Feature Article

Assessing and managing fever in children

Alan Chong



The febrile infant or child remains one of the most common clinical problems that presents to family doctors.

Key Points

  • All febrile infants aged less than 3 months should be referred to hospital for admission, investigation and management.
  • In febrile older babies and children, first assess for reduced alertness and activity, breathing difficulty, circulatory impairment and dehydration.
  • Generally, nontoxic febrile children aged over 3 months may be managed as outpatients in general practice.
  • Fever less than 40oC does not routinely need antipyretic treatment unless the child appears uncomfortable.
  • Paracetamol can be given to children over 1 month of age; care must be given to explain dose clearly when prescribing because available liquid preparations vary in concentration.
  • Ibuprofen may be given to otherwise well children aged 6 months or over.