Fevers are a common occurrence in childhood and parents should not panic when it occurs, but also at the same time, be cautious and patient when managing it. Here are some tips and tricks to consider as well as some considerations we do have as doctors when we are managing children with fever – they include the temperatures to look out for, how to manage them without and with medications and some practical tips at home to look after your child. 

Check out the table of contents below to see what are the commonly asked questions and you can click to the relevant section for that answer or alternatively, you could read the whole post!

What temperature is a fever for a child?

There are various ways to measure temperature in a child – you could use a ear thermometer, armpit thermometer or rectal thermometer. The last method is the most invasive and generally least likely used by parents. Armpit thermometers can be pretty difficult to use in a struggling toddler so the easiest to use would be a quicker ear thermometer. Here I will be talking about ranges in reference to that. 

Is 37.7 degrees celsius a fever in a child?

Anything above 37.5 degrees celsius is considered a fever, so 37.7 degrees celsius is considered a low grade fever for a child and it could progress to a higher temperature from there or it could go down on its own. When you see this temperature in a child, you might not want to start giving medications for the fever yet because it could come down or if you do give and the temperature later goes up to something higher, you can’t give the medication until much later. 

Consider using a cold patch for the forehead or a cool shower for the child and monitor the temperature for another 30 minutes to an hour to see if it goes up again. 

Is 38 a fever in a child?

If you encounter the temperature going up to 38 degrees then the child is having a higher fever. At this point, apart from the cooling measures I mentioned above, assuming the child does not have any drug allergies, you could try paracetamol or panadol to bring down the fever. 

When is fever too high in a child?

The temperature for a child when he or she is having a fever can vary from 38 degrees all the way up to more than 41 degrees. If you have trouble managing the fever at home, you should bring your child to see a doctor to evaluate the possible causes of the fever. Generally the temperature can go up and down, all the way up to 39 degrees and beyond. If it goes above 40 degrees, it would be a good idea to see a doctor and if it goes beyond 41 degrees, your child might even need to go to the hospital. 

What is a dangerously high temperature for a child?

A dangerously high temperature is above 41 degrees. If it goes above 40 degrees but it intermittently comes back down with medications, you could find your trusted GP to see your child for evaluation. You might still be able to manage the fever at home after your doctor’s visit. If the fever goes beyond 41 degrees, consider going straight to the hospital for further evaluation. 

For a baby less than 3 months old, any fever, even above 38 degrees, warrants a visit to the hospital for further evaluation – to check for any lung infection, urine infection, or infection of the brain lining. 

How high is too high for fever in a toddler?

Similar to what I mentioned previously, if you have difficulty managing the fever and it consistently goes up to 40 degrees and beyond, see a doctor for a thorough check and examination. If it goes up to 38-39 degrees and you are able to manage it at home, you could consider monitoring it for a few hours before deciding how to proceed. 

sick child seeing doctor

How do you bring a fever down in a child?

If the fever is not brought down constantly throughout the day, the rapid rises in temperature can lead to febrile seizures or fever seizures, commonly known as fits. It is not the absolute temperature that triggers the fits but rather the rapid rise in temperature, that causes the fits. Which means it is crucial to keep the temperature down throughout the day if possible. 

Remember that the fever is the child’s response to an infection, which means he or she is mounting an immune response to it and fighting off the infection!

How to reduce fever in child naturally?

You could try a cold forehead compress, wiping the child down in a cool towel, or giving him or her a room temperature shower. Letting them wear lighter clothing which is more airy might be helpful and remember to get them to drink lots of water, this will also cool them down. 

How do you break a fever fast for kids?

To break a fever fast for kids, would be to make use of medications like paracetamol to bring it down. Depending on how high the temperature is, your child’s age, as well as any pre-existing allergies, you could also use ibuprofen syrup to bring down the fever, apart from paracetamol. Below I will briefly discuss how you could use both to keep the temperature down throughout the day. I will also talk about some caveats and why you might want to seek medical advice for the first time before trying.

girl drinking paracetamol syrup

What to do if paracetamol doesn’t reduce fever in my baby or child?

There are many considerations as to why paracetamol does not reduce the fever in your child. Firstly, the medication does take some time to work, so giving the paracetamol and then only checking 10 minutes later may look like it is not working. Generally after paracetamol is given, we are looking at checking the temperature about 1-2 hours later to see that it has come down, so in the meantime, you might need to use the cooling measures I mentioned as an interim.

Also, the dosage of the medication has to be sufficient. Sometimes for larger kids with heavier weights, the dosing suggested on the bottle might be insufficient as it is suggested based on age. The easiest estimation for dosing is usually what is recommended on the bottle. Remember that different bottles have different concentrations (some are 250mg/5ml, some are 125mg/5ml), so that does affect the dosing required. 

Oftentimes, when you bring your child to see a doctor and the paracetamol is prescribed, it is based on your child’s weight and the bottle concentration and the appropriate number of ml calculated for your child. So you might want to get that checked if you are worried the paracetamol ‘does not seem to work’.

Other obvious considerations would be if your child has been vomiting, especially sometimes after being given medications (or even spitting it out), then the medicine might not work. You could try suppositories, which are inserted into the rectum to bring the temperature down, but again, remember to get the dosage correct! 

Also see the intervals you are giving the paracetamol, it is generally given up to every 6 hours, but sometimes we do allow for it up to every 4 hours, depending on the age of the child. The shorter intervals between each dose might give a better chance of the fever coming down and staying down throughout the day. 

With all these considerations, if you are worried that you are not dosing correctly or would want to consider suppositories and have no experience of doing so, remember to seek advice from your trusted GP instead of worrying and struggling at home.

What do I do if my child’s fever won’t go down?

If your child’s fever does not go down, consider all the tips mentioned above about the paracetamol timing, dosing and intervals. Having ruled all of those out and you have given appropriate dosing at right intervals and regularly reviewed the temperature, the next possible step is to consider using ibuprofen together with paracetamol. 

Remember there are some caveats to this, which should be mentioned first. Most times when we advise this in a clinic, there is a medical background to the child that is being evaluated before we suggest this. There must be no drug allergies to the ibuprofen and paracetamol class and the child should be more than 1 year old. Also, the dosing of both medications must be appropriate either for the age or the weight of the child. 

If you have seen a doctor in a clinic and been given the medications (so the doses should be accurate), then it is a matter of how to administer it appropriately to keep the temperature down. We would usually recommend not to give both of them together because though it brings down the temperature quickly, it also means you cannot give anything for the next 6 hours in case the temperature comes up again. 

Here is a chart of how we would suggest alternating ibuprofen and paracetamol syrup to manage fever in a child. Give ibuprofen for when the temperature is more than 38.5 degrees, and/ or paracetamol when it is more than 38 degrees. After one medication is given, consider giving the next one 3 hours later, then repeat the first medication another 3 hours later. For instance, if you have given paracetamol at 8am in the morning, then alternate with ibuprofen at 11am and paracetamol again at 2pm. So you see that the interval between the 2 doses of paracetamol is 6 hours.

dosing schedule for kids fever medicine

Depending on the cause of the fever in your child (which is why we still do recommend to see a doctor for evaluation), you might have to alternate these medications for the first few days of the fever to keep the temperature down throughout. If you only decide to give the medications when the fever comes, you might find yourself having difficulty with managing the temperature the whole day. 

Should I let my toddler sleep alone with a fever?

It really depends on the cause of the fever and whether your child is responding well to the fever medications. If your toddler is very active during the day with a good appetite and generally sleeping well despite the fever, you do not have to break his or her sleeping routine by sleeping with them. You should always be able to monitor them, like for instance with a monitoring camera, should they wake up in discomfort or even wake up vomiting or coughing. 

On the other hand, if your child has very poor appetite and drowsy throughout the day, or you have brought your child to see the doctor and there may be a serious infection going on, you might want to opt on the side of caution and keep a close eye on your little one throughout the night. 

Should you use a blanket if you have a fever?

Try to keep the clothing light for your child or minimize the layers of blankets when he or she is sleeping, as this can prevent body heat from escaping and might worsen the chills. Consider light pyjamas and maybe one lightweight blanket for sleeping. 

How do I break my toddler’s fever while sleeping?

If you do notice the trend of the fever going up and down throughout the day, expect it to happen overnight as well, even if the temperature seems to have gone down just before your child goes to bed. We would sometimes recommend giving either paracetamol or ibuprofen syrup before the sleep to keep the temperature down overnight so that the child may sleep properly and recover well. This is especially so if the child has been waking up the past few nights with difficulty sleeping because of fever. If you have brought your child to see a doctor, you could consider giving syrup or suppositories just before you child goes to bed. 

febrile child with thermometer

Should I wake up my toddler with a fever at night to keep giving medicine?

Assuming you have given some medicine to bring down the fever before your child goes to sleep (even if there was not high fever just before bedtime), hopefully it can keep the temperature down for at least 8 hours overnight. If your child is sleeping well and does not wake up in discomfort, you might want to consider NOT waking up your toddler to check on his or her temperature and to keep giving medicine. 

If he or she wakes up because they are very uncomfortable because of the chills or the temperature, then quickly check on them with a thermometer and if it is high, give them the medications and some cold compress to help with the symptoms, in hopes of getting them back to sleep properly. 

Should I let my child’s fever run its course?

Like I mentioned before, if you do not actively try to bring down the fever and it keeps hitting higher temperatures, it might precipitate a fever seizure. So try all the measures I talked about, both with and without medications to bring down the fever. As for letting the fever run its course throughout, it really depends. 

Everything that I have mentioned so far is all about managing the fever, we have not even considered the CAUSE of the fever! That is why it is always a good idea to bring your child for a check with a doctor, to not only get the medications at the right dosing with the right usage, but also to evaluate what caused the fever in the first place. So, the answer is no, especially if you have no idea what is causing the fever. 

How many days with a fever is too many for a child?

The fever in a child could be from a whole host of reasons, as I will talk about below under causes but suffice to say, it could be from a flu infection, from stomach flu, from food poisoning, from urinary tract infection, from ear infection and the list goes on. If the fever was from a common cold, meaning the child has other florid symptoms like runny nose, cough, then sometimes the fever could last up to 5 days. 

We would usually advise parents (of course after seeing the doctor and getting a thorough and proper examination done), to continue monitoring the fever for the initial 5 days with medications and see if it comes down nicely. If it does not, the child needs to be brought in for evaluation again. This is also with the caveat that with the first visit, we did not spot anything dangerous that requires further management in the hospital (this could be anything from severe breathlessness from a common cold to even suspected brain infection). 

A fever with no localizing sources is even more dangerous, meaning the child does not have any other symptoms to suggest where the fever is coming from. Sometimes even with a doctor’s review, checking the throat, tonsils, ears, groin and we cannot elicit a possible cause, the end result might be to further monitor the temperature for the next 2-3 days. If the feverdoes not show any sign of coming down, then more tests will be required. In some cases, a hospital visit may be warranted also. 

Instead of bringing your child straight to the Children’s Emergency department in Hospital, it may be a good idea to check in with your trusted GP / Doctor first. After all, no one wants to wait in a busy Emergency Department. 

baby with high fever

How many days is too long for a child to have a fever?

If the fever has a source then beyond 5 days is too long, while if the fever has no source at all, beyond 3 days would be a need for a doctor’s evaluation. If in doubt on the cause or even how to manage the fever at home, opt on the side of caution and get help from your trusted GP.

Why do fevers spike at night?

Yes this is a common occurrence especially for children, that the fever temperatures do tend to go up at night. There are a variety of reasons for it, one could be that symptoms are generally more prominent at night before bedtime because there are fewer distractions than there are usually in the daytime. Covering up the child in multiple layers of blanket might be another reason that it worsens the fever. 

Also other possibilities considered is that the cortisol and adrenaline responses that you have during the daytime to mount the immune response is reduced at night, causing the temperature control to be reduced at night. Not to mention that parents are also anxious about the child at night being unable to sleep and likewise for them too. 

As I mentioned above, consider giving the medications just before bedtime (about 30 minutes to 1 hour) to get the temperature under control overnight and more importantly to let your child get a good long uninterrupted sleep at night. 

At what fever should I take my child to the hospital?

If the temperature goes above 41 degrees, go straight to a hospital. If it hovers around 39 to 40 degrees plus, you could still visit your neighbourhood GP and get some friendly advice on managing the fever as well as possibly diagnose the cause. He or she will refer you to the hospital if he assesses that to be the safer option.

What age is fever an emergency?

Any baby less than 3 months old with a fever of more than 38 degrees should go straight to the hospital for evaluation. Even if you do decide to bring to your GP or even community based paediatrician, he or she will most likely refer you to a hospital where more detailed and timely tests can be done for your child. 

When should I take my toddler to the hospital?

Apart from the absolute temperature to consider, and also the duration of the fever, think about other softer considerations that might suggest you need more help in a hospital setting. For example, if your child is very drowsy and not active like he or she usually is (even when the fever comes down), the appetite is very very poor (less than half the usual intake) or the diaper changes are significantly reduced from what it was previously, which means your child is very dehydrated. If in doubt and you are very worried, if your GP is not available or despite management for a few days and there is no improvement, it might be prudent to bring your toddler to the hospital. 

contact clinic when child is sick

What are the main causes of fever in children?

There are many causes of the fever, which is what the doctor has to evaluate during a visit. Most times they are related to some common cold infection, or it could be from a stomach flu, food poisoning, ear infection, urinary tract infection, skin infection, throat infection, eye infection. To cover more of these conditions and their possible presentations, there will be other relevant posts added to the resource library of articles for the children’s section so do look out for them. 

Why does my 2 year old have a fever and no other symptoms?

Sometimes it is possible for a child to have a fever and no other symptoms. Even despite our best efforts during a doctor’s consultation to find the cause, it might sometimes not be apparent at the first visit. The symptoms could simply have not appeared yet, it could appear 1-2 days later. Or in some cases, the fever might appear with no other symptoms and just go off on its own after 5 days. If in doubt, see your trusted GP to look out for dangerous causes of fever and if they have all been ruled out, you might be advised to monitor the fever for a set period of time – if it resolves then you do not have to pursue the cause but if the fever persists, it might be time for some tests. 

Even if the fever doesn’t settle after 1 to 2 days, and your child looks relatively well, there is no real need to rush to the Children’s Emergency Department. It would be better to check in with your trusted GP first for assessment and examination. 

Conclusion of Fever in Children

Hope this has been helpful in managing your child’s fever at home and also the appropriate steps to take next and when to do it. Always remember at the back of your head, what are the situations to bring your child to see a doctor or even go to the hospital.

Remember to always seek help with your trusted doctor, whether it be your GP or your pediatrician, if you have any doubt at all. 

At Paddington Medical Clinic, both Dr Zhang Huipei and Dr Lee Joon Loong are comfortable with treating common conditions such as fevers, runny nose, common cold, diarrhoea, rashes, in children. Being parents ourselves, we understand the anxiety of most parents, and we will do our best to help you help your child manage his or her fever. 
If you need to find us in Paddington Medical Clinic, just walk in during our clinic opening hours, or alternatively you can always book an appointment below.


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