Cold Sweats and Chills With a Child's Fever: What They Mean
Chills and cold sweats are part of how the body raises and lowers its temperature during a fever, and are usually not a sign of anything dangerous on their own. Here's why they happen, what to do (and not do), and the signs that need a closer look.
Why fever causes chills and sweating
A fever happens because the body's internal thermostat resets to a higher temperature than normal. Chills and shivering are the body's way of generating heat to reach that new, higher target, which is why your child can feel cold or start shivering even while their temperature is rising. This usually happens as a fever is climbing.
Sweating happens for the opposite reason. When the thermostat drops back toward a lower setting, for example once medicine starts working or an infection begins to settle, the body releases heat through sweat to cool down. Cold, clammy sweats overnight are a common part of this and often mean the temperature is coming down.
Both are part of normal temperature regulation, not separate illnesses on top of the fever.
What to do when your child has chills or sweats
- During chills or shivering, a light blanket is fine until it passes. Remove it once your child warms up or starts sweating.
- During sweating, change your child out of damp clothes and bedding so they stay comfortable and do not get cold afterward.
- Offer a sip of water either way. Sweating adds to fluid loss on top of the fever itself.
- Keep the room at a comfortable temperature, around 25°C, with light clothing rather than heavy layers.
What not to do
- Do not use cold water baths, ice packs, or alcohol or vinegar rubs to try to cool a shivering child down faster. Cold water can cause shivering, which generates heat and can push the core temperature higher.
- Do not bundle your child up tightly to "sweat the fever out". Trapping heat this way can raise the temperature further and adds to fluid loss.
- Do not judge your child's temperature by their hands and feet alone. Check the chest or back of the neck instead, since hands and feet often feel cooler during a fever regardless of how high the temperature is.
When to look closer
Chills and sweating on their own are usually not a concern. Pay closer attention if:
- Shivering is violent, or does not settle after a short time.
- Sweating comes with your child being very drowsy, hard to wake, or not drinking.
- Cold hands and feet come with mottled or pale-looking skin, especially with a high fever.
- The fever keeps spiking back up despite medicine, alongside repeated chills.
Any of these alongside a fever is worth a same-day call to your GP or polyclinic. If your child is also very drowsy, floppy, or hard to wake, go to your nearest 24-hour A&E.
→ Fever and dehydration: signs to watch for and what to offer
→ Fever not coming down with paracetamol: what to do
→ Fever at night: when should parents worry?
Frequently asked questions
Why does my child feel cold and shiver when they have a fever?+
During a fever, the body resets its internal temperature target higher. Shivering is the body generating heat to reach that new target, which is why your child can feel cold or shiver even as their temperature is climbing. This is a normal part of how a fever develops.
Is sweating a sign the fever is breaking?+
Often, yes. Sweating happens as the body releases heat to bring the temperature down toward a lower target, for example after medicine starts working or as an infection settles. Cold, clammy sweats overnight are a common part of this and are not usually a separate problem.
Should I cover my child with a blanket if they have chills?+
A light blanket while the shivering passes is fine, but remove it once your child warms up or starts sweating. Avoid piling on heavy layers to try to warm them up, as this can trap heat and push the temperature higher.
My child's hands and feet are cold but their body feels hot, is that normal?+
Yes, this is common during a fever. Blood flow shifts toward the body's core, so hands and feet can feel cool even while the chest and back feel hot. Check how warm your child feels at the chest or back of the neck rather than their hands and feet to judge their temperature.
When should I worry about chills or sweating with a fever?+
Chills or sweating on their own are rarely a concern. Look more closely if shivering is violent or does not settle, if sweating comes with your child being very drowsy or not drinking, or if cold hands and feet come with mottled or pale skin. Combined with these, see your GP the same day or go to your nearest 24-hour A&E.