Covid 19Information Hub

Alder Hey Children’s NHS Foundation Trust

Advice for parents on what to do if a child has a fever, including with a COVID-19 infection

Children can get COVID-19, but they seem to get it less often than adults and it’s usually less serious.

A case series of 45 infants with Omicron showed:

  • Most infants presented with fever or cough.
  • Only one infant required a paediatric intensive care unit (PICU), the others were managed in assessment units or on general wards.
  • Only 10% of infants required respiratory support.
  • The average length of stay was two days.
  • All have made a complete recovery and been discharged.

A fever is very common in children and can also be a symptom of many illnesses. It is therefore timely to reassure and support parents in making informed decisions on what to do if their child has a high temperature, including with a COVID-19 infection.

The following key messages and information are to help you raise awareness with parents about high temperatures in children and what actions should be taken.

Key messages for parents:

  • A high temperature is very common in young children. The temperature usually returns to normal within three or four days.
  • A normal temperature in babies and children is about 36.4C, but this can vary slightly from child to child. A high temperature is 38C or more.
  • Many things can cause a high temperature in children, from common childhood illnesses like chickenpox and tonsillitis, to vaccinations and COVID-19.
  • Children with COVID-19, including Omicron, seem to get it less often than adults and it’s usually less serious.
  • If your child has a high temperature, you can usually look after your child or baby at home. The temperature should go down over three or four days.
  • Visit the NHS website for information on how to care for your child or baby at home with a high temperature:
  • High temperatures in children are usually not serious, but you should contact your GP or call NHS 111 if your child:
    • is under 3 months old and has a temperature of 38C or higher, or you think they have a high temperature
    • is 3 to 6 months old and has a temperature of 39C or higher, or you think they have a high temperature
    • has other signs of illness, such as a rash, as well as a high temperature
    • has a high temperature that’s lasted for 5 days or more
    • does not want to eat, or is not their usual self and you’re worried
    • has a high temperature that does not come down with paracetamol
    • is dehydrated – such as nappies that are not very wet, sunken eyes, and no tears when they’re crying

Dial 999 for an ambulance if your child:

  • has a stiff neck
  • has a rash that does not fade when you press a glass against it (use the “glass test” from Meningitis Now)
  • is bothered by light
  • has a fit (febrile seizure) for the first time (they cannot stop shaking)
  • has unusually cold hands and feet
  • has blue, pale or blotchy skin, lips or tongue
  • has a weak, high-pitched cry that’s not like their normal cry
  • is drowsy and hard to wake
  • is extremely agitated (does not stop crying) or is confused
  • finds it hard to breathe and sucks their stomach in under their ribs
  • is not responding like they normally do, or is not interested in feeding or normal activities
  • Good respiratory and hand hygiene can reduce the spread of infections that cause high temperatures in children and babies. Parents are advised to carry tissues and use them to catch coughs or sneezes, bin the used tissues as soon as possible and wash your hands with soap and warm water to kill the germs.

Further information