Few things cause as much worry for parents as a child with a fever. The flushed cheeks, warm forehead and droopy eyes often send caregivers into a spiral of concern. Although fevers can seem alarming, they are usually the body’s natural way of fighting off infection.
“Fever is not an illness in itself but a sign that the immune system is working to protect the body,” says Meichi Quek, a general paediatrician at Aga Khan University Hospital in Nairobi. “It’s a common reason why parents bring children to hospital, but in most cases, it’s not a cause for panic.”
A fever is generally considered to be a body temperature above 37.5 degrees Celcius. It is often triggered by infections such as colds, flu or ear infections. Think of it as the body’s way of creating an inhospitable environment for germs, which thrive at normal temperatures.
Globally, fever remains one of the top five symptoms prompting visits to paediatric health facilities. According to Unicef, nearly 40 per cent of outpatient visits for children under five in low- and middle-income countries are fever-related.
The Ministry of Health reports show that fever-related illnesses, particularly malaria, respiratory infections and viral fevers account for nearly half of paediatric consultations in public hospitals.
Knowing how to measure your child’s temperature correctly is a key step in managing fever. For babies under three months, use a digital thermometer placed in the armpit or rectum. Rectal readings are the most accurate at this age. For children between three months and five years, armpit, ear or forehead thermometers are suitable.
Over the age of five, oral thermometers can be introduced, though ear and forehead readings are also acceptable. Avoid old-fashioned mercury thermometers or temperature strips, as they are less accurate.
Dr Quek points out that parents should not worry about reading the number on the thermometer alone. “What matters more is how the child is acting. If they’re playful, drinking fluids and generally alert, the fever is unlikely to be dangerous.”
Still, there are moments when medical attention is necessary. If a child under three months develops any kind of fever, a doctor should be consulted immediately. Older children with a high fever above 39 degrees Celsius that does not respond to medicine, or a fever lasting more than three days, should also be checked by a health professional.
Other warning signs include difficulty breathing, a stiff neck, persistent vomiting, a rash that does not fade under pressure or if the child is unusually sleepy or irritable. In such cases, trust your instincts. “Parents know their children best. If something feels off, don’t hesitate to call your doctor,” Quek advises.
Many parents associate teething with fever, but experts say this is a common misconception. “Teething may cause drooling, fussiness or a slight rise in body temperature, but it does not cause a true fever,” states the American Academy of Paediatrics. The UK’s National Health Service (NHS) echoes this, noting that if a baby has a fever of 38 degrees Celsius or higher while teething, it is likely due to an underlying infection rather than the teething process itself.
There are several simple measures to help a child feel better at home. Keep them well hydrated with water, diluted juice or oral re-hydration drinks. Babies should continue breastfeeding or taking formula. Dress them in light clothing and avoid bundling them in heavy blankets, which can trap heat and worsen the fever.
Fever-reducing medication such as paracetamol or ibuprofen can help relieve discomfort, but dosing should always follow the instructions on the label or your doctor’s advice. If your child is sleeping peacefully, it is usually not necessary to wake them for medication.
One of the more frightening experiences for parents is a febrile seizure. These are convulsions that may occur when a child’s temperature rises rapidly, not necessarily when it is very high. Most common in children aged six months to five years, febrile seizures are usually harmless, though they look severe.
“About two to five per cent of children will have at least one febrile seizure in their lifetime,” according to the US Centres for Disease Control and Prevention. “While scary to witness, most febrile seizures last less than five minutes and don’t cause long-term health problems.”
“If your child has a seizure, stay calm. Place them on their side to prevent choking and don’t put anything in their mouth. Time the seizure, it usually lasts less than five minutes,” Quek explains. Afterwards, seek medical advice to rule out other possible causes.
Although fever cannot always be prevented, there are steps you can take to reduce the risk.
Keeping up to date with vaccinations is one of the most effective ways to guard against illnesses that cause fever. Good hygiene, including regular handwashing and teaching children to cover their mouths when coughing or sneezing, also plays an important role. Avoiding contact with sick individuals, especially in infancy, can provide added protection.
One mistake parents often make, according to Quek, is focusing too much on bringing the fever down rather than making the child comfortable. “Fever is a symptom, not the problem itself. It’s the body’s way of healing. If you overuse medication or wrap your child up too tightly, you might actually make things worse.”
She adds that panicking at the first sign of temperature can lead to unnecessary hospital visits and anxiety. Instead, she encourages parents to observe the whole picture, including the child’s behaviour, eating habits and other symptoms.
In most cases, fever in children is mild and short-lived but it is natural to worry. “It’s okay to feel anxious,” Dr Quek reassures. “Just remember you’re not alone, and help is always available.”
With the right knowledge, parents can manage fever calmly and effectively at home. By staying informed, following safe care practices, and seeking help when needed, you are giving your child the best chance to recover quickly and comfortably.
