Fever / High Temperature (Babies aged under 3 months)

Royal Hospital for Children for Patients, Carers & Visitors

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Fever in babies less than 3 months of age is much more likely to be due to a serious infection that needs urgent treatment than a fever in an older child. All children under 3 months of age with a temperature above 38°C (100.4°F) should be seen by a healthcare professional. The only time your baby doesn't need to see a doctor with their fever is if they have had their vaccines in the last 48 hours (given from 8 weeks of age) .

If your baby has had their vaccinations in the last 48 hours follow the advice given by your community nurse at their vaccination appointment.

How to take your baby’s temperature:
You should measure your baby’s temperature under their armpit. Hold their arm against their body to keep the thermometer in place for however long it says in the manufacturer's instructions – usually about 15 seconds; some digital thermometers beep when they're ready. You should not measure their temperature on the forehead or in their ear – it will not be accurate in young children.
How to take a temperature

When should I get help?


If your child has any of the following: Is pale, mottled (blotchy rash) and feels abnormally cold to touch Has blue lips lips Has a fit/ seizure Is very agitated (crying inconsolably despite distraction), confused or very difficult to wake Has a rash that does not go away when you press on it (the ‘Glass Test’) Has a hot chest, face or back and is sweaty or clammy (a temperature of 38°C / 100.4°F or higher) unless this is within two days of vaccinations and there are no other signs from this box or the AMBER box below Is getting worse or if you are worried	You need help now Go to the nearest Hospital Emergency Department or phone 999

If your child has any of the following:

Is pale, mottled (blotchy rash) and feels abnormally cold to touch
Has blue lips lips
Has a fit/ seizure
Is very agitated (crying inconsolably despite distraction), confused or very difficult to wake
Has a rash that does not go away when you press on it (the ‘Glass Test’)
Has a hot chest, face or back and is sweaty or clammy (a temperature of 38°C / 100.4°F or higher) unless this is within two days of vaccinations and there are no other signs from this box or the AMBER box below
Is getting worse or if you are worried

You need help now

Go to the nearest Hospital Emergency Department or phone 999


If your child has any of the following: Is finding it hard to breathe Seems dehydrated (dry mouth, sunken eyes, no tears, drowsy or less wet nappies) Is becoming very sleepy or irritable (you are unable to settle them with toys, TV, food or by picking up) – especially if they are still drowsy or irritable after their fever has come down Has extreme shivering Has a fever higher than 39°C/102.2°F within 48 hours after vaccinations Is getting worse or if you are worried	You need to see a doctor or nurse today. Please ring your GP surgery or call NHS 111 - dial 111 If symptoms persist for 4 hours or more and you have not been able to speak to either a member of staff from your GP practice or to NHS 111 staff, then consider taking them to your nearest ED.

If your child has any of the following:

Is finding it hard to breathe
Seems dehydrated (dry mouth, sunken eyes, no tears, drowsy or less wet nappies)
Is becoming very sleepy or irritable (you are unable to settle them with toys, TV, food or by picking up) – especially if they are still drowsy or irritable after their fever has come down
Has extreme shivering
Has a fever higher than 39°C/102.2°F within 48 hours after vaccinations
Is getting worse or if you are worried

You need to see a doctor or nurse today.

Please ring your GP surgery or call NHS 111 - dial 111

If symptoms persist for 4 hours or more and you have not been able to speak to either a member of staff from your GP practice or to NHS 111 staff, then consider taking them to your nearest ED.


If your baby DOESN’T have any signs from the RED or AMBER boxes, the following are normal: Your baby is less than two weeks old (or three weeks old and breastfed) and looks slightly yellow, mainly on the face. (This may slowly increase over a day or two but will then start to fade). Has four to six wet nappies a day. Has green, brown, orange, yellow or black poo. (The poo of breastfed babies is usually yellow and can often look ‘seedy’ – it’s a sign your baby is healthy). Keeps feeding well with breast or formula milk. Baby wakes up often and cries to be fed.	Self care You can keep looking after your baby at home. If you are still concerned about your child, call NHS 111 – dial 111

If your baby DOESN’T have any signs from the RED or AMBER boxes, the following are normal:

Your baby is less than two weeks old (or three weeks old and breastfed) and looks slightly yellow, mainly on the face. (This may slowly increase over a day or two but will then start to fade).

Has four to six wet nappies a day.
Has green, brown, orange, yellow or black poo. (The poo of breastfed babies is usually yellow and can often look ‘seedy’ – it’s a sign your baby is healthy).
Keeps feeding well with breast or formula milk.
Baby wakes up often and cries to be fed.

Self care

You can keep looking after your baby at home. If you are still concerned about your child, call NHS 111 – dial 111

What should I do?

Paracetamol can be given to children aged two months or older for pain or fever (ibuprofen can only be used above three months of age).
Do the ‘glass test’ if your baby has a rash. Press a clear drinking glass firmly against the rash. If you can see the spots through the glass and they do not go away as you press the glass onto the skin then they have a ‘non-blanching rash’.

Meningitis Glass Test

Fever with spots/rash that do not fade under pressure is a medical emergency
On dark skin, the spots/rash can be more difficult to see, check lighter areas such as the palms of the hands, soles of the feet, inside the eyelids and the roof of the mouth. Be aware of all signs and symptoms

Photograph showing a red rash that doesn't disappear when pressed on by a glass
From: Meningitis NOW

Where can I get help?

If it is non urgent, speak to your local pharmacist or health visitor.
If your child has any of the above red or amber features, urgently see your GP. For an urgent out-of-hours GP appointment, call NHS 111.
You should only call 999 or go your nearest Emergency department in critical or life threatening situations.

Self Care
For wear and tear, minor trips and everything in between. Self-care You can treat your child's very minor illnesses and injuries at home. Some illnesses can be treated in your own home with support and advice from the services listed when needed.	Sound advice Children can get better from illness quickly but also can become more poorly quickly. it is important to get further advice if a child's condition gets worse. More information on common childhood illnesses.
Local Pharmacist
Pharmacists are experts in many aspects of healthcare. They are the first port of call for minor ailments and can provide advice and medication (if needed) for a wide range of long term conditions and common ailments including coughs and colds. Pharmacy First is a free service. You do not need an appointment and many pharmacies have a private consultation area. Your pharmacist will let you know if you need further medical attention.	Sound advice Visit a pharmacy if your child is ill, but does not need to see a GP. Remember that if your child's condition gets worse, you should seek further medical advice immediately.
Health Visitor
Health visitors are nurses or midwives who are passionate about promoting healthy lifestyle and preventing illness through the Universal Health Visiting Pathway. They work with you through your pregnancy up until your child is ready to start school. Your health visitor may be able to refer you on to other health professionals, for example if there are hearing or vision concerns. Contact them by phoning your local health visiting team.	Sound advice Health visitors also provide advice, support and guidance in caring for your child, including: Breastfeeding, weaning and healthy eating Exercise, hygiene and safety Your child’s growth and development Emotional health and wellbeing, including postnatal depression Safety in the home Stopping smoking Contraception and sexual health Sleep and behaviour management (including temper tantrums!) Toilet training Minor illnesses For more information watch the video: What does a health visitor do?
GP (General Practitioner)
GPs assess, treat and manage a whole range of health problems. They also provide health education, give vaccinations and carry out simple surgical procedures. Your GP will arrange a referral to a hospital specialist should you need it.	Sound advice You have a choice of service: Doctors/GPs can treat many illnesses that do not warrant a visit to the Emergency Department. For minor injuries such as cuts that need stitches, broken bones, sprains and minor burns in children aged 5 or over, go to one of our Minor Injury Units (MIU).
NHS 24
If you’re not sure which NHS service you need, call 111. An adviser will ask you questions to assess your symptoms and then give you the advice you need, or direct you straightaway to the best service for you in your area.	Sound advice Use NHS 24 if you are unsure what to do next, have any questions about a condition or treatment or require information about local health services.
Emergency Department
Emergency departments provide vital care for life-threatening emergencies, such as loss of consciousness, suspected heart attacks, breathing difficulties, or severe bleeding that cannot be stopped. If you’re not sure it’s an emergency, call 111 for advice.	Sound advice Many visits to the Emergency Department and calls to 999 could be resolved by any other NHS services. If your child's condition is not critical, choose another service to get them the best possible treatment.