Fever in Children (High Temperature), Causes and Treatment, Patient

Fever in Children High Temperature

Dr Sarah Jarvis MBE, Reviewed by Dr Colin Tidy | Last edited 18 Feb 2020 | Certified by The Information Standard

A fever occurs when your child’s body temperature is higher than normal. Normal body temperature varies a little, but a temperature above 38°C is considered a fever.

Fever in Children

High Temperature
In this article

Why does it happen?

Fever in young children usually means that they have an underlying infection. This understandably worries parents and carers.

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  • Most fevers in young children over 6 months of age are not serious.
  • Fever in children aged 3-6 months has a higher chance of being serious. You should seek medical advice if the temperature is 39°C or more.
  • Fever in a baby aged less than 3 months is unusual and worrying. You should seek medical advice if the temperature is 38°C or more.

When young children have a fever, if can be difficult for parents to work out why. In most cases, the fever is due to a non-serious viral infection. Many viral infections that affect young children cause a fever of up to 48 hours in duration before other symptoms develop. A small number of common viruses cause fevers that last longer than this.

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Why do children get fevers?

The most common causes of fever in children in the UK are viral infections. There are many other uncommon causes.

Our normal body temperature is around 37°C. Our temperature can go up and down a little, around this figure, during the day. Children’s temperatures can easily rise slightly with things like hot baths, exercise and wearing overly warm clothes. Teething often increases a toddler’s temperature by 0.5°C.

Fever is a part of the body’s natural defences against infection. Fever is created by your immune system under the direction of a part of the brain called the hypothalamus. The hypothalamus acts like a central heating thermostat. Fever happens when the hypothalamus sets the body temperature above its normal level.

It does this in response to an infection with germs, usually because it detects the presence of infectious agents like bacteria or viruses. It is believed that the increased temperature is a protection the body has developed to help fight the germs that cause infections, as they tend to multiply best at normal body temperature.

How does the body create a fever?

The mechanism through which the body increases its temperature is by reducing heat loss. We sweat less and feel dry to the touch, we shiver (the movement tends to increase temperature) and, because we feel as though we are cold, we curl up and seek different ways of warming up. The blood vessels in our skin shrink to preserve heat loss, so we look pale.

All of this is why, as the temperature is rising to meet the directions of the thermostat, we are hot to the touch but we feel that we are cold. During this stage of a fever your child will not be pleased when you try to cool them down, as they will already feel as though they are cold.

Eventually, the body’s temperature reaches the new ‘thermostat’ setting, and the feeling of being cold goes away. Eventually it reverses, the thermostat setting drops down again towards normal, and the body tries to lose the extra heat it has on board. It does this by sweating and by opening up the blood vessels in the skin so that we are flushed and sweaty.

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Children tend to get higher fevers than adults — although this is only true after the age of 6 months. Before that age the immune system of a baby is quite immature. After the age of 6 months the actual temperature, in a fever, is not a good guide to whether or not your child is seriously unwell.

What can cause a fever/high temperature?

The most common causes of fever in children in the UK are viral infections. There are many other uncommon causes. Some of these will show other obvious signs:

  • Infections with germs called viruses are the most common cause. Viral infections cause many common illnesses such as colds, coughs, flu, diarrhoea, etc. Sometimes viral infections cause more serious illnesses.
  • Infections with germs called bacteria are less common than viral infections but also cause fevers. Bacteria are more likely to cause serious illness such as pneumonia, joint infections (septic arthritis), urine infections, kidney infections, septicaemia and meningitis. However, bacteria can also cause fever in less serious infections such as ear infections and infected skin rashes.
  • Inflammatory conditions and reactions may cause fever, including Kawasaki disease, some types of arthritis, and reactions to some medicines.
  • Immunisations: sometimes children develop a fever after an immunisation. This is because immunisations are generally designed to ‘trick’ the body’s immune system into thinking it sees an infection, so that it develops immunity. Fevers following immunisation are not usually high or prolonged.
  • Other types of infection: these include ‘tropical’ infections such as malaria and dengue, and conditions which are more common outside the UK, such as tuberculosis.
  • Heat stroke is a possible cause of raised body temperature, although technically this isn’t a fever, as the body is being heated from the outside (whereas in fever the body does the heating itself).

How common is fever in children?

Fever and feverish illness are very common in young children, particularly in those aged less than 5 years, and it can be really worrying for parents. It’s not always easy to judge how sick your child is, or whether you should ask for medical help.

Three to four out of every 10 parents of children aged less than 5 years say their child has had a fever in the past year. It is probably the most common reason for a child to be taken to the doctor. Fever is also the second most common reason for a child being admitted to hospital and it can be a cause of great anxiety in parents. This leaflet offers guidance with:

  • Understanding how best to manage a fever.
  • Knowing when to seek professional help or advice.
  • Knowing what signs suggest that your child may be seriously unwell, including how to check for signs of lack of fluid in the body (dehydration) and other signs of serious illness.

Whether or not you decide to seek help or advice, you should always give a child with a temperature lots to drink. It is not always necessary to give them paracetamol or ibuprofen.

How should I measure my child’s temperature?

Forehead strip thermometers are not very accurate. Ideally you should use one of the following to measure your child’s temperature:

  • Under 4 weeks old, with an electronic thermometer in the armpit.
  • Between 4 weeks and 5 years old:
    • With an electronic thermometer in the armpit.
    • With a chemical dot thermometer in the armpit.
    • With a digital thermometer designed to be placed in the ear.

What are the symptoms of fever?

The actual level of the temperature in fever is not a good guide to how severely ill a child is once they are older than 6 months.

The central symptom of a fever is a raised body temperature, measuring above 37.5°C. The recommendation is that this measurement should be taken under the arm in children less than 5 years old. This gives a reasonable guide to the body’s ‘core’ temperature.

Fever associated with common, self-limiting viral infections such as a cold typically rises and falls over a total of 12-48 hours. Children often complain of feeling cold at the start of a fever. They may look pale and feel shivery, yet will feel hot and dry to the touch. Later they often say they feel hot, and will be sweaty and flushed.

Headache and tummy ache are very common at the same time as fever. Children may be listless, tired and miserable and they may have watery eyes. They may have swollen glands in the neck, under the arms and in the tummy. Drooling may suggest that they have a sore throat, and they feel sick and may be off their food.

What is a febrile convulsion?

Some children have a tendency to febrile convulsions. This is a type of seizure triggered by a rapid rise in body temperature. Some children have only one febrile convulsion, ever, but others go on to have them more often. See the separate leaflet called Febrile Seizure (Febrile Convulsion).

Febrile convulsions, and seizures due to infections such as meningitis, can look very similar. If a child has a seizure for the first time, it is important to rule out serious conditions such as meningitis before deciding it is a febrile convulsion.

When does a fever indicate serious illness?

All the symptoms associated with harmless viral fevers can also occur in more serious illness. It can be difficult to determine whether or not your child’s fever symptoms should worry you. You know your child better than anyone else. If your child has a fever with symptoms that are unlike those they have had with fevers in the past, consider the possibility of more serious illness.

There are some features of a fever which will help you assess whether you need to seek medical advice:

Features of a fever that help reassure you that your child is not seriously unwell

These include that your child:

  • Has normal-coloured skin, lips or tongue.
  • Responds to you normally.
  • Is basically content and will smile.
  • Stays awake or awakens quickly and easily when you wake them.
  • Has a strong normal cry, or is not crying.
  • Has moist lips and tongue.

Features of a fever that suggest your child may be more unwell

  • Your child is aged 3-6 months and has a temperature of over 39°C.
  • Pale skin, lips or tongue.
  • Not responding normally to you.
  • Not smiling.
  • Wakes only with prolonged effort by you.
  • Not wanting to do anything; inactive.
  • Dry mouth and lips.
  • Poor feeding in babies.
  • Reduced wet nappies in babies.
  • Attacks of shivering.
  • Has had a fever for five days or more.
  • Has swelling of a limb or joint.
  • Isn’t using an arm or leg or isn’t able to put any weight on one leg.
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Features of a fever that suggest your child is seriously unwell

  • Your child is less than 3 months of age and has a temperature of over 38°C.
  • Pale/mottled/ashen/blue skin, lips or tongue.
  • No response to you.
  • Does not wake, or if you wake them, does not stay awake.
  • Weak, high-pitched or continuous cry.
  • Grunting noises when breathing.
  • Indrawing of the muscles between the ribs when breathing (this is particularly true in babies).
  • Reduced skin turgor (when you very gently pinch the skin on the back of the hand between your fingers, it does not bounce back but keeps the pinched shape).
  • Bulging fontanelle (the ‘soft spot’ on the top of the head of babies up to about 18 months of age).
  • Sunken fontanelle — suggests lack of fluid in the body (dehydration).
  • A rash that doesn’t fade when you press a glass against it.
  • Neck stiffness.
  • Seizures.
  • A bulging fontanelle (the soft spot on the top of a baby’s head).

Features that suggest your child is dehydrated

Some children who become irritable with a fever do not drink as much as they need, often because they feel sick (nauseated) and things taste strange. In particular, dehydration can develop quickly in a child who is being sick (vomiting) or has diarrhoea. Once dehydration sets in, nausea and vomiting can get worse, which can be a vicious cycle that is hard to break.

Signs of dehydration
These include:

  • Dry mouth or tongue.
  • No tears when crying.
  • Sunken appearance to eyes.
  • Drowsiness.
  • Cool hands and feet.
  • Generally becoming more unwell.
  • Reduced skin elasticity, or turgor (when you very gently pinch the skin on the back of the hand between your fingers, it does not bounce back but keeps the pinched shape).
  • Babies stop passing urine (although this can be difficult to detect if they also have diarrhoea), and the soft spot (on the top of the head) may become sunken in. Small babies can become dehydrated very quickly.

Seek medical advice if you suspect that your child is becoming dehydrated.

What do meningitis and septicaemia look like?

Two of the most serious infections are meningitis and blood infection (septicaemia). These are uncommon; the vast majority of children with a fever do not have these infections.

The symptoms often develop quickly, over a few hours or so, or more slowly, over a few days. The symptoms may suggest a less serious illness at first, such as flu. But, even if you think it was flu to start with, if symptoms become worse and your child seems really sick you should seek urgent medical advice.

Meningitis and septicaemia are always medical emergencies, so it is essential to know what signs to look out for. See the separate leaflets called Meningitis symptoms checklist and Child Sepsis Safety Net for more details.

When should we go to the doctor?

The National Institute for Health and Care Excellence (NICE) has produced guidelines aimed to help healthcare professionals assess children with fever. These can also be useful to parents. They look at the symptoms seen in children with fever and allocate them to categories of ‘green’, ‘amber’ and ‘red’. They are shown in the table below.

Green symptoms are reassuring. They mean that your child’s symptoms suggest they are at low risk of serious illness.

Amber symptoms suggest that you need a doctor’s advice. They suggest that your child might be at slightly increased risk of more serious illness.

Red symptoms suggest that you need urgent medical advice. They suggest that your child’s symptoms could indicate a serious illness, needing emergency help.

Not all possible symptoms are included in the guidance — for instance, tummy (abdominal) pain is not mentioned and, unless it is mild, it usually does need assessing by a doctor.

Some of the guidance concerns the kind of symptoms which a trained healthcare professional is expected to assess but which you may feel uncomfortable trying to measure, such as number of breaths per minute (respiratory rate) and heart rate (which usually needs a stethoscope for accurate assessment in a small child). They are included here for completeness: if ANY red or amber signs are present you should seek help or advice; you do not need all of them to be present in order to do so.

Green/amber/red symptoms in fever in children aged below 5 years

Low risk

Medium risk

Responds normally to you.
Stays awake or awakens quickly.
Strong normal cry/not crying.

Not responding normally to you.
No smile.
Wakes only with a lot of stimulation.
Decreased activity, listless.

No response to you.
Does not wake or if roused does not stay awake.
Weak, high-pitched or continuous cry.


Increased breathing rate (>40 breaths per minute aged over 12 months, >50 breaths per minute aged 6-12 months).

Flaring of the nostrils when they breathe.

Respiratory rate >60 breaths per minute.
Chest indrawing between ribs when breathing in.

Dry tongue and lips.
Poor feeding (babies).
Not producing wet nappies/needing to pass urine.
Fast heart rate (‘normal’ varies with age, and rate is difficult to judge without a stethoscope: your doctor will check this).

High risk
Colour Normal colour Pale Very pale, mottled or blue.
Circulation Moist tongue and lips, normal eyes. Reduced skin elasticity.
Other No red or amber signs. Age 3-6 months, temperature ≥39°C.

Fever for ≥5 days.
Rigors (repeated episodes of alternating shivering bouts then sweating, as temperature repeatedly goes up and down).
Swelling of a limb or joint.
Non-weight-bearing limb/not using an extremity.


French idioms & expressions

Weird things French speakers say

As an English speaker you might find yourselfВ chasing your tailВ while trying toВ get all your ducks in a rowВ so you canВ get this show on the road.

French speakers have their own collection of weird expressions that make just as much sense as their English counterparts. Here are a few common ones to stuff in your vocabulary rucksack.

«Perdre la boule»

  • Literal meaning:«To lose your ball»
  • What it really means: To lose your head

«Ce n’est pas la mer Г boire»

  • Literal meaning:«It’s not like you have to drink the ocean»
  • What it really means: It’s not difficult

«Faire la grasse matinГ©e»

  • Literal meaning:«To have a fat morning»
  • What it really means: To sleep in

«Passer une nuit blanche»

  • Literal meaning:«To have a white night»
  • What it really means: To stay up / awake all night (usually on purpose, not because of insomnia)

«Passer un mauvais quart d’heure»

  • Literal meaning:«To have a bad quarter of an hour»
  • What it really means: A short, difficult period in one’s life

«Dormir Г la belle Г©toile»

  • Literal meaning:«To sleep in the pretty star»
  • What it really means: To sleep outside

«ГЉtre blanc comme neige»

  • Literal meaning:«To be as white as snow»
  • What it really means: To be completely innocent

«Faire boule de neige»

  • Literal meaning:«To make like a ball of snow»
  • What it really means: To get bigger / more important

«Faire du chemin / faire son chemin»

  • Literal meaning:«To go along the path / to go along your path»
  • What it really means: To make progress

«Mordre la poussiГЁre»

  • Literal meaning:«To bite the dust»
  • What it really means:В To suffer a defeat

«TraГ®ner quelqu’un dans la boue»

  • Literal meaning:«To drag someone through the mud»
  • What it really means: To dirty someone’s reputation

«Se perdre les chГЁvres»

  • Literal meaning:«To lose your goats»
  • What it really means: To forget what you were just saying, or lose your place in a conversation. (This isn’t widely used, but there are goats!)

You might also like.

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What Are Nits of Brightness on a TV or Other Display?

January 25, 2019, 9:00am EDT

The competition between TV and display manufacturers has been heating up rapidly, and everyone is talking about how many “nits” their displays have. But what even is a nit? And why should you care?

Nits Are a Unit of Brightness

No, we’re not talking about head lice here, but rather a piece of terminology used in the tech world. Long story short, a nit is the unit of measurement that describes how bright a television, smartphone, computer monitor, laptop screen, or another type of display is. The higher the number of nits, the brighter the display.

Sounds simple, right? But doesn’t “lumens” describe brightness? And why are nits so important to you as a consumer? Let’s answer some of these questions.

What Exactly Is a “Nit” Anyway?

Interestingly enough, nit (which comes from the Latin word nitere, meaning “to shine”) isn’t an official unit of measurement since it’s not technically a part of the International System of Units or any other measurement system. The official term is actually “candela per square meter.” But we guess “nit” is easier to remember.

So let’s break it down. Since you now know that “nit” is just slang for “candela per square meter,” then you also now know that a nit is measuring two things: Luminous intensity (the candela) and area (the square meter).

As you might have guessed, “candela” is Latin for “candle.” So one candela is equal to the brightness of a single average candle. Two candelas is equal to the brightness of two candles, and so on.

When you add in square meters, you now measure the luminous intensity spread out over a surface. So one candela per square meter (or one nit) is the brightness of one candle shining onto a surface that measures one meter across and one meter down.

Putting that into simpler terms, imagine that you’re holding a piece of poster board that measures one meter by one meter—which is about the size of an average poster board, by the way. You then light a single candle and hold it up in front of your poster board. The amount of light that hits your poster board from the candle is equal to one nit (or one candela per square meter).

If measuring brightness in terms of candles seems a bit strange, remember that we still use the word “horsepower” when talking about engines.

What’s the Difference Between Nits and Lumens?

You might be thinking that we already have a unit of measurement for measuring light intensity—the lumen. After all, it’s what we use to measure the light intensity of light bulbs, flashlights, projectors, and more. But nits and lumens measure different things.

One big difference is that lumens don’t indicate light over a specific area like nits do. Rather, lumens indicate the intensity of light coming from the source, however big or small it. Light bulbs, flashlights, and projectors are all measured in lumens.

Another way of putting it is that lumens indicate the amount of light that a projector itself emits, whereas nits measures the amount of light coming off of the projector screen.

Why Should You Care About Nits?

So now that you know all of the technical mumbo jumbo about nits, you might be asking yourself the most important question: Why should you even care?

The gist is that the higher number of nits a TV has, the brighter the display is. This may not be a huge factor for you when shopping for a new television, but for what it’s worth, the brighter a TV can get, the better the image will look in a bright room.

Nits are even more important when it comes to smartphones, which you’re more likely to use outdoors in the bright sunlight. A screen with a lot of nits will look bright and clear even on the sunniest of days.

However, I’d argue that when it comes to television shopping, you don’t need to pay super close attention to how many nits a TV has, and most people won’t even be able to tell the difference.


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