A child under three months with a temperature of 38°C or more needs immediate medical assessment.
At any age, difficulty breathing, a seizure, unusual drowsiness, confusion, pale or grey colour, poor drinking or sharply reduced urine output are emergency signs.
Age changes the threshold
HealthHub flags 38°C in a child under three months as an immediate Children’s Emergency reason. Record age and how temperature was measured. (HealthHub child fever guide)
A child who is difficult to awaken, confused, inconsolable or very lethargic needs urgent care even if the temperature is not extreme. Assess the child while awake, not only during sleep.
| Situation | What changes |
|---|---|
| Under three months and 38°C or more | Seek immediate medical assessment |
| Breathing trouble, seizure, difficult to wake or grey colour | Go to Children’s Emergency or call 995 for life-threatening distress |
| Alert, drinking and no red flags | Contact a GP and monitor closely |
| Mild-to-moderate problem but GP refers onward | Use the documented GPFirst referral route where applicable |
Breathing and colour are red flags
Difficulty breathing and pale or grey appearance are emergency signs. Call 995 when breathing is severely compromised or the child is unresponsive. (MOH seeking a doctor)
Drinking less and passing significantly less urine can signal deterioration. Record fluids, vomiting and last urine rather than saying the child drank “some”.
Example: A two-year-old has 38.7°C fever but is alert, drinking and urinating normally with no breathing problem or rash. A GP assessment may be appropriate. If the same child becomes hard to wake or struggles to breathe, the route changes immediately to emergency care.
Seizures need safe first aid
Place the child on the side, clear nearby objects and put nothing in the mouth. HealthHub says a seizure over five minutes warrants 995; a shorter seizure still needs medical review. Time the seizure from the start.
MOH advises GP care for many mild-to-moderate conditions so Emergency Departments can focus on emergencies. Call ahead for holiday opening and disclose the child’s age and symptoms.
- Measure temperature correctly
- Record the child’s age
- Check alertness and consolability
- Watch breathing and colour
- Track fluids and urine
- Time any seizure
- Escalate when a red flag appears
