Fever in children under 5 years

• The most common reason for your child to have a fever is a viral infection. Viral infections usually get better on their own and do not need treatment.
• Some fevers are caused by bacterial infections.  Antibiotics can be needed to treat bacterial infections. 
• Fever can also be common up to 48 hours after some childhood immunisations. 
• Fever can sometimes be due to an inflammatory disorder and is not caused by infection.

• It is important to give your child plenty of fluids (drinks). If your child is still breast feeding, the best way to do this is with frequent breast feeds. 
• If your child is vomiting (being sick), give them small drinks often. This should be milk (breast or formula) in infants under 6 months of age. If your child is older but is not eating, make sure they have some sugary drinks.
• Watch your child for signs of dehydration. See the amber section of the table below ‘When Should I get Help’ for signs of dehydration in your child.
• To get medical advice call your GP or phone NHS 24
• Do not under or over wrap your child with clothes or blankets, dress them as you would normally. 
• Your child should not go to school or nursery while they have a fever. You should also let your school or nursery know about your child's fever. 
• Do not try to bring your child’s fever down with tepid (cool) sponging or fans.

• If your child is distressed with their fever, you can consider giving them paracetamol (Calpol) or ibuprofen. Give one medicine at a time. If your child has not improved after 2-3 hours you can consider giving the other medicine.
• Some children should not have ibuprofen, for example, children with chicken pox. If you don’t know whether you should give your child ibuprofen, ask your doctor.
• Follow the instructions on the medicine bottle to know how much to give and how often.  
• If your child has had too much medicine or takes it too often it can be harmful.
• Call NHS 24 (111) if you think your child has taken too much medicine.
• Do not give paracetamol or ibuprofen to babies under three months of age unless your doctor or health professional has told you to. (for example – after some immunisations)
• Ask your local pharmacist if you need more help and advice about medicines for your child

• Most fevers caused by a viral infection will get better after 2-3 days. Symptoms should gradually improve
• However, how long a fever lasts will depend on what is causing the fever

Advice for parents and carers of children younger than 5 years

If your child has any of these signs: Your child is pale, mottled (blotchy) skin or feels cold to touch Your child has blue lips Your child is finding it very hard to breathe – your child is grunting, or your child is too breathless to talk, eat or drink Your child has a fit or seizure Your child is not responding to you, your child is hard to wake up or your child cannot stay awake Your child has a weak, high-pitched or constant cry Your child has a rash that does not go away when you press on it (see 'The Glass Test’ below) Your child has a severe headache that doesn’t go away, your child has neck stiffness (doesn’t want to move their head) and, or your child has a bulging ‘soft spot’ Your child is under 3 months of age with a fever of 38°C or above (unless they have had their immunisations in the last 48 hours and they have no other red or amber features)

You need help now. Go to the nearest Hospital Emergency Department or phone 999

If your child has any of these signs: Your child is finding it hard to breathe - you can see their ribs or tummy moving while they are breathing. Your child has signs of dehydration including: sunken eyes, dry mouth, no tears when crying or has not passed urine (had a wee) for 12 hours. In babies the ‘soft spot’ on their head may be sunken Your child has swelling of an arm or leg or joint Your child finds it too painful to stand up on their own Your child is drowsy (very sleepy), your child does not want to play or is irritable – especially if your child is still like this after their fever settles Your child is shivering a lot or has muscle pain. Your child has a fever of 38.0°C or above for more than 5 days Your child is 3-6 months of age with a fever of 39°C or above Your child was starting to improve, and the fever settled, but the fever returns within the same illness Your child has a fever within 2 days of stopping antibiotics Your child seems to be getting worse, or you are worried

You should speak to a doctor or nurse today. Call your GP surgery or call NHS 24 - dial 111

If your child has none of the above signs	Self care You can keep looking after your child at home. If you are still concerned call NHS 24 – dial 111

Content adapted with permission from the what0-18.nhs.uk resource produced by the Healthier Together initiative