Childhood Fevers: When to Worry

MH speaks to the experts and finds out all you need to know about babies and fevers.



You may be surprised to learn this, but your child’s behaviour is a more important indication of their wellbeing than their body temperature. This means that there is no specific temperature at which you need to bring your child to see the doctor. Instead, watch out for these signs regardless of how low or high your child’s fever is:


  • If your child is younger than six months of age
  • If your child appears more lethargic than normal
  • If your child’s fever lasts for longer than four or five days
  • If your child’s fluid intake drops to less than two-thirds of their usual intake
  • If your child begins to show signs of dehydration (they pee less than once every eight hours, cry without tears, exhibit significant lethargy and have significant weight loss of more than five per cent of their body weight)
  • If your child has been vomiting multiples times and has difficulty eating or drinking
  • If your child develops a rash or mouth ulcers


If your child is below three months of age and has a fever, don’t wait to bring him to the doctor. Instead, head to the emergency department immediately.


When Can You Self-Medicate?

Fevers are so common that running to the doctor every time your child develops one can be a huge drain on time, energy and money. Knowing when you can keep your child at home to rest and recuperate can save a great deal of resources.


There are two types of medication that you should keep in your medicine cupboard for fevers: paracetamol and ibuprofen. You are probably already familiar with paracetamol, which is commonly available over the counter and is safe in appropriate doses even for infants as long as they are above six months of age. Ibuprofen is administered in older children above one year of age and is especially useful for high fevers of more than 38.5°C. Both these medications are available in syrup, tablet and suppository form.



If your child is active and generally has no problems eating and drinking,

you can try self-medicating during the first few days of a fever.



As the appropriate dosage depends on your child’s weight which changes rapidly during the first two years of life, you should check with your doctor on the appropriate dosage.

Dr Rajeev Ramachandran, consultant, Division of General Ambulatory Paediatrics and Adolescent Medicine, National University Hospital cautions that “parents should follow the dosage instructions on the packet properly and carefully or ask the pharmacist or doctor if unsure.”


Dr Christelle Tan, specialist in paediatrics and consultant, Raffles Specialists, Raffles Holland V agrees. “Do check with your doctor on the appropriate dose for your child at the time of use. If parents follow an old dosage, you may end up underdosing the child with little effect on bringing down the fever. This is especially important if parents are sharing medications between two children of different ages as they should ensure that the appropriate dose is administered.”


One other precaution parents should note is the concentration of paracetamol. “Paracetamol may come in different dilutions at different clinics and stores and some are almost twice as concentrated as others,” continues Dr Tan. “Parents should always check the appropriate dose on the bottle before administering the medication. Also, parents should take note to adhere to the prescribed time interval for the medications to avoid an overdose.”


Of course, when in doubt, pay your doctor a visit.


What if a Febrile Seizure Occurs?

A febrile seizure may happen if your child has a high fever of over 38°C. Both doctors that Motherhood spoke to assure parents that although they are scary, febrile fits aren’t anything to worry about in the long term. “Febrile fits are typically harmless and almost all children make a complete recovery as they grow older,” says Dr Ramachandran.


Dr Tan recommends taking the following steps:


First, find a safe place to lay the child flat on his or her side. Clear their surroundings. Do not put any objects like fingers or forks into your child’s mouth as this can cause injury to their mouth and can break their teeth.



Laying the child on the side can ensure better breathing as it causes

the child’s tongue to move to the side and not block the air flow.



Secondly, wipe away any saliva from the side of the mouth. Loosen tight-fitting clothes to help them feel more comfortable. Call for the ambulance if the fits last beyond five minutes. If your doctor has prescribed suppository anti-fits medication for your child, administer it while waiting for the ambulance.


Above all, keep calm so that you are able to be there for your child.




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