Your baby feels hot: a calm guide to fever and when to get help

It is late, the house is quiet, and as you lift your baby for a feed you notice it: they feel hot. Your heart starts racing before your mind has caught up. This guide is for that moment, and for the calmer daylight hours when you want to be prepared. Save it somewhere you can find it quickly.

First, check the temperature properly

Touch is a useful first clue, but a thermometer gives you a number your doctor can use. For babies, a digital thermometer placed in the armpit is a common, simple choice. Hold your baby's arm gently against their side for as long as the thermometer instructions say. A normal temperature in babies is usually around 36.4°C, though it varies a little from baby to baby. A fever is generally a temperature of 38°C or higher.

Write down the reading and the time. If you check again later, note that too.

Age matters most

In young babies, a fever is taken more seriously because their immune systems are still developing and they can become unwell quickly.

• Under 3 months with a temperature of 38°C or higher: get urgent medical advice straight away, even if your baby seems otherwise fine. Call your doctor or an urgent advice line, or go to your nearest emergency department.
• 3 to 6 months with a temperature of 39°C or higher: get urgent medical advice the same day.
• Any age: call your doctor or clinic if your baby has a fever and seems unwell to you, the fever lasts more than a few days, or you are worried.

Seek emergency help now if your baby

• Has skin, lips or tongue that look blue, grey, very pale or blotchy. On brown or black skin, check the palms, soles, lips and inside of the mouth.
• Is struggling to breathe: grunting, breathing very fast, pausing in their breathing, or the skin sucking in under the ribs or at the neck.
• Is floppy, very drowsy, hard to wake, or does not stay awake when woken.
• Has a weak, high-pitched or unusual cry that will not stop.
• Has a rash that does not fade when you press a clear glass firmly against it.
• Has a fit or seizure, even if they seem to recover.
• Has a stiff neck, or a bulging soft spot on the top of the head.
• Is not feeding, or shows signs of dehydration such as very few wet nappies.

In an emergency, call your local emergency number or go straight to the nearest emergency department. Do not wait to see if it passes.

Caring for a baby with a mild fever at home

If your doctor is happy for you to care for your baby at home, or your older baby has a mild fever and is otherwise alert and feeding:

• Offer plenty of feeds. Breastfeed or bottle-feed more often. Babies lose fluid faster when they are hot.
• Do not overwrap. Dress your baby in light layers and keep the room comfortably cool. Avoid heavy blankets.
• Skip cold baths and sponging. These are no longer recommended and can make babies shiver and feel worse.
• Ask before giving any medicine. Speak to a pharmacist or doctor before giving fever medicine to a baby, especially a very young one, and always check the product is right for your baby's age and weight.
• Keep checking on them, including through the night, and watch for any of the emergency signs above.
• Keep them at home rather than at nursery or with a childminder while they are unwell.

What about teething and vaccinations?

Babies may have a mild rise in temperature for a day or two after vaccinations, and your clinic will tell you what to expect. Teething, however, is not a known cause of a high fever. If your baby has a temperature of 38°C or higher, do not assume it is teeth. Treat it as a fever and follow the guidance above.

Trust what you see

Numbers matter, but so does how your baby seems. A baby with a fever who is still feeding, making wet nappies and responding to you is reassuring. A baby who is just not themselves, unusually quiet, hard to engage or very different from their normal, deserves a professional opinion, whatever the thermometer says. You know your baby best. Asking for help is never a waste of anyone's time.

Held in the hard nights

Fever nights are long, and fear can feel very loud in the dark. The psalmist wrote, “God is our refuge and strength, a very present help in trouble” (Psalm 46:1). Very present: not far off, not waiting until morning. He is with you as you check the thermometer, make the phone call and sit by the cot. Prayer and practical action are not opposites. You can whisper a prayer while you dial.

A prayer for a feverish night

Lord, You are my very present help. Calm my racing heart so I can think clearly. Guide the hands and minds of every nurse and doctor who cares for my baby, and bring healing and rest to this little body. Amen.