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What to do when your child has a fever

Does your child have a fever?

This week, my daughter, like many people in Hong Kong right now, has been bed-ridden with a fever. It had me thinking, if I’d been away, would my helper know what to do to correctly deal with a fever? Moreover, if the fever had become worse, and she’d had febrile convulsions, what immediate actions should be taken? Babies and young children can experience a much faster rise in core body temperature than adults. So when we act, we need to know what to do fast, leaving nothing to guesswork.

This information offers practical advice that every care-giver in your home should read and comprehend.

How to measure temperature

There are a few ways for measuring body temperature; forehead, oral and rectal/ear. There is some variance in temperature readings across these methods. Please see chart below for comparison:

Temperatures in Centigrade by method
Axillary/Forehead (°C) Oral (°C) Rectal/Ear (°C)
36.4-36.7 37.0 37.3-37.6
36.9-37.4 37.5-37.7 38-38.3
37.5-38.4 37.8-38.5 38.4-39.1
38.5-38.9 38.6-39.1 39.2-39.7
39-39.5 39.2-39.7 39.8-40.3
39.6-40 39.8-40.3 40.4-40.9


Fever and febrile convulsions

A normal body temperature is around 37°C (98.6°F) according to the NHS. (All temperatures referred to are oral temperatures.) This is an average normal body temperature so the actual body temperature can vary by 0.6°C or more depending on time of day and activity. Below 36°C is recognised as the beginnings of mild hypothermia. Above 38°C and the body begins to suffer from heat exhaustion and can experience febrile convulsions. Body temperature is maintained by the hypothalamus which is a small structure in the base of the brain. The hypothalamus is not fully developed until around four years old. So it is especially important to regularly check the temperature of babies and young children because a rise in temperature can occur much quicker than in those over four years old.

Temperature (°C)

What your child may experience

>40 (and over) Heat stroke / Febrile convulsions
38-39.9 Heat exhaustion / Febrile convulsions
36-37.9 Normal body temperature
31.5-35.9 Mild hypothermia
31.4 and below Severe hypothermia

Source: Safe&Sound Child safety and first aid

The word ‘febrile’ means ‘related to fever’. Febrile convulsions are almost always triggered when a child’s temperature rises quickly (above 38°C). Reportedly 1 in 20 children between the ages of one and four years old, are affected by febrile convulsions. The first phase of the fit can include the child appearing to stop breathing and the lips may turn blue. It is important that the care-giver remains calm and offers reassurance to the child.

To monitor temperature, I personally opt to use this infrared non-contact thermometer in our home. We find that it’s easier to achieve an accurate reading without interrupting the child when they’re asleep. It's also a stress free way to measure your child's temperature before school. Peek Concepts provides this thermometer with free and fast delivery.

infrared body thermometer

What to do if your child has a febrile convulsion

  1. Remove clothing and bedding. Turn on the air con / fan or open window if there’s a breeze. Your aim is to immediately and very quickly cool the child.
  2. Place the child on their side if possible to protect the airway.
  3. Remove any hard objects away from the child that they may thrash into during the fit, causing injury. Pay particular attention to the area surrounding the head.
  4. Call 999 and ask for an ambulance.
  5. If the child is still having a fit, cool their head with tepid water from a sponge or flannel. Do not cool the child too much.
  6. Constantly monitor the child’s airway and breathing until the ambulance arrives. If a second adult is present then this person can inform your building security (if applicable) and wait for the ambulance crew by the front door of your home.

NEVER hold the child down; you could cause injuries including dislocation and fractures.

Treatment of heat exhaustion

This can occur when the core temperature rises above 38°C. If the problem is not treated, then the child can quickly escalate to heat stroke.

Signs may include:

  • Confusion, dizziness
  • Pale, sweaty skin
  • Loss of appetite, nausea, vomiting, stomach cramps
  • The child may complain that they feel cold even though they feel hot to the touch

What to do:

  • Turn on the air con / fan to cool them down
  • Lay them down in bed
  • Give them a drink of water to help rehydration
  • Obtain medical advice from your doctor straight away, even if the child appears to recover quickly

Treatment of heat stroke

This can occur when the core temperature rises above 40°C. Heat stroke is an incredibly dangerous situation. The body’s ability to control core temperature fails.

Signs may include:

  • Severe confusion, restlessness
  • Fitting, lowered levels of consciousness
  • Flushed hot dry skin (no sweating)
  • Throbbing headache, dizziness, nausea, vomiting

What to do:

  • Turn on the air con / fan to cool them down
  • Call 999 and request an ambulance
  • Cool the child rapidly by removing outer clothing and sponge with cold water. Do not overcool
  • If the child fits, see above guidance on febrile convulsion

Recording medication

For the most part, children who suffer from a fever, tend to remain below 40°C and do not exhibit the signs of heat exhaustion and heat stroke. In our home, we choose to alternate between children’s Calpol (paracetamol) and Nurofen (ibuprofen) when the temperature rises above 38.5°C but is below 40°C and there are no signs of heat exhaustion or heat stroke. We ensure that we immediately write down the date, time, amount and type of medicine given. Sometimes we also include a short description of our child’s demeanor. I find this is particularly helpful when more than one adult is involved with administering medication. I want to avoid accidental overdose by keeping track of what medicine was given and when. Plus, if our child did require a doctor, then I have a full record of the duration of the fever. Always check that the medicine has not expired. I recently threw out a large percentage of our old medicine bottles because they had expired. Expired medicines may have altered potency.

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This is a practical guide based on advice from the Safe&Sound team in England and from WebMD. Whilst every effort has been made to offer accurate information, Peek Concepts does not accept any liability for subsequent mistreatment of any person. If you suspect illness, you should always seek professional medical advice.

Ang Mo is a Director of Peek Concepts.

Peek Concepts brings hard to find monitoring, measuring and safety products direct to your home at affordable prices. Shop from the comfort of your home whilst experiencing the level of customer service available from traditional retail outlets.

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