Health Insights · Paediatrics
Fever in children: what to do and when to worry
A fever is a temperature of 38°C or above. It is the body's normal response to infection, and in most children it settles within a few days. How your child looks and behaves tells you far more than the number on the thermometer.
Call 999 or go to an emergency department if your child
- has a rash that does not fade when you press a glass against it (see over);
- has a fit or seizure;
- is very difficult to wake, unusually floppy, or does not respond to you as they normally would;
- is struggling to breathe — grunting, breathing very fast, or sucking in below the ribs or at the neck;
- has skin that looks blue, grey, very pale or blotchy;
- has a stiff neck, dislikes bright light, or has a bulging soft spot on the head;
- is under 3 months old with a temperature of 38°C or above, or 3 to 6 months old with a temperature of 39°C or above.
Trust your instinct. If you feel your child is more unwell than a temperature alone explains, seek help — do not wait to see whether a rash appears. Tower Bridge Hospital London is not an emergency service. The nearest emergency department is the Royal London Hospital, Whitechapel Road, London E1 1FR.
The glass test
If your child has any rash, press the side of a clear drinking glass firmly against it and look at the spots through the glass.
If the spots do not fade under the glass, get medical help immediately.
Spots that fade under pressure are usually less serious, but keep checking — a rash can change over hours. Illustration for guidance only.
Looking after your child at home
Do
- Offer small drinks often. Breast milk is best if you are breastfeeding.
- Dress them normally and keep the room at a comfortable temperature.
- Check on them during the night.
- Keep them off nursery or school while they have a fever and feel unwell.
Do not
- Do not sponge your child with cool water or put them in a cold bath.
- Do not undress them completely, and do not wrap them in extra layers.
- Do not give medicine purely to bring the number down if your child is otherwise comfortable.
- Do not give aspirin to any child under 16.
Medicines
- Paracetamol and ibuprofen are equally effective. Give whichever you have, at the dose on the packet for your child's age and weight, if they are distressed or uncomfortable.
- Use one at a time. Do not give both together. If the first has not helped after the recommended interval, you may try the other instead. Ask a pharmacist if you are unsure.
- Check the label of any other medicine you are giving — cold and cough remedies often contain paracetamol or ibuprofen, and it is easy to double up by accident.
- Medicines that lower a temperature do not prevent a febrile convulsion, and are not needed simply to make a number look better.
Signs your child may be dehydrated
- a dry mouth or tongue, and no tears when crying;
- sunken eyes, or a sunken soft spot on a baby's head;
- fewer wet nappies than usual, or dark, strong-smelling urine;
- unusual drowsiness, or cold hands and feet.
Offer frequent small amounts of fluid rather than large drinks. If your child will not drink at all, or you are seeing several of these signs, contact us or NHS 111 the same day.
Book an appointment with us if the fever lasts more than five days, your child seems to be getting worse rather than better, they develop a rash, you have been asked to bring in a urine sample, or you simply want your child examined by a doctor. We see children 7 days a week, usually the same day.
Same-day private assessment for a feverish child in East London
Fever is common and usually due to a viral infection, but it is important to know the warning signs. Our private paediatric team and a same-day private GP in East London can examine your child and give clear advice. Call 999 or seek emergency care for a stiff neck, a rash that does not fade under a glass, difficulty breathing, a fit, drowsiness, or a baby under three months with a fever. Tower Bridge Hospital is on Whitechapel Road in East London, a short journey from Canary Wharf and the City, with same-day appointments and no referral required.
High temperature in children in London: common questions
When is a child's fever an emergency?
A non-fading rash, stiff neck, difficulty breathing, a seizure, unusual drowsiness, or a baby under three months with fever — seek emergency care.
How do I bring a fever down?
Paracetamol or ibuprofen if your child is distressed, plenty of fluids, and light clothing; the aim is comfort, not a normal number.
When should I get my child assessed?
If they are very unwell, not improving, drinking poorly, or you are worried — trust your instinct and get them seen.
Can my child be seen the same day?
Yes — same-day private paediatric and GP appointments are available most days.
Seen today, not next week
Same-day appointments most days, 7 days a week, 9am–7pm, on Whitechapel Road.