Persistent Raised Temperature and Lethargy

A fever in a child is one of the most common reasons parents seek medical advice. I have created this video to help you understand, when a temperature can be watched at home and when it may need urgent review. A fever is a temperature of 38 degrees Celsius or higher. It is the body's natural response to infection; and most fevers come from common viral illnesses that settle within a few days. How your child looks and behaves is often more important than the exact number on the thermometer. A child who is alert; drinking; and playing between bouts of fever is usually safe to care for at home. NHS guidance highlights several groups who need closer attention with any fever. These include babies under three months, who can become unwell quickly from even modest temperatures and always need a same-day review. For older babies and toddlers - paracetamol or ibuprofen can ease distress and lower temperature when your child seems uncomfortable. However, these medicines will only treat the symptoms, rather than the infection itself. Encourage small frequent drinks throughout the day to prevent dehydration during a feverish illness. Loose, light clothing helps your child feel more comfortable; and be aware that over-wrapping can sometimes make a fever feel worse. A fever that lasts more than five days deserves a medical review, even when your child appears reasonably well. Persistent fevers can occasionally signal infections - such as urinary tract infection, or a hidden bacterial cause. Lethargy is the most important warning sign to recognise in any unwell child. A truly lethargic child is difficult to rouse; makes little eye contact; and lacks any interest in surroundings, toys or food. Several other signs always need an immediate 9 9 9 call without any hesitation. These include: a non-fading rash; difficulty breathing; blue lips; a stiff neck; repeated vomiting; or a fit or seizure. A fever alongside reduced wet nappies; sunken eyes; dry mouth; or no tears when crying - suggests dehydration. Younger babies become dehydrated more quickly, so early review with your GP or 1 1 1 is sensible. If your child has any long-term health condition or weakened immune system, please contact your usual team early. Standard advice may need to be adjusted, to reflect their individual circumstances and history. As a paediatric intensive care specialist; I have looked after many children with fever and lethargy. Please contact me anytime if you have further questions or need help when your child is unwell.