What should you know about neonatal fever?

A temperature can be affected by infection, the environment or how it was measured, so clinicians confirm the reading with an appropriate method and examine the baby. Fever may occur with a viral or bacterial illness, but the temperature alone cannot identify the cause. The team may ask about feeding, breathing, wet nappies, alertness, rash and recent contact with illness. Conditions such as bronchiolitis or a common cold can be considered, while other causes may also need attention.

Contact urgent medical services or your maternity or paediatric team promptly for advice and assessment. Record how the temperature was taken and when, and note feeding and wet nappies. Keep the baby comfortably dressed and continue usual feeds if the baby is alert and able to feed. Do not give fever medicine, antibiotics or other remedies unless a clinician tells you the correct product and dose for the baby.

Call emergency services for difficult breathing, blue or grey skin, a seizure, collapse, severe sleepiness, inability to feed, repeated vomiting, or a rapidly spreading rash. A newborn with fever needs prompt assessment even when these warning signs are absent; do not wait for the fever to settle before seeking medical advice.

What temperature method should we use? Does the baby need tests or observation? Which treatment is appropriate? How should we support feeding and hydration? What changes mean we should return immediately?