High temperature

A PDF version of High Temperature Pathway Guidance for Parents & Carers is available. If you would like to print out the Pathway information please do so from this document.

Is my child with a high temperature unwell?

A normal temperature is less than 37.5 C

The use of a digital thermometer gives the most accurate reading.

A high temperature alone in a child over 6 months is not a good guide to how ill the child is.

A high temperature in children and babies over 6 months is common and is usually due to a virus.  This usually gets better by itself within a few days.

Please note that very small babies may have low temperatures which may be worrying

How to take a temperature

What to use:

Digital thermometers are recommended

Ear thermometer (not for babies)

Forehead strips may be used by families, but not by health professionals

It is not always possible to find a cause for high temperature. This is common.

When should I seek help?

Baby under 3 months with a temperature above 38 C

Baby 3-6 months with a temperature above 39 C

For a baby or child over 6 months

If your child has any of the following seek immediate help

- Unusually sleepy or hard to  wake up

- Pale or mottled skin
(blotchiness, with different shades and colours)

- Unusual breathing or, an unusual cry

- A rash that doesn’t disappear with the tumbler test 

- Fits (convulsion)

- No wee or no wet nappy all day

- Headache

- Stiff neck

- Discomfort with bright lights

Call 999 immediately if your child shows signs of a life threatening illness which may include:

- Your child's colour becoming extremely pale or blue or both

- Your child becoming unresponsive or you are unable to rouse them

- Your child has a rash which you can see through a glass in the Tumbler Test

The Tumbler Test

If a rash appears, press a glass firmly against the skin.  If you can still see the rash through the glass call 999 immediately. (The PDF guidance includes an example image of this - Select Here to view the PDF)

What can I do practically at home?

- Offer small amounts of drinks (water/juice) often, or – aim for wee to be pale yellow

- If your child is breastfeeding continue as normal

- Keep the room cool (approx 18-20 C)

- Check your child regularly(including 2-3 times during the night)

- Do the Tumbler Test if your child has a rash

- Keep your child away from school or nursery while they have a raised temperature

What medications?

It is not necessary to use medicines to treat your child’s temperature. If your child has a fever and is distressed you can help to make them feel more comfortable by giving them either paracetamol or ibuprofen. Always follow the instructions on the bottle or packet or check with a health professional.

Paracetamol:
Do not give to babies under 2 months of age, unless advised by a health professional

Ibuprofen:
Do not give to babies under 3 months unless advised by a health professional

Asprin:
Do not give to children & young people under 16 years old

Antibiotics:
Do not give unless a bacterial infection is identified, the majority of children do not require antibiotics

People I can turn to for help

The key health professionals trained to help children with high temperature are; health visitors, school nurses, family doctors (GPs), out of hours doctors (CHoC), pharmacists, 111 and NHS Choices.

Friends and Family may be able to give advice.

What the health professional will do?

With you they will reach a clear understanding of your child's needs by:

- Listening to you and your child’s concerns

- Taking a full history

- Usually carrying out a physical examination (including breathing rate and pattern, heart rate, activity and hydration) and they may arrange to test a sample of wee


With you they will agree a plan based on national guidance (NICE)*

The plan will depend on:

- If the child is less than 6 months old

- If there are signs of illness that need treatment

-The need for further assessment

*NICE – National Institute for Health and Clinical Excellence (www.nice.org.uk)

The Plan

The plan will include:

- Where to look after your child – most will stay at home

- Advice on home care – including when to ask for help again

- Expected length of illness and likely outcomes

- If and when a review of your child is necessary this may be by your GP or in hospital

For some, the plan will include advice on:

- Further assessment or tests

- Attending nursery or school

- Referral to hopsital may be for assessment in the first place, but may lead to admission

You will always receive:

- A copy of this Health Builders High Temperature pathway

How will I know my child is better?

- The most common outcome for children with high fever is to return to normal without treatment

- The temperature will be normal (37.5◦C or less) within 5 days

- Drinking, eating, weeing and sleeping will be back to normal