High body temperature in babies and children. Fever itself is not dangerous — it is the body fighting infection. The cause and the child's behaviour matter more than the number alone.
Measure the temperature correctly. Normal is 36.1 to 37.2°C. Fever is above 38°C. High fever is above 39°C. Dangerous fever is above 40°C — act immediately.
Remove excess clothing and blankets. Do not wrap a feverish child tightly — heat must escape.
Give paracetamol syrup dosed by weight, not age. Dose is 15mg per kilogram. Example: a 10kg child receives 150mg. Give every 4 to 6 hours. Do not exceed 4 doses in 24 hours.
Ibuprofen syrup can be alternated with paracetamol for high fevers. Give ibuprofen 3 to 4 hours after paracetamol if fever has not reduced. Do not give ibuprofen to infants under 3 months.
Encourage fluids constantly — breast milk, formula, water, or diluted fruit juice. Fever causes dehydration rapidly in children.
Sponge the child with lukewarm water — not cold. Lukewarm sponging helps reduce temperature without causing shivering which paradoxically raises temperature.
Monitor the child's behaviour as closely as the temperature. A child with a 39°C fever who is playing and drinking is less concerning than a 38.5°C child who is listless and refusing all fluids.
Recheck temperature 30 to 60 minutes after giving paracetamol.
For a child who has had a febrile seizure before: begin fever treatment at 38°C to prevent the temperature reaching seizure threshold.
Fever in a baby under 3 months — always a medical emergency regardless of temperature.
Fever above 40°C in any child.
Seizure occurring with the fever.
Child is extremely difficult to wake or unusually unresponsive.
Child has a rash that does not fade when pressed with a glass.
Severe headache or stiff neck with fever.
Child is not passing urine — severe dehydration.
Fever lasting more than 3 days.
Never give aspirin to children under 16 — causes Reye syndrome, a rare but fatal liver and brain condition.
Do not use cold water or ice for sponging — causes shivering which raises temperature.
Do not overdress or over-wrap a feverish child.
Never exceed the recommended paracetamol dose — liver damage occurs with overdose.
✓ What Helps
· Paracetamol syrup dosed by weight — 15mg per kilogram every 4 to 6 hours
· Ibuprofen syrup for children over 3 months — 5 to 10mg per kilogram every 6 to 8 hours
· Oral rehydration salts to prevent dehydration
✗ What To Avoid
· Aspirin in any child under 16
· Cold water sponging
· Combining two paracetamol-containing products simultaneously
→ Ask The Pharmacist For
· Weight-appropriate dosing chart at the pharmacy
· Malaria RDT test — fever in malaria-endemic Africa needs malaria excluded first
· Medical assessment if fever lasts more than 3 days
🏥 Get Professional Help
Go to hospital immediately for fever in any baby under 3 months, fever above 40°C, seizure, rash, severe drowsiness, or a child who cannot be woken. See a doctor for any fever lasting more than 3 days or a child who is not drinking.
What temperature is dangerous for a child?
Above 40°C is dangerous and needs immediate medical attention. Any fever in a baby under 3 months is an emergency regardless of the exact temperature.
Should I take my child to hospital for fever?
Yes immediately if the child is under 3 months, has a seizure, has a rash, cannot be woken, or the fever is above 40°C. Otherwise monitor closely and go if no improvement after 24 hours.
Can I give my child both paracetamol and ibuprofen?
Yes, you can alternate them — give ibuprofen 3 to 4 hours after paracetamol if fever has not reduced. Never give them at the same time.