Fever is the most common reason a parent messages me at midnight. So here is the whole approach in one place: what to do in the first hour, how to use fever medicine correctly, and the short list of signs that mean stop managing at home.

First, one thing to hold on to: fever itself is not the illness. It is the body's normal response to an infection, and in an otherwise healthy child it is not dangerous by itself. The number on the thermometer matters far less than how your child looks and behaves.

The first hour: work through this list

1. Look at your child before you look at the thermometer

Are they drinking? Passing urine? Smiling or playing at all, even if low? A child with 39.5°C who is drinking, talking and interested in a toy is usually less worrying than a child with 38.2°C who is limp and unreachable. Treat the child, not the number.

2. Measure the temperature properly

Use a digital thermometer in the armpit, or follow your device's instructions. Touch alone misleads all of us. Write the reading and the time down - a pattern over hours tells a doctor far more than one number.

3. Make them comfortable

Light clothing, a normal room temperature, sips of water, ORS, milk or whatever fluids they will take. Do not pile on blankets "to sweat it out", and do not give a cold-water or ice sponge bath - it makes children shiver and miserable without helping. Never use alcohol rubs.

4. Give fever medicine for comfort, not to chase a number

Paracetamol is the first choice. The dose is by weight - 15 mg per kg per dose - and can be repeated every 4 to 6 hours if needed, no more than 4 doses in 24 hours. Check the strength of your syrup (120 mg/5 ml and 250 mg/5 ml are both common in India) and measure with the cup or syringe that came with the bottle, not a kitchen spoon. Ibuprofen is an option for children over 6 months, given with food. Do not alternate the two on a schedule - it confuses dosing and rarely helps. And never give aspirin to a child.

5. Note the company the fever keeps

Cold symptoms, a sore throat, vomiting, loose motions, a rash, ear pain, burning during urination - these point a doctor toward the cause. Jot them down as you notice them.

When to call the doctor today

  • Your baby is under 3 months old and the temperature is 38°C or more. This one never waits, and do not give fever medicine first - the doctor needs to see the baby as they are. (See the full guide: fever in a baby under 3 months.)
  • The fever has lasted more than 3 days, even if it seems mild.
  • Your child is drinking poorly, has very little urine (fewer than 3-4 wet nappies or trips in 24 hours), or has no tears when crying.
  • They are unusually drowsy, difficult to wake fully, or not themselves between fever spikes.
  • They have had a seizure with this fever for the first time, or you simply feel something is wrong. That feeling counts - call.

When to go to the emergency room now

  • Hard or fast breathing, chest pulling in with each breath, or lips that look blue
  • A purple or dark-red rash that does not fade when you press a glass against it
  • A stiff neck, severe headache, or pain when the chin moves toward the chest
  • A seizure lasting more than 5 minutes, or repeated seizures
  • A child you cannot fully wake

The full red-flag guide lives here: My child has a fever - when is it an emergency? Bookmark it before you need it.

What you can stop worrying about

Fever does not damage the brain. A fever that comes back when the medicine wears off is normal - the medicine buys comfort, not a cure, and most viral fevers run 3 to 5 days. And you do not need to wake a sleeping child just to give a dose; sleep is doing its own work.

This article is general information and does not replace medical advice for your child. If your child looks seriously unwell, or your instinct says something is wrong, see a doctor.

Sources

Sources checked 16 September 2026.