A hot forehead in the middle of the night is enough to worry any parent. The reassuring news is that most fevers in children are caused by common viral infections, and settle within a few days with rest, fluids and comfort care. A fever is a symptom rather than an illness in its own right, and it's part of the body's normal response to infection.
The key question is rarely "how high is the temperature?" but "how is my child?" This guide explains what a fever is, how to measure it properly, what you can safely do at home, and the signs that mean your child should see a doctor.
What Is a Fever?
In children, a fever is generally defined as a temperature of 38°C (100.4°F) or higher. Normal body temperature varies slightly between children and through the day, and is usually around 36.5–37.5°C.
Fever happens when the body raises its internal "thermostat", usually in response to infection. The higher temperature helps the immune system fight off germs. On its own, a fever from infection is not harmful to the brain or body. The number on the thermometer matters less than your child's age and how unwell they seem.
Common Causes of Fever in Children
- Viral infections — colds, flu, sore throats, and stomach bugs are by far the most common causes
- Ear, throat and chest infections — some of which may be bacterial and need treatment
- Urinary tract infections — a common and easily missed cause, especially in babies and young children who can't describe their symptoms
- Vaccinations — a mild fever for a day or two after some routine vaccines is common and expected
- Infections common in Pakistan — such as dengue, typhoid and malaria, which need proper testing when a fever persists or other symptoms appear
Our guide to common childhood infections covers many of these in more detail.
How to Measure Your Child's Temperature Correctly
A digital thermometer is the most practical choice for home use. Avoid old glass mercury thermometers, which can break.
- Under the arm (axillary) — commonly recommended for babies and young children. Place the tip in the centre of the armpit and hold your child's arm gently against their side until the thermometer beeps. Underarm readings can be slightly lower than core body temperature.
- Rectal — the most accurate method in young babies, but only if you've been shown how to do it safely.
- Ear thermometers — quick and useful in older children when used correctly, but less reliable in young babies.
- Forehead strips — not reliable enough to depend on.
Feeling your child's forehead can tell you they're warm, but it can't tell you how high the temperature is. Wait around 20–30 minutes after a bath or heavy activity before measuring, and note the time and reading, as this helps a doctor judge how the fever is changing.
Fever Versus Overheating
A raised temperature isn't always fever. Babies and young children can also overheat if they're overdressed, wrapped in too many blankets, or kept in a hot room. This is particularly relevant in Pakistan's summer months. If you think your child may simply be too hot, remove extra layers, move them somewhere cooler, offer fluids and recheck their temperature after 15–30 minutes.
Heat illness is different from fever and can be serious. A child who has been in strong heat and becomes confused, very drowsy, stops sweating or has a very high temperature needs urgent medical care.
What Parents Can Do at Home
Fluids and Hydration
Fever increases fluid loss, so keeping your child hydrated is the most important part of home care. Offer regular sips of water, and continue breast or formula feeds for babies, offering them more often. Watch for signs of dehydration: fewer wet nappies or trips to the toilet, dark urine, a dry mouth, no tears when crying, or unusual drowsiness.
Rest and Comfort
Let your child rest, but they don't need to be kept in bed if they feel like playing. Dress them in light clothing and use a light sheet rather than heavy blankets. Don't wrap a feverish child up tightly to "sweat it out", and don't sponge them with cold water, which can make them shiver and feel worse.
Fever-Reducing Medicines
The goal of medicine is to make your child more comfortable, not to bring the temperature back to normal. If your child is miserable or in pain, paracetamol or ibuprofen can help. A few important points:
- Always follow the dosing instructions on the pack for your child's age and weight, or the dose your doctor gives you
- Use the measuring syringe or cup supplied, not a kitchen spoon
- Check whether other medicines (such as cough and cold syrups) also contain paracetamol, to avoid giving a double dose
- Don't give both medicines at the same time unless a doctor has advised it
- Speak to a doctor before giving any fever medicine to a baby under 3 months
- If dengue is possible — for example during the monsoon season or a local outbreak — don't give ibuprofen without medical advice. Paracetamol is generally preferred, and your child should be assessed.
Why Aspirin Should Not Be Given to Children
Aspirin should not be given to children or teenagers unless a doctor specifically prescribes it for a particular condition. In children with viral infections, aspirin has been linked to Reye's syndrome, a rare but serious condition affecting the liver and brain.
When Does a Fever Need Medical Assessment?
Arrange for your child to see a doctor, the same day where possible, if:
- The fever lasts more than 2–3 days, or keeps coming back
- Your child is drinking noticeably less than usual or has fewer wet nappies
- They have ear pain, a sore throat with difficulty swallowing, pain when passing urine, or a rash
- They seem to be getting worse rather than better
- They have a long-term medical condition or a weakened immune system
- You're worried, even if you can't pinpoint why
Our guide on when to see a pediatrician explains how to tell a problem that needs urgent care from one that can wait for a routine visit.
Special Considerations for Young Babies
Babies can't show you how unwell they feel, and their immune systems are still developing. For that reason:
- Babies under 3 months with a temperature of 38°C (100.4°F) or higher should be seen by a doctor urgently, even if they otherwise seem well
- Babies aged 3–6 months with a temperature of 39°C (102.2°F) or higher should be checked by a doctor promptly
- A newborn with a low temperature, or who feels unusually cold, also needs prompt assessment
For more on warning signs in the first weeks of life, see our guide to newborn warning signs.
Seek Urgent Medical Care If Your Child Has:
Go to your nearest emergency department straight away if your child with a fever has any of the following:
- Difficulty breathing — fast breathing, grunting, or the skin between the ribs sucking in with each breath
- Unusual sleepiness, is floppy, or is difficult to wake
- A seizure (fit)
- A stiff neck, or pain when bending the neck forward
- Signs of severe dehydration — no urine for 8 hours or more, sunken eyes, a very dry mouth
- Persistent vomiting and cannot keep fluids down
- Severe pain anywhere, including severe headache or abdominal pain
- A rash that does not fade when you press a glass against it
- Blue, grey, or very pale or mottled skin, lips or tongue
- A significant change in responsiveness — not reacting normally to you, confused, or has a weak, high-pitched or constant cry
- Any fever of 38°C or higher in a baby under 3 months
Trust your instincts. If your child seems seriously unwell, don't wait for the fever to reach a particular number.
Worried about your child's fever? Dr. Yasser Masood sees patients Monday–Saturday, 9am–5pm, with walk-in appointments available 11am–3pm at Shifa International Hospital, Islamabad. For emergencies, always go to your nearest emergency department. Book an appointment or call 051-8464646.
Final Thoughts
Most childhood fevers are caused by minor infections and pass on their own. Focus on your child rather than the thermometer: keep them comfortable and well hydrated, and watch for the warning signs above. Babies under 3 months are the exception — any fever at that age needs prompt medical assessment.
This article is for general educational purposes and does not replace personalised medical advice. Please consult Dr. Yasser Masood or your child's pediatrician for guidance specific to your child. In an emergency, contact your nearest emergency department immediately.
