Last updated on Feb 17th, 2021 at 10:13 am

A baby’s less likely to run a fever during the first few weeks after being born, so symptoms may be vague, explains paediatrician Sibusiso Kuzwayo. There may be a slightly elevated temperature or a drop in temperature – a hypothermic reaction. “Consider 36.8°C to 37.2°C to be a normal range of body temperature for your newborn,” Kuzwayo advises.

Also be vigilant for symptoms of lethargy, poor feeding, unexplained irritability or poor perfusion, says Kuzwayo.
Cold extremities are a marker of poor perfusion. If your baby’s hands and feet feel icy, gently press down on the skin. “Usually, the skin blanches and returns almost immediately. If it doesn’t, it could be a sign of infection or decreased cardiovascular function and you need to seek medical attention,” he notes.

Signs and symptoms

General practitioner, Yvette Lamberts, describes the signs and symptoms of fever as:

  • Shivering and shaking
  • Rapid heart rate and possibly rapid breathing
  • Skin that’s hot or warm to the touch
  • Flushed face
  • Sweating
  • A temperature-reading above 37.5°C.

In addition to the fever, your baby may show symptoms of an underlying infection. These include:

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  • Lethargy and listlessness
  • Not wanting to feed
  • Unexplained irritability
  • Vomiting
  • Diarrhoea
  • Ear pain
  • Snotty nose
  • Coughing.

When and how to treat fevers at home

“The most important reason to treat fever in children is to make them feel better,” advises paediatrician, Gary Reubenson. If the child’s miserable, irritable or in pain, it makes sense to give an antipyretic (paracetamol or ibuprofen) to help him feel better. “Just because a fever’s present it’s no reason to treat it,” he stresses.
Reubenson believes that parental ‘fever phobia’ needs to be counteracted. “It’s a myth that fever’s bad, harmful, dangerous and needs to be medicated. Fever’s actually thought to be beneficial – germs often don’t ‘like’ the higher temperature.”

Instead of focussing on the number on the thermometer, he counsels parents to watch more closely for symptoms that indicate serious illness and to monitor their baby’s hydration.

He disputes the statement that treating fever prevents febrile seizures. “Antipyretics won’t reduce the risk of a child having a febrile seizure.”

When treating a baby with a fever at home, Reubenson suggests the following:

  • If your baby has a fever but is happy, drinking well or sleeping, he usually won’t benefit from an antipyretic.
  • Dress your baby comfortably. Removing clothes may make them feel cold – even when their temperature’s high.
  • Paracetemol and ibuprofen are generally safe, but can have side-effects if given repeatedly and at high doses. Paracetemol shouldn’t be given more than four times a day and ibuprofen shouldn’t be given more than three times a day.
  • Don’t mix paracetamol and ibuprofen (one dose of paracetemol and then the next dose ibuprofen).
  • With most kids, sponging them with lukewarm water or giving them a lukewarm bath won’t break the fever.
  • Don’t give an antipyretic routinely before your baby gets a vaccine.

When should you seek medical attention?

When your baby’s running a fever, the following symptoms should prompt you to seek immediate medical attention, advises paediatrician Dr Nadia Khan.

  • Fever in newborns
  • Fever higher than 40°C
  • Inconsolable crying – especially when moved or touched
  • Baby’s difficult to rouse
  • A rash that has developed with the fever
  • Neck stiffness
  • Difficulty breathing
  • Convulsions
  • Baby’s drooling, unable to swallow or not feeding
  • Baby has an underlying medical condition.

And, see a doctor within 24 hours if your baby:

  • Is younger than a year old
  • Is in pain when urinating
  • Has had a fever for more than 24 hours without an obvious source of infection
  • Had a fever that subsided for more than one day, but then returned
  • Has been running a fever for more than three days.

Is a fever a sign of infection?

“Not always,” says paediatrician Ashraf Coovadia. “Teething can cause a mild elevation in temperature and it’s not uncommon for a child to have a slight fever after a vaccination.” Infections (usually in the respiratory and gastrointestinal tract) are by far the most common causes of fever”.

Keep an eye on the symptoms

When your baby runs a fever, paediatricians counsel that being watchful for accompanying symptoms of a possible infection is more important than focusing on the number on the thermometer. But seek immediate medical attention if your newborn – or baby under 28 weeks old – runs even a ‘mild’ fever.