A fever can be a sign of a more serious illness, although this is unusual.
About fever in children
A fever is generally considered to be a temperature of 38.0 degrees Celsius (°C) or above. Body temperature can vary slightly from one child to another. The important thing to focus on is how your child feels generally.
Children with a fever can become confused
Some children may become confused for a short period when they have a fever. When this happens, it is normally called delirium. Children may see, hear and feel things that are not really there, or their surroundings may appear different to them. This can be upsetting both for you and your child, but this state of confusion is harmless and tends to pass after a short while.
How to take your child’s temperature
There are a number of ways to take your child’s temperature, but not all are reliable.
The most reliable way to take the temperature of a child over the age of one year is in the ear using an ear thermometer. Alternatively, you can take the temperature rectally (in the bottom). This is recommended for children up to the age of one year.
You can buy thermometers at a pharmacy. To take a temperature reading from the ear you need a special ear thermometer. Read the instructions on the packaging or ask the pharmacy staff for advice.
If possible, get your child to rest for half an hour before you take a temperature reading. Use the same method each time. Take your child’s temperature in the morning and in the afternoon and write down the results.
How to take a temperature reading from the ear
Put a disposable cover over the probe of the ear thermometer. Gently pull your child’s ear upwards before inserting the thermometer into the ear. It is important that you position the thermometer so that it fits snugly into the ear canal. Otherwise, the reading you get may be too low. The probe will not reach as far as the eardrum, but it is the heat produced by the eardrum inside the ear that is measured.
How to take a rectal temperature
Put a little ointment or lubricant on the thermometer so that it slides more easily into the anus. The thermometer must be inserted one to two centimetres in order to get an accurate temperature reading. For babies up to the age of six months, only insert the very tip of the thermometer. It is important that your child lies still while you take the temperature, in order not to be hurt.
Clean the thermometer after each use.
When should I seek medical care?
A fever is not dangerous in itself, but it may be necessary to see a doctor about the cause of the fever. A fever often clears up on its own.
You should seek medical advice immediately at a health centre, paediatric clinic or emergency department if your child:
- is less than three months old and has a temperature of 38.0 °C or above.
- is between three and six months old and has a temperature of 39.0 °C or above.
- has a fever and appears very ill.
- has a febrile seizure for the first time.
- has a fever and appears to be in pain somewhere or cries inconsolably.
- does not want to drink anything or is showing signs of dehydration, such as a dry mouth or passing less water (urine) than usual.
Seek medical advice at a health centre if your child still has a fever after four days.
You can always call the telephone number 1177 if you are concerned about your child or are uncertain about whether or not to seek medical advice.
What can I do to help my child?
A child with a fever needs to stay at home in order to rest and recover. Your child does not need to rest in bed, but should avoid any physical exertion. The best thing to do is to let your child decide how much they want to do.
Children with a fever should drink frequently
A child with a fever needs to drink more than normal. Otherwise they may easily become dehydrated. Give your child water, diluted cordial or juice, for example, to drink. A child who has not drunk enough may become tired and out of sorts, and will pass less water than usual. A child should pass water several times a day.
Sometimes a child with a fever does not want to eat their normal food. There is no danger if your child has a somewhat reduced appetite for a few days. Give your child something that they like to eat and drink.
Make your child comfortable
It is common for children to shiver and to feel cold as the fever rises. They may also feel sweaty. Try to ensure that clothing and bedding are appropriate for your child’s temperature. If your child has a high fever, they may be more comfortable if the room is cool. It must not be cold, however. You can remove blankets and quilts for short periods, or you can cover your child with a thin sheet instead of a quilt as they sleep.
Give medication to reduce the fever if necessary
A fever is the body’s reaction to an infection and is a way for the body to defend itself. Therefore, do not give fever-reducing medication to children who have a fever but otherwise feel well.
If your child is upset, will not eat or drink, or has difficulty settling at night, you can give non-prescription fever-reducing and pain-relief medication containing paracetamol. For example, Alvedon or Panodil. These can be given from the age of three months, but always seek medical advice before giving medicine to a baby under six months old.
From the age of six months, children may be given medication containing the active ingredient ibuprofen, such as Ipren or Ibuprofen.
This medicine is available in a variety of forms to suit different age groups. Ask at a pharmacy what is suitable for your child. Follow the instructions on the packaging carefully, and do not combine different medications.
Avoid certain medications
Do not give a child with chickenpox and a fever medicines containing ibuprofen or other drugs from the NSAID or COX inhibitor group. In the case of chickenpox, these medications can increase the risk of rare but serious infections.
Children up to the age of 18 years should not take medicines containing acetylsalicylic acid (aspirin), unless prescribed by a doctor. Examples of such medicines are Treo and Bamyl. There is a risk of the child developing Reye’s Syndrome. This is a rare disease that can lead to severe brain damage, among other things.
Does my child need antibiotics?
Sometimes children may need antibiotics to treat the infection that has caused the fever. Antibiotics can help if the infection is caused by bacteria, but not if it is caused by a virus.
Should my child stay at home?
Children who go to preschool or school, for example, should stay at home until the fever has gone. Children must be lively enough to be able to participate in group activities for a full day before returning to preschool or school.
Can fever in children be prevented?
The most common cause of a fever in children is an infection caused by a virus or bacteria. Fever in itself cannot be prevented, but you can reduce the risk of your child picking up an infection. Infections are spread through small droplets in the air and by physical contact. It is difficult to avoid children becoming infected, but there are ways to reduce the risk of infections spreading:
- Wash your own hands and your child’s hands often. Before and after every meal and after visiting the toilet.
- Teach your child to sneeze into the crook of their elbow instead of straight ahead.
- Teach your child not to poke their fingers up their nose or into their eyes, because that is where viruses can most easily take hold.
- Get your child to play outside as much as possible, even in winter. Viruses spread more easily indoors.
Cigarette smoke leads to more respiratory infections
Children in environments where they breathe in cigarette smoke get respiratory infections more often than children in smoke-free environments. Cigarette smoke can affect the mucous membrane in the airways, making it easier for an infection to develop. Keep children away from environments where people are smoking.
Young children often develop infections
Children develop infections most easily between the ages of 7 and 18 months. Up to the age of 6 months, children have a certain amount of natural protection in the form of antibodies they got from their mother towards the end of pregnancy.
Children up to the age of 2–3 years can have as many as 12 viral infections each year.
Examination to determine the cause of a fever
The doctor will first check how your child feels. Your child will usually have to sit on your lap while the doctor examines their throat and ears and listens to the heart and lungs. The doctor will also feel your child’s neck and throat. Sometimes your child will have to lie down so the doctor can feel their tummy. Sometimes the doctor will also check your child’s muscles and joints.
The doctor may sometimes need to take samples to determine what sort of infection your child has. A throat swab can show whether or not your child has streptococci, which are bacteria found in the throat. Sometimes a urine or blood sample is also taken. Blood samples are taken by means of a fingerstick or a needle inserted into the crook of the elbow.
If necessary, your child will be referred to a children’s clinic, potentially for further tests.
You have the right to understand
In order for you to participate actively in the care you receive and make good decisions, it is essential you understand the information you are given by healthcare professionals. If you do not understand, ask questions. If you prefer, ask them to print out the information so that you can read it in the peace and quiet of your own home.
If you do not speak Swedish or if you have a hearing impairment, you may be entitled to the help of an interpreter.
How a fever works
The body regulates its own temperature and works best at a temperature of between 36.0 °C and 38.0 °C. Your body temperature varies throughout the day. It tends to be lowest at night and highest in the afternoon.
A fever is the body’s normal reaction to infections that are caused by viruses or bacteria. In order to defend itself against viruses and bacteria, the body raises its temperature. Viruses and bacteria find it more difficult to multiply at temperatures above 37.0 °C.
A fever is common with viral infections such as colds, coughs and sore throats.
Febrile seizures are rare
When they have a fever, it is possible for children to have febrile seizures. Most children never have seizures, even if they have a high fever. It can be upsetting when a child has a seizure, but it is not dangerous.
When a child has a febrile seizure for the very first time, you must seek medical advice for your child immediately at a health centre or emergency department. This is to rule out the seizure having been caused by something other than the fever.