Fever in babies and children

It can be very worrying when your child has a fever, and it’s easy to want to keep checking the number on the thermometer. But children can have a fairly high fever without being particularly impacted, so it’s more important to keep an eye on their general state than it is to watch those numbers. However, if you have a newborn or infant under six months of age with a fever, you should always get a medical assessment.

What is a fever for a baby?

If the thermometer reads just over 38 °C or higher, we generally consider that a fever in infants, children and adults. Children get fevers fairly easily and it doesn’t have to indicate anything serious. Usually, a fever occurs alongside a cold– that is, in the presence of the sniffles. Slightly older kids can still be on the move and relatively unaffected by a fever, even with a temperature of a bit over 38 °C, which may seem inconceivable to an adult, who would likely be bedridden with that same temperature. On the other hand, it’s quite common for a feverish baby to be fussier and to sleep more fitfully than usual.

What to do when your child has a fever

If the fever is mild, you can help your child by:

• Removing some of their clothing.
• Keeping the room cool.
• Not using a thick blanket for sleep.
• Offering liquids regularly. Try options that your child enjoys, like juice or a popsicle.
• Guide the child towards quiet play, and above all: let them decide how much they can handle.

When is it time for a fever reducer?

A fever itself isn’t dangerous; fever is the body’s way of fighting infection. So as long as your child is getting enough liquids and calories, and feels well enough otherwise, there is no particular reason for trying to reduce a fever. Nor will a fever reducer offer any protection from fever cramps.

However, it is usually easier to take in calories when a fever isn’t too high. If your child is eating and drinking less than usual, has pain, or seems to be affected by the fever in some other way, you can try a fever reducer specifically intended for their age. Babies under six months should not be given fever reducers without first consulting a medical professional.

What does ‘general state’ mean?

In a medical context, you will often hear the phrase ‘general state’, which is simply an overall assessment of health. When babies are too young to express how they feel in words, it is particularly important to consider their general state. Here’s what to watch for:

• Your baby should respond normally to social cues: they should be interested in play or other things happening in their surroundings in between periods of rest.
• Baby should have the same tension in their body as usual – their muscles shouldn’t be overly lax.
• Breathing should be normal.
• The skin and lips should be the same colour as usual.
• You should be able to wake your baby as easily as usual, at which point they should respond to social cues.
• Baby should smile, laugh, or be content at regular intervals.
• They should be willing to eat and especially drink. You can check the fluid intake of infants when they pee. This isn’t always easy to see in a baby, but if their nappy has a wetness indicator, you should see that it has changed colour.
• Crying or screaming should sound the same as usual.

If the baby’s general state is bad and a fever reducer doesn’t help, you should seek medical attention the same day. Babies over six months who have a good general state can often get better at home. But if the fever is drawn out or returns for another bout, your child should see a doctor.

Fever cramps (febrile seizure) in babies and children

Some babies and children might have fever cramps, also called febrile seizures, in conjunction with a sharply rising fever. If this happens, the child’s body will become stiff, they will have muscle spasms in their arms and legs, and they may briefly become dazed. Fever cramps aren’t dangerous, but they can look alarming. Try to calm your child by being calm yourself and cuddling them, but don’t try to stop a cramp, for example by firmly holding their arms or legs. The cramps will pass within a minute or two. While this isn’t dangerous, you should always seek emergency medical care to rule out any other possible cause of the seizure; sometimes you may need to stay at the hospital overnight.

Fever, but no cold

A fever is often part of a cold, but if your child only has a fever and no sniffles, you should keep an extra eye on them. Sometimes it’s just a completely harmless, but contagious case of roseola infantum, but if so, the fever will always disappear after a few days. A high fever with no cause might also be part of another infection, such as a urinary tract infection – which often needs to be treated. So if your child has a fever with no apparent cause, you should contact your clinic. The same applies if you are worried, or if you have a feeling that something isn’t right: always contact a doctor.

Please note that all information above is based on Swedish recommendations.