Fever in Children: How to Care for Them and When to Worry

A hot forehead at two in the morning is enough to make any parent panic. Fever is one of the commonest reasons children see a doctor, and in the monsoon season it is also when dengue, typhoid and malaria are around. The reassuring part is that fever itself is not an illness. It is a sign that the body is fighting an infection, and most fevers in children are caused by common viral infections and settle in a few days. Knowing what to do, and which signs mean you should not wait, helps you stay calm.

What counts as a fever?

A temperature of 38°C (100.4°F) or above is a fever. A normal body temperature is around 36.5 to 37.5°C. Check with a digital thermometer: under the arm for older children, and in the armpit or by a method your doctor recommends for babies. A hot forehead alone is not accurate.

Common causes

• Colds, flu, sore throat and other viral infections
• Ear infections and urinary infections
• Gastroenteritis, see diarrhoea in children
• Childhood illnesses such as chickenpox and measles
• In the rainy season, dengue, typhoid and malaria
• Teething can cause a slightly raised temperature, but not a high fever
• Vaccines can cause a mild fever for a day or two

How to care for a child with fever at home

• Treat the child, not the number. If your child is playful and drinking, there is no need to bring the temperature down.
• Offer plenty of fluids: water, ORS, milk, soup and breastfeeds. Fever makes children lose water.
• Dress lightly, with a thin cotton layer, and keep the room comfortably cool. Do not bundle a child in blankets.
• Let them rest, and give light food if they want it.
• A lukewarm sponge is not necessary. Never use cold water, ice or alcohol rubs.

Fever medicines for children

• Paracetamol is the usual first choice for pain and discomfort with fever. The dose depends on your child’s weight, so measure it with the syringe or spoon that comes with the syrup, and do not give extra doses within the time gap on the label.
• Ibuprofen can be used for babies older than three months, and is best given with food. Avoid it if your child is dehydrated, vomiting or has asthma or kidney problems, unless a doctor has said it is safe.
• Never give aspirin to a child under 16, because it can cause a rare but serious illness called Reye’s syndrome.
• Do not give adult tablets, mixed or “double” medicines, or leftover antibiotics. Antibiotics do not help viral fevers.
• Do not combine several cold or fever products without checking, because many contain paracetamol, and accidental overdose can happen.

When to see a doctor immediately

• A baby under 3 months with a temperature of 38°C or above. This is an emergency.
• A temperature of 40°C or above
• Fever lasting more than 3 days, or going away and returning
• Unusual drowsiness, difficulty waking, floppiness or a high-pitched cry
• A stiff neck, severe headache, or discomfort looking at light
• A rash that does not fade when you press a glass against it
• Fast or difficult breathing
• A fit (seizure), particularly the first time. Febrile seizures in children aged 6 months to 5 years are usually harmless, but need medical review.
• Signs of dehydration: no tears, dry mouth, very few wet nappies
• Persistent vomiting, severe stomach pain, or pain when passing urine
• A child with a long-term illness or weak immunity
• Your instinct says that something is wrong

Fever in the rainy season

During and after the monsoon, a fever that lasts more than two to three days, especially with severe body aches, rash, headaches behind the eyes, shivering or vomiting, should be tested for dengue, malaria and typhoid. Do not treat blindly with antibiotics or injections from a local clinic. Avoid ibuprofen and aspirin when dengue is possible, and use paracetamol only until a doctor decides.

Key takeaways

• Fever is the body fighting infection, and the child’s behaviour matters more than the number.
• Fluids, rest and paracetamol in the right dose for the weight are enough for most fevers.
• Never give aspirin to children, and avoid unprescribed antibiotics.
• Babies under 3 months, very high fever, drowsiness, a non-fading rash or breathing trouble need urgent care.

Related medicines on Medimart

These are commonly used for fever and discomfort in children. Please check the dose for your child’s weight with a doctor or pharmacist.

• Paracetamol: the usual first medicine for fever and pain
• Ibuprofen: for fever and pain in children older than three months, when advised
• Oral rehydration salts (ORS): to prevent dehydration when a child has fever and vomiting

Prescription medicines are supplied only against a valid prescription. Please take them only as advised by your doctor.

Browse fever medicines and care products on Medimart with delivery across Pakistan. Prescription medicines are supplied only against a valid prescription.

This guide is for general information and does not replace advice from a doctor. If you are worried about your child, please see a doctor.