Fever is one of the most common reasons for doctor visits in children – around 70% of pediatric consultations are related to fever.
Fever is a natural and important response to pathogens. It can occur for various reasons, such as viral infections, bacterial infections, post-immunization reactions, and other medical conditions. Here’s a guide to help you understand and manage fever in children and babies.
3. Fever as a Sign of immune activation
1. Recognizing the Signs of Fever
When your child has a fever, you may notice their body feeling warm, redness in the face, sweating, fussiness, and weakness. During temperature spikes, their hands and feet may feel cold and appear bluish, while they may experience heavy sweating during temperature drops.
2. How to Measure Body Temperature?
For small children, the most accurate method is using a digital thermometer rectally. For older children, an ear thermometer is a convenient and reliable option.
3. Fever as a Sign of immune activation
A raised temperature is a clear sign that your child's body is fighting an infection. The body’s temperature rises because the immune system is activated.
Normal body temperature: 36.5°C – 37.5°C
Higher Temperature: 37.6 °C - 38.4°C
Fever: >38.5°C (for Newborns > 38.0°C
In most infections, fever lasts around 3-5 days and then subsides on its own as your child's immune system successfully fights off the pathogens. Some children have a shorter fever, while others may have it a bit longer – this is completely normal. The most important thing is to pay attention to your child's overall well-being. If the fever persists for a long time or your child does not feel better despite a decreasing temperature, seek medical advice.
4. Managing Your Child's Fever
Fever itself is not dangerous; it’s a sign that your child’s immune system is actively helping them recover. The human body can effectively handle fever up to 41°C. The key is to provide your child with plenty of rest, fluids, and gentle care during this time."
Create a comfortable environment
Stay calm
Observation
Monitor your child closely, measure the temperature regularly, and record it.
Prevent dehydration: Make sure your child drinks enough, especially babies and toddlers, as they can dehydrate quickly and may require immediate medical attention in case of dehydration. Diapers should be regularly wet, or your child should be using the toilet regularly.
Avoid overdressing your child to prevent overheating.
To gently lower the fever, try these methods:
Warm calf compresses with lukewarm water (avoid cold water, and change the compress after 10 minutes).
Damp, lukewarm washcloth on the forehead.
Frequent linen changes for bedding, towels, and clothing.
Managing a fever can be a worrying time for parents. Remember to take breaks and stay hydrated while caring for your child.
5. When to Use Fever-Reducing Medication
Fever-reducing medications, such as ibuprofen or paracetamol, are mainly used to alleviate discomfort rather than reduce the temperature itself. If your child is generally doing well, you do not need to administer medication immediately.
Always check the medication’s packaging for dosage instructions based on your child’s weight. Medications should generally not be given more than every 8 hours. Combined or alternating use of different fever-reducing medications is not recommended.
Never give acetylsalicylic acid (ASA) to children under 12. This medication can, in rare cases, cause Reye’s syndrome, a serious condition affecting the liver and brain, which can be life-threatening.
If the fever persists or the fever medication is not sufficient, consult your doctor for advice.
!!!Be cautious when giving over-the-counter medicines to children. Not all medicines are suitable for children of every age. Ask your doctor or pharmacist about the correct dosage based on your child’s age and size.
6. When to Seek Medical Attention
The timing for seeking medical attention depends on your child's age and the overall condition.
For Babies under 12 month:
If your baby falls into this age group and has a fever, it's crucial to consult a pediatrician the same day. It is important to determine the cause of the fever (e.g., an ear infection or bronchitis).
For Children older than 1 year:
If your child is older than 1 year and appears otherwise well, you can attempt to manage the fever at home. The exact temperature alone is not decisive for the next steps. What’s important is always assessing how your child is doing, whether there is an underlying cause, and if that cause needs treatment.
You should see a doctor if:
Fever does not decrease despite fever-reducing measures.
Your child feels consistently very unwell.
The cause of the fever remains unclear.
Rash.
Breathing difficulties or labored breathing.
Ear pain in children under 2 years old.
Stiff neck, severe headaches.
Dehydration.
Signs like pinpoint bleeding (petechiae).
Persistent, high-pitched crying.
Ongoing vomiting or diarrhea.
Repeated fever spikes.
High fever (over 41°C) that rises rapidly.
Apathy or unusual drowsiness.
Call emergency services (112) for febrile seizures or if your child is unresponsive.
Trust your parental instinct and contact your pediatrician if you need advice.
Weekends/Nights: The Fever is Very High, and I’m Worried—What Can I Do?
You can call the medical on-call service at 116117. This helpline provides medical support for non-life-threatening situations. A team of professionals will carefully listen to your concerns, offer valuable advice, and guide you on whether your child’s condition can be managed at home or requires a visit to a doctor.
7. What happens at the doctor's?
When you take your feverish child to the doctor, they will first ask detailed questions: How long has your child had a fever? What is the temperature? Are there additional symptoms like a rash, breathing problems, or restlessness?
Next, the doctor will examine your child thoroughly. This includes listening to the heart and lungs with a stethoscope, checking the ears to detect a possible middle ear infection, and examining the mouth and throat. The lymph nodes, skin, and sometimes the abdomen will also be examined to gather further clues about the cause of the fever.
Depending on the suspected cause, additional tests may be necessary, such as a urine test or a throat swab. In rare cases, a blood test may also be required to make an accurate diagnosis.
The treatment will depend on what is causing the fever. If it is a bacterial infection, antibiotics may be needed. For viral infections, Fever-reducing medications and patience is often the key until the body has fought off the pathogens.
In rare cases, a hospital stay may be necessary, for example, if your child is severely dehydrated or a serious cause is suspected. Your doctor will provide guidance and make the best decision for your child.
Last updated: 02/2025
Resources:
https://www.dgkj.de/eltern/dgkj-elterninformationen/elterninfo-fieberkrampf https://www.kinderaerzte-im-netz.de/krankheiten/fieber/
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