin around the lips.
Rash - may occur with meningitis or septicaemia, but not always
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.)
Other symptoms that may occur in babies with meningitis or septicaemia
- Excessive crying - often high pitched or moaning and different to their usual cry.
- Fast breathing, or unusual patterns of breathing.
- Fever - but the baby may not look hot and the skin may look pale or
blotchy, or turn blue. The hands and feet may feel cold. The baby may
shiver.
- Will not take feeds - sometimes repeated vomiting.
- Being irritable - especially when picked up and handled. Normally a baby will be happier when picked up and held.
- Drowsiness or sleepiness - does not wake easily.
- The 'soft spot' on the baby's head may bulge out, instead of being indented. This is called a 'bulging fontanelle'.
- Jerky movements may occur and the body may appear stiff. Sometimes
the opposite occurs and the body appears floppy. Convulsions (fits)
sometimes develop.
Other symptoms that may occur in older children or adults with meningitis or septicaemia
- Fever and shivering - however, the hands and feet often feel cold.
- Stiff neck - cannot bend the neck forward.
- Headache - which can become severe.
- Fast breathing.
- Aches and pains in muscles or joints - the pains can become quite severe.
- The skin may look pale or blotchy, or turn blue.
- Dislike of bright lights - will shut eyes and turn away from the light.
- Drowsiness, confusion or odd behaviour - may appear 'vacant'.
- Repeated vomiting. Sometimes abdominal pain and diarrhoea.
The course of symptoms of meningitis or septicaemia
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. For example, fever, headaches, and vomiting are
common with many viral illnesses such as flu. Therefore, even if you
think it was flu to start with, if symptoms become worse then it may be
meningitis or septicaemia.
In summary
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.
Disclaimer: This article is for information only and should not
be used for the diagnosis or treatment of medical conditions. EMIS and
PiP have used all reasonable care in compiling the information but make
no warranty as to its accuracy. Consult a doctor or other health care
professional for diagnosis and treatment of medical conditions.
© EMIS and PiP 2008 Reviewed: 24 Jul 2008
