Fever causes more parental anxiety than almost anything else, and much of that anxiety is directed at the number on the thermometer, which is not where the useful information is.
What fever is
A regulated increase in body temperature, driven by the immune system in response to infection. The body's thermostat is deliberately reset higher.
This is a functional response. Elevated temperature impairs replication of many pathogens and enhances aspects of immune function. It's the body doing something, not something going wrong.
Which means the goal of treatment is comfort rather than normalising the number.
The number matters less than expected
A point worth emphasising because it contradicts most instincts.
The height of a fever correlates poorly with the seriousness of the underlying illness. A common viral infection can produce a high temperature; a serious bacterial infection can produce a modest one or none.
What matters far more is how the child appears and behaves.
A child with a high temperature who is drinking, responsive, and playing between episodes is generally less concerning than one with a lower temperature who is lethargic, difficult to rouse, or not taking fluids.
The warning signs
These are what warrant urgent medical attention, largely independent of the temperature reading.
A rash that doesn't fade when pressed. Test by pressing a clear glass against it. A rash that remains visible under pressure requires immediate emergency assessment.
Difficulty breathing. Rapid breathing, grunting, drawing in of the chest between or below the ribs, flaring nostrils, or blue discolouration around the lips.
Reduced responsiveness. Unusually drowsy, difficult to wake, floppy, or not responding normally.
Signs of dehydration. Substantially reduced wet nappies or urination, no tears when crying, dry mouth, sunken eyes, or a sunken soft spot in an infant.
A stiff neck, or severe headache with light sensitivity.
A seizure.
Persistent vomiting preventing fluid intake.
Any fever in a very young infant. In babies under three months, fever warrants prompt medical assessment regardless of how well they seem, because their immune systems and their presentation differ from older children.
Your own strong sense that something is wrong. Parental concern is a recognised warning sign in clinical guidance for good reason. If you're worried in a way you can't articulate, that is a reason to seek advice.
Treating it
The purpose is comfort.
Paracetamol and ibuprofen both reduce temperature and relieve discomfort. Dosing is by weight, and following the specific product's instructions matters — formulations differ in concentration and errors are a genuine risk.
Current guidance in most places is not to alternate the two routinely, and to consider the second only if the child remains distressed. This varies between jurisdictions and is worth checking locally.
Aspirin should not be given to children due to the risk of a rare but serious condition.
What isn't recommended: tepid sponging, cold baths, or removing all clothing to cool a child. These cause discomfort, can cause shivering which raises temperature, and don't address the underlying reset thermostat.
Fluids matter more than anything. Small amounts frequently is more effective than trying to get a large volume down at once.
Undressing to a comfortable level and keeping the room comfortable is sensible. Wrapping up warmly is not.
Febrile convulsions
Frightening to witness and worth understanding in advance.
These are seizures occurring with fever in young children, most commonly between six months and five years. They affect a small percentage of children.
Simple febrile convulsions are typically brief and don't cause lasting harm or brain damage, and most children who have one do not develop epilepsy.
If one occurs: place the child on their side on a safe surface, don't put anything in their mouth, don't restrain them, and note the time. Seek emergency help if it lasts more than a few minutes, if the child doesn't recover normally afterwards, or if it's the first one.
Any first febrile convulsion warrants medical assessment.
What doesn't work
Antibiotics do nothing for viral infections, which cause the large majority of childhood fevers. Pressure for antibiotics is understandable and contributes to resistance without helping the child.
Most cough and cold remedies are not recommended for young children, with several having been withdrawn or restricted due to safety concerns and limited evidence of benefit.
The general picture
Young children get a lot of infections — many per year in the early years is entirely normal, particularly once they start nursery or school. Most are viral, self-limiting, and resolve without treatment.
The task is not to prevent fever but to recognise the small number of situations that need attention, and otherwise to keep the child comfortable and hydrated while they get better.
This article is general information and not medical advice. If you are concerned about your child, contact a healthcare professional. If a child shows any of the warning signs described, seek urgent medical attention.