The Truth About Fever in Toddlers

By Dr. Leo Bennett, Child Development Advisor | Expert Advice Column | Childcare Standards Council

Few things worry parents more than a fever in their toddler. That warm forehead, flushed cheeks, and fretful mood often trigger a rush of concern and sometimes panic. Is it serious? Should I give medicine? Should I take them to the GP?

The good news is that in most cases, fever is a normal and even helpful part of a toddler’s immune response. Understanding what fever really means, how to manage it safely, and when to seek medical attention can provide clarity and peace of mind during those stressful moments.

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What Is a Fever?

Medically, a fever is defined as a body temperature above 38°C. For toddlers, this is most commonly measured using a digital thermometer under the armpit (axillary), although ear thermometers are also widely used in children over 6 months.

A fever itself is not an illness, but rather a symptom usually of infection. It’s a sign that the body’s immune system is working to fight off invaders like viruses or bacteria. In fact, a raised body temperature helps slow the growth of pathogens and boosts the effectiveness of immune cells.

What Causes Fever in Toddlers?

Fever in toddlers is most commonly caused by viral infections, such as:

• The common cold

• Flu

• Roseola

• Hand, foot and mouth disease

• COVID 19

  
  

Occasionally, fever can result from bacterial infections, such as:

• Ear infections

• Urinary tract infections (UTIs)

• Tonsillitis

• Pneumonia

  
  

In rare cases, fever can be a symptom of more serious conditions, such as meningitis, which is why it's important to recognise the red flags discussed later in this article.

Should I Be Worried About a Fever?

Most fevers are not dangerous and resolve on their own within a few days. However, it’s completely natural for parents to feel anxious particularly if the child seems very unwell or the temperature is persistently high.

Here are a few reassuring facts:

• Fever is the body’s natural defence against illness.

• High temperature alone does not predict severity a child with a mild illness may have a high fever, while a child with a serious infection might have only a mild fever.

• Febrile seizures (convulsions caused by fever) can occur in some children, but they are usually brief and not harmful long term.

  
  

When to Seek Medical Advice

You should contact your GP, NHS 111, or go to A&E if your child:

• Is under 3 months old and has a temperature of 38°C or higher

• Is 3 to 6 months old and has a temperature of 39°C or higher

• Has a fever that lasts more than 5 days

• Shows signs of dehydration (dry mouth, no tears, fewer wet nappies)

• Has a rash that doesn’t fade when pressed

• Is difficult to wake, unusually sleepy, or confused

• Has a seizure

• Has a stiff neck, sensitivity to light, or persistent vomiting

  
  

When in doubt, it is always better to err on the side of caution and seek professional advice.

Managing Fever at Home: What the Evidence Says

For mild to moderate fevers, home care is usually sufficient. Here are the most up to date, evidence based strategies:

1. Keep Your Toddler Comfortable

Don’t worry about trying to “break” the fever. The aim is to keep your child comfortable:

• Dress them in light clothing

• Keep the room cool and well ventilated

• Offer frequent fluids to prevent dehydration

  
  

2. Use Medication Wisely

Paracetamol (e.g., Calpol) or ibuprofen (e.g., Nurofen for Children) can be given to relieve discomfort, such as aches or fussiness. But they’re not strictly necessary if your child is otherwise well and playing normally, even with a raised temperature.

Do not:

• Use both medicines together unless advised by a doctor

• Give aspirin to children under 16

• Wake a sleeping child just to give them medicine

  
  

3. Don’t Rely on Touch Alone

Parents often say their child “feels warm,” but touch can be unreliable. Use a digital thermometer to confirm fever.

4. Avoid Overcooling

Cold sponging or ice packs are not recommended they can make your child shiver, which may raise their internal temperature further. Comfort, hydration, and rest are far more effective.

Common Myths About Fever

Let’s address a few misconceptions:

• Myth: A higher fever always means a more serious illness

• Truth: Not necessarily. Some mild viruses cause high fevers, while some serious illnesses cause only a mild rise in temperature.

• Myth: Fevers must always be treated with medication

• Truth: Treat the child, not the number. If they’re playing, drinking, and interacting normally, medicine may not be needed.

• Myth: A fever above 40°C will cause brain damage

• Truth: Fevers caused by infection do not cause brain damage. Brain damage is typically only associated with heat stroke or prolonged hyperthermia from external sources.

  
  

When Is It Not a Fever?

It’s worth noting that body temperature can rise for reasons other than infection. Teething, for example, may cause a slight increase, but typically does not lead to a true fever above 38°C. Similarly, physical activity, warm environments, or excessive clothing can lead to temporary warmth.

Final Thoughts

In the vast majority of cases, fever in toddlers is a normal part of childhood a sign that the body is doing exactly what it was designed to do. While it can feel alarming in the moment, understanding the nature of fever and recognising when to seek help allows you to respond with calm and confidence.

Every parent has faced a long night with a warm, restless toddler and it’s not easy. But with the right knowledge, you can manage most fevers safely at home and know when expert care is needed.