Your little one’s forehead feels warm and her cheeks are flushed. Before you start panicking,
here’s what you should know about fever in babies and toddlers.
1. It’s not a fever until the
thermometer reads 38deg C.
That is, if you are going by your
baby’s rectal temperature (taken in
her bottom), according to the
American Academy of Paediatrics
A person is said to have a high
fever when his body temperature is
38.5 deg C and above.
The normal body temperature
can range from 36.1 deg C to 37.8
deg C, said Dr Leo Deng Jin, an
associate consultant at the department
of emergency medicine at KK Women’s and Children’s Hospital
Not only do babies and younger
children have a higher body temperature
than adults, but it can also
vary throughout the day for
different reasons, from being overdressed
to the time of the day,
Even the device and method you
use to measure your little one’s
temperature can make a difference.
For example, a temperature reading
taken in the bottom tends to be
higher than that taken in the
You may also get slightly higher
readings from infrared thermometers,
compared to electronic
ones, Dr Leo said.
2. Rectal readings are
the most spot-on.
No one likes sticking a thermometer
into their little one’s bottom.
But it gives the most accurate
readings for babies, especially
those under three months, and
toddlers up to the age of three, said
Dr Michael Wong, deputy medical
director at Raffles Medical.
For accuracy, take your child’s
temperature twice each time.
Digital ear thermometers, which
use infrared rays, are not recommended
for newborns. They are for
babies above six months, older kids
Armpit temperatures are the
least accurate. And don’t bother
feeling your baby’s skin to check if
she is having a fever – it is not
accurate as it depends a lot on your
own body temperature, said Dr
He said that your child has a fever
- Rectal temperature
is above 38 deg C.
- Ear temperature
is above 37.8 deg C.
- Oral temperature
is above 37.5 deg C.
- Underarm temperature
is above 37.3 deg C.
3. Don’t just focus on the numbers,
look at the symptoms.
It is hard to remain calm as your
child’s temperature climbs. But a
high reading on the thermometer
doesn’t necessarily mean her illness
is serious, said Dr Leo.
Likewise, don’t dismiss a
low-grade fever as a minor issue, Dr
Wong warned. A fever is not an
illness, but usually a symptom of an
Instead of focusing solely on the
numbers, look at other signs to
determine how sick your baby is –
is she still playing and eating well?
See a doctor if her fever rises
above 40 deg C or goes on for more
than 24 hours, the AAP advises.
Dr Wong said you should take
your child to the doctor if she:
- Feeds poorly.
- Is vomiting.
- Looks lethargic or drowsy.
- Is very young, especially if she
is under three months old.
- Has breathing difficulties.
- Looks sicker than before.
- Has stomach pain
- Has a rash.
- Passes less urine than usual.
4. If your two-month-old is heating
up, go straight to hospital.
A hospital stay is usually required
for babies under three months old
who are running a temperature.
That is because the younger the
baby, the higher the chance of getting
a serious bacterial infection,
such as a bloodstream or urinary
tract infection, or meningitis (brain
infection),Dr Leo said.
It is important that the baby gets
the right tests and treatment in
time. Symptoms of a serious illness
tend to be more subtle in very
young babies, which is why doctors
are generally more cautious and
may recommend additional tests
for this age group, Dr Wong said.
For babies older than three
months, see the doctor first to
check if the condition warrants a
visit to the emergency department.
5. Sponge baby with
Bringing a high fever down with ice
or cold water sounds logical, but the
AAP advises against it. Doing so
may cause chills or shivering, further
raising the baby’s temperature.
KKH suggests using tap or lukewarm
water instead. Apply a cool
compress to the forehead, nape of
neck, armpits, neck and groin area,
for no more than 30 minutes at a
stretch. Stop sponging when your
child starts shivering. Keep the
roomcool and well-ventilated.
6. Bundling up your feverish baby
does more harm than good.
“When parents see their babies
shivering, their usual reaction is to
cover them with blankets. This
would only trap more body heat,
causing the body temperature to
stay high,” Dr Leo said.
Like adults, babies and children
often feel cold or shiver during a
bout of fever.
He said this occurs when the
body tries to produce more heat to
raise its temperature during illness
to fight an infection.
Even if your baby is not sick,
overwrapping can cause her
temperature to be slightly above
normal, especially in Singapore’s
“A blanket might be suitable if
your baby is in an air-conditioned
shopping mall, but not outdoors on
a sunny day,” Dr Leo said.
Ditch the swaddle, long-sleeved
pyjamas and thick blankets. Opt for
light clothing and offer plenty of
fluids. Bring your baby’s fever
down with medication prescribed
by the doctor, and then sponge her,
7. You may reuse fever medications,
but check the dosage.
Syrup paracetamol or ibuprofen
can be kept in the refrigerator for
up to six months or three months at
room temperature, said Dr Leo.
But take note of the expiry date
and storage instructions on the
You will also need to know
exactly how much medication to
give your baby, which is based on
her weight and not age.
The dose prescribed when she
was six months old may not be
suitable several months later.
To be safe, Dr Leo said parents
should call the clinic or pharmacist
to check the correct dosage, especially
if the baby’s weight has
changed significantly since the last
visit to the doctor.
You should never give your child
For example, aspirin is not safe
for children under the age of 18, as
it can cause a rare but serious illness
knownas Reye’s syndrome, Dr