Children’s Fevers: When to Wait, When to Worry, When to See a GP

ByFamily Doctor Editorial

Children get fevers — often. Most are caused by viral infections that resolve on their own within a few days. But some fevers signal something more serious. This guide helps parents tell the difference.

What Counts as a Fever

  • Under 3 months — any temperature 38.0°C or above is considered significant and needs urgent review.
  • 3 months and older — fever is usually defined as 38.0°C or above.
  • How you take it matters — rectal (most accurate in babies), tympanic (ear), temporal (forehead), or axillary (armpit). Each has slightly different normal ranges.

When to Call 000 or Go Straight to Emergency

  • A baby under 3 months with any fever
  • Non-blanching rash (doesn’t fade when pressed with a clear glass) — possible meningitis
  • Difficulty breathing, fast breathing, or breathlessness
  • Looks very unwell, pale, or blue-tinged lips
  • Unresponsive, lethargic, or extremely drowsy
  • Severe neck stiffness with headache and fever
  • Seizure lasting more than 5 minutes or repeated seizures
  • Extremely severe headache
  • Signs of severe dehydration — no urine for 8+ hours, sunken eyes, dry mouth, no tears
  • High fever (over 40°C) that doesn’t respond to paracetamol or ibuprofen
  • Any child who “looks really wrong” to you as a parent — trust your instinct

When to See a GP the Same Day or Next Day

  • Infant 3-6 months with fever above 38.5°C
  • Fever lasting more than 3 days in any age child
  • Ear pain, severe sore throat, or painful urination with fever
  • Unusual rash with fever (other than the non-blanching rash above)
  • Persistent cough with fever
  • Not drinking much, vomiting repeatedly, or fewer wet nappies than normal
  • Lethargic or much more drowsy than usual (even if responsive)
  • Your child seems especially unwell between fever peaks
  • You’re worried — trusting parental judgement is good medicine

When You Can Probably Wait It Out

  • Child over 6 months with fever who is still drinking, reasonably active between fever peaks, and alert
  • No other worrying features
  • Fever under 3 days in a child with a runny nose, mild cough, or other mild viral symptoms
  • Responsive to paracetamol and returning to themselves between doses

Managing a Fever at Home

  • Fluids — the most important thing. Small frequent sips of water, breastmilk, oral rehydration (not fruit juice for young kids).
  • Rest — but don’t force bed rest if the child wants to play between peaks.
  • Light clothing and a cool room — not icy baths, which can cause shivering.
  • Paracetamol or ibuprofen — for comfort, not to “treat” the fever itself. Follow the weight-based dosing on the bottle.
  • Don’t combine — use one or the other as instructed; alternating has no proven benefit for most children and risks dosing errors.
  • Aspirin is NOT for kids — risk of Reye’s syndrome.

The goal isn’t necessarily to bring the temperature down to normal — it’s to keep the child comfortable, hydrated, and monitored.

Common Causes of Fever in Kids

  • Viral upper respiratory infections — by far the most common
  • Gastroenteritis — often with vomiting and diarrhoea
  • Ear infections
  • Tonsillitis
  • Urinary tract infections — can be missed in young children; worth testing if fever without obvious cause
  • Roseola — high fever for 2-3 days followed by a distinctive rash
  • Chicken pox, hand-foot-mouth, and other viral exanthems
  • Immunisation reactions — low-grade fever for 24-48 hours after vaccines is normal
  • Bacterial infections — rarer but more serious (pneumonia, urinary tract infection, bacterial meningitis, appendicitis)

Febrile Convulsions

Fever-triggered seizures affect about 3% of children, typically between 6 months and 5 years. Most last under 5 minutes and don’t cause lasting harm. First-ever febrile convulsions always warrant a medical review. Call 000 if:

  • Seizure lasts more than 5 minutes
  • Multiple seizures in one illness
  • Child doesn’t regain full awareness
  • Any other worrying features (breathing difficulty, unusual movements in one side of the body)

Frequently Asked Questions

Do antibiotics help a fever?

Only if the infection is bacterial. Most fevers are viral and antibiotics don’t help — and cause side effects. Your GP will assess whether antibiotics are needed.

Should I give paracetamol every 4 hours overnight?

Only if the child is uncomfortable or having trouble sleeping. Waking a sleeping child to give medication isn’t usually necessary — temperature itself doesn’t need treating, comfort does.

Is teething causing the fever?

Teething can cause mild temperature rises but should not cause true fever above 38°C. If a teething baby has a fever, look for another cause.

Can I use telehealth for children’s fevers?

For mild illness in older children, telehealth often works. For babies, children with significant symptoms, or anything that needs examination (ears, throat, abdomen), in-person is better. Your clinic can advise.

Are children’s GP visits bulk billed?

Many clinics bulk bill children under 16. Check your clinic’s fees page. After-hours home doctor services typically bulk bill as well.

Book an Appointment for Your Child

If your child has a fever and you’re unsure, find your nearest Family Doctor clinic. Many offer same-day appointments for sick children.

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