Fever/high temperature (3 months and over)

Fever is very common in children and can happen when your child has an infection. Most children recover quickly with no treatment. Please see red/amber/green tables in the when to worry section for advice on when and where to seek care for your child

  • Viral infections are far more common than bacterial infections.
  • Symptoms such as runny nose, cough, wheeze, sore throat, red eyes and diarrhoea are more likely with a viral infection. If several people are unwell in the same home, this also suggests a viral infection (because viral infections are easily spread).
  • Most viral infections get better on their own and do not need antibiotics. Antibiotics can cause side effects such as rash and diarrhoea and can increase the risk of them developing antibiotic resistance.
  • How your child is compared to their usual self is more important than what the temperature is.
  • Fever is common in babies up to 48 hours after immunisations - it is OK to give paracetamol after the MenB vaccine if your baby is otherwise well.
  • Occasionally, children with fever can have a seizure/fit. This is called a febrile convulsion and most often happens in children aged between 6 months and 3 years.

Operation Ouch has a video on fever that you and your child can watch together.

How to take a temperature

You should use a digital thermometer, which you can buy in supermarkets and
pharmacies.

This should be under the armpit for children 5 years and younger, and in the mouth
for children over 5 years of age.

You could also use an in the ear thermometer for children over six months of age.

 

When should you worry?

If your child has any of the following:

  • Is under 3 months old with temperature more than 38°C or under 36°C (unless fever in the 48 hours following vaccinations and no other red features)
  • Breathing very fast, too breathless to talk, eat or drink
  • Working hard to breathe, drawing in of the muscles below the rib or noisy breathing (grunting)
  • Is pale, blue, mottled or feels unusually cold to touch
  • Difficult to wake up, very sleepy or confused
  • Weak, high-pitched cry or can’t be settled
  • Has a fit (seizure)
  • Has a rash that does go away with pressure (see the 'Glass Test')

You need urgent help

Go to the nearest Hospital Emergency (A&E) Department or phone 999

If your child has any of the following:

  • Is 3-6 months old with temperature 39°C or above (unless fever in the 48 hours following vaccinations and no other red or amber features)

  • Temperature of 38°C or above for more than 5 days or shivering with fever (rigors)

  • Temperature less than 36°C in those over 3 months 

  • Breathing a bit faster than normal or working a bit harder to breathe

  • Dry skin, lips or tongue

  • Not had a wee or wet nappy in last 8 hours

  • Poor feeding in babies (less than half of their usual amount)

  • Irritable (unable to settle them with toys, TV, food or hugs even after their fever has come down)

  • Swelling of a limb or joint

  • Not using or putting weight on an arm, leg, hand or foot

  • Complaining of severe pain that is not improving with painkillers

  • Has had chickenpox in the past few days and is now getting worse with a high fever or spreading red rash

  • Getting worse or you are worried about them

You need to contact a doctor or nurse today

Please ring your GP surgery or call NHS 111 - dial 111

If symptoms persist for 4 hours or more and you have not been able to speak to either a member of staff from your GP practice or to NHS 111 staff, recheck that your child has not developed any red features

If your child has none of the above:

Self care

Continue providing your child’s care at home. If you are still concerned about your child, call NHS 111 – dial 111

This guidance has been reviewed and adapted by healthcare professionals across North East and North Cumbria with consent from the Hampshire development groups.

Choose appropriate sized spacer with mask (or mouthpiece if child is over 3 years with good technique and is not significantly short of breath).

 

 

  1. Shake the inhaler well and remove cap.

  2. Fit the inhaler into the opening at the end of the spacer.

  3. Place mask over the child’s face or mouthpiece in their mouth ensuring a good seal

  4. Press the inhaler once and allow the child to take 5 slow breaths between each dose or count to 10

  5. Remove the inhaler and shake between every puff. Wait 1 minute between puffs.

    Repeat steps 1 – 5 for subsequent doses
    Plastic spacers should be washed before 1st use and every month as per manufacturer’s guidelines

Videos on inhaler technique.

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Asthma Attack 2.jpg

  • Keep your child well hydrated by offering them lots to drink
  • Most children with coughs and colds do not require treatment with antibiotics. 
  • If your child seems to be in pain or discomfort, you can give your child Paracetamol or Ibuprofen, following the instructions on the container.
  • Do not give cough syrup. It is not recommended for children under 6 years. It can make children sleepy and does not help.
  • Try using saline nose drops or spray if your baby has a blocked nose.
  • For children over 2 years, vapour rubs (containing camphor, menthol and/or eucalyptus) may help children sleep better.

What should you do?

 

Keep checking your child for red and amber signs and seek help if they are there. 

  • Fever is a normal response that helps your child’s body to fight an infection.
  • If your child seems unsettled or uncomfortable, you may wish to give your child paracetamol or ibuprofen.
  • It can take 30 minutes for your child’s temperature to start to fall and for your child to start to feel better after taking paracetamol or ibuprofen.
  • If you have given your child one of these medicines and they are still uncomfortable 2 hours later you could try the other medicine.

Paracetamol

  • There are different types of paracetamol for children of different ages including 2 different strengths of syrup - infant and Six plus. Always read the dose instructions carefully. You must wait at least 4 hours between doses. Do not give more than 4 doses in 24 hours.

Ibuprofen

  • Ibuprofen is available in syrup and tablet form. Ibuprofen is not suitable for some children. If you are unsure whether your child can take ibuprofen, check with your pharmacist or doctor. Always read the dose instructions carefully. Don't give ibuprofen if your child has not had a wee in the last 12 hours. You must wait at least 6 hours between doses. Do not give more than 3 doses in 24 hours.
  • It can be normal for the temperature to go back up when the medicine wears off. 
  • Avoid tepid sponging your child. It doesn’t actually reduce your child’s temperature and may cause your child to shiver.
  • Encourage them to drink plenty of fluids.
  • If a rash appears, do the glass test.

 

How long will your child’s symptoms last?

  • Fever caused by a viral infection tends to improve within 2 to 3 days.

  • If your child’s fever lasts for more than 5 days, get them assessed by your GP

 

Where should you seek help?

A&E departments provide vital care for life-threatening emergencies, such as loss of consciousness, suspected heart attacks, breathing difficulties, or severe bleeding that cannot be stopped. If you’re not sure it’s an emergency, call 111 for advice.

Sound advice

  1. Many visits to A&E and calls to 999 could be resolved by any other NHS services.
  2. If your child's condition is not critical, choose another service to get them the best possible treatment.
  3. Help your child to understand – watch this video with them about going to A&E or riding in an ambulance

If you’re not sure which NHS service you need, call 111. An adviser will ask you questions to assess your symptoms and then give you the advice you need, or direct you straightaway to the best service for you in your area.

Sound advice

Use NHS 111 if you are unsure what to do next, have any questions about a condition or treatment or require information about local health services.

For information on common childhood illnesses go to What is wrong with my child?

GPs assess, treat and manage a whole range of health problems. They also provide health education, give vaccinations and carry out simple surgical procedures. Your GP will arrange a referral to a hospital specialist should you need it.

Sound advice

You have a choice of service:

  1. Doctors/GPs can treat many illnesses that do not warrant a visit to A&E.
  2. Help your child to understand – watch this video with them about visiting the GP or going to a walk in centre

For information on common childhood illnesses go to What is wrong with my child?

School nurses care for children and young people, aged 5-19, and their families, to ensure their health needs are supported within their school and community. They work closely with education staff and other agencies to support parents, carers and the children and young people, with physical and/or emotional health needs.

Contacting the School Nurse

Some primary and secondary schools may have an allocated school nurse, however this can vary depending on the area  – telephone your child’s school to ask for the contact details of your school nursing team.

There is also a specialist nurse who works with families who choose to educate their children at home.

North Cumbria

Northumberland

North Tyneside

Newcastle

Gateshead

South Tyneside

Sunderland

County Durham

Darlington

Hartlepool

Stockton

Middlesbrough

Redcar and Cleveland

Sound Advice

Before your child starts school your health visitor will meet with the school nursing team to transfer their care to the school nursing service. The school nursing team consists of a school nursing lead, specialist public health practitioners and school health staff nurses.

They all have a role in preventing disease and promoting health and wellbeing, by:-

  • encouraging healthier lifestyles
  • giving information, advice and support to children, young people and their families
  • supporting children with complex health needs

Each member of the team has links with many other professionals who also work with children including community paediatricians, child and adolescent mental health teams, health visitors and speech and language therapists. The school health nursing service also forms part of the multi-agency services for children, young people and families where there are child protection or safeguarding issues.

Health visitors are nurses or midwives who are passionate about promoting healthy lifestyles and preventing illness through the delivery of the Healthy Child Programme. They work with you through your pregnancy up until your child is ready to start school.

Health Visitors can also make referrals for you to other health professionals for example hearing or vision concerns or to the Community Paediatricians or to the child and adolescent mental health services.

Contact them by phoning your Health Visitor Team or local Children’s Centre.

North Cumbria

Northumberland

North Tyneside

Newcastle

Gateshead

South Tyneside

Sunderland

County Durham

Darlington

Hartlepool

Stockton

Middlesbrough

Redcar and Cleveland

Sound advice

Health visitors also provide advice, support and guidance in caring for your child, including:

  • Breastfeeding, weaning and healthy eating
  • Exercise, hygiene and safety
  • Your child’s growth and development
  • Emotional health and wellbeing, including postnatal depression
  • Safety in the home
  • Stopping smoking
  • Contraception and sexual health
  • Sleep and behaviour management (including temper tantrums!)
  • Toilet training
  • Minor illnesses

For more information watch the video: What does a health visitor do?

Pharmacists are experts in many aspects of healthcare and can offer advice on a wide range of long-term conditions and common illnesses such as coughs, colds and stomach upsets. You don’t need an appointment and many have private consultation areas, so they are a good first port of call. Your pharmacist will say if you need further medical attention.

Sound advice

  1. Visit a pharmacy if your child is ill, but does not need to see a GP.
  2. Remember that if your child's condition gets worse, you should seek further medical advice immediately.
  3. Help your child to understand - watch this video with them about going to the pharmacy.

For information on common childhood illnesses go to What is wrong with my child?

Self-care

You can treat your child's very minor illnesses and injuries at home.

Some illnesses can be treated in your own home with support and advice from the services listed when required, using the recommended medicines and getting plenty of rest.

Sound advice

Children can recover from illness quickly but also can become more poorly quickly; it is important to seek further advice if a child's condition gets worse.

For information on common childhood illnesses go to What is wrong with my child?

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