Febrile Seizure in a Child: What to Do
A febrile seizure is a fit brought on by a fever, usually in children between 6 months and 6 years. Most last under 5 minutes and stop on their own. Stay calm, time it, keep your child safe, and do not put anything in their mouth. Call 995 (Singapore’s emergency number) if it lasts longer than 5 minutes or your child will not wake afterwards.
What to do during a seizure
Work through these in order. The aim is to keep your child safe and let the seizure run its course. Most stop on their own within a few minutes.
When your child is seizing, every minute will feel far longer than it is. You cannot trust your sense of how long it has been. Duration decides what happens next: 5 minutes is the threshold for calling an ambulance. The start time matters when you speak to a doctor.
If your child is on a raised surface, guide them carefully to the floor. Keep them flat and away from hard edges, stairs, and water. Loosen any tight clothing around their neck.
No fingers, spoons, or medicine. They cannot swallow their tongue. Objects in the mouth cause injury and can block the airway.
You cannot interrupt a febrile seizure from the outside. The brain has to work through it on its own. No amount of shaking, calling their name, or stimulation will shorten it. Restraining the jerking can injure joints. Clear hard or sharp objects from nearby and let the seizure run its course.
As soon as you can do it safely, roll them onto their side so saliva can drain. You do not need to wait for the jerking to stop first.
Talk calmly and reassuringly. When it stops, note how long it lasted and what you saw, to tell the doctor.
When to call emergency services
Call 995 for an ambulance if
- !The seizure lasts longer than 5 minutes
- !A second seizure begins before your child has fully recovered
- !Breathing does not start to return to normal within a minute or two of the seizure stopping, or your child turns blue or grey
- !Your child cannot be woken after the seizure stops
- !Your child has a stiff neck (can be a sign of something more serious)
- !This is the first seizure and you cannot get to a hospital quickly
If the seizure lasts longer than 5 minutes, call 995. If your doctor has already prescribed rescue medication, such as rectal diazepam, for this child, give it as instructed, but giving it does not replace calling for the ambulance.
If the seizure was brief and has stopped, an ambulance may not be needed, but your child still needs to be seen. For a first febrile seizure, take them to your nearest 24-hour Children's Emergency even though it has stopped. A doctor needs to confirm what it was and check the cause of the fever. If your child stopped seizing quickly but is not recovering as you would expect, go to A&E or call 995.
If your child has had febrile seizures before, the fit was short and typical, and they are recovering normally, contact your doctor or polyclinic the same day for advice on whether to bring them in. Follow any specific plan your doctor has already given you.
After the seizure stops
When the jerking stops, most children go limp and appear deeply unresponsive. Breathing may sound shallow, slow, or irregular for a short period. This is the most frightening moment for bystanders and is often described as the child not breathing at all. It is part of the normal postictal phase. Keep them on their side and watch closely. Breathing should gradually settle and become more regular within a minute or two.
If breathing does not start to improve, or your child turns blue or grey, call 995 immediately. If breathing is settling, stay calm and let the postictal phase run its course.
After the initial limp phase, your child will likely remain drowsy, confused, or irritable. This can last from a few minutes to an hour. What to look for is gradual improvement: your child slowly becoming more alert over time. If they are not improving at all after 30 minutes, take them to the nearest 24-hour Children's Emergency.
- Keep them on their side and comfortable while they come round.
- Do not try to give food, drink, or medicine until they are fully awake and alert.
- Once awake, you can treat the fever for comfort with paracetamol by weight if needed.
- Note the duration and what you saw. This helps the doctor confirm it was a simple febrile seizure.
What a febrile seizure is
A febrile seizure is a convulsion triggered by a fever, most often between 6 months and 6 years of age. It is linked to the rise in temperature rather than to how high the fever gets, which is why it can happen as the fever is climbing, sometimes before you even knew your child was unwell.
A typical febrile seizure moves through phases. The body usually stiffens first, eyes may roll back, and there may be frothing or drooling at the mouth. Then the arms and legs jerk rhythmically. The child is unresponsive throughout. When the jerking stops, the child typically goes limp and quiet, and breathing may sound shallow or irregular for a short time before gradually returning to normal. Not every seizure follows this pattern exactly: some children go straight to the limp phase, or the jerking may be subtle.
A simple febrile seizure lasts under 15 minutes, involves the whole body, and does not repeat within 24 hours. These are the common kind and do not cause lasting harm. Seizures that last longer, affect only one part of the body, or repeat in the same illness are less common and need closer assessment, which is one reason to get your child seen.
Two more things not to do
- Do not put your child in a bath or splash water on them to cool the fever. This can cause shivering, which raises core temperature and makes things worse.
- Do not give medicine by mouth during the seizure or before they are fully awake and alert.
If it happens again
Around 1 in 3 children who have a febrile seizure will have another during a future fever. Giving fever medicine does not reliably prevent febrile seizures, so the goal of treating a fever stays the same: keeping your child comfortable, not preventing a fit.
If your child has a known tendency to febrile seizures, your doctor may give you a specific plan. Follow that plan. The steps for keeping your child safe during a seizure remain the same every time.
→ Fever with rash in a child: the blanch test and when to call 995
→ Toddler fever 39°C: when to monitor vs seek help
→ Fever at night: when should parents worry?
Frequently asked questions
What is a febrile seizure?+
A febrile seizure is a convulsion triggered by a fever in a child, most often between 6 months and 6 years of age. The body usually stiffens, then the arms and legs jerk rhythmically, and the child is unresponsive. When the jerking stops, the child typically goes limp and breathing may be shallow for a short time before gradually returning to normal. This limp, quiet phase is often the most alarming moment for bystanders. Most febrile seizures are brief and cause no lasting harm.
How long does a febrile seizure usually last?+
Most febrile seizures last less than 2 to 3 minutes and stop on their own. A simple febrile seizure lasts under 15 minutes and does not repeat within 24 hours. Time it if you can, because the duration affects what to do next.
When do I call 995 during a seizure?+
Call 995 if the seizure lasts longer than 5 minutes, if a second seizure starts before your child has recovered, if your child has trouble breathing or turns blue, or if they cannot be woken after the seizure stops. If you are ever unsure, call 995 and describe what you are seeing.
My child had a brief seizure and is now recovering. Do I still need to go to hospital?+
Yes, get them assessed. If this is the first febrile seizure, take your child to your nearest 24-hour Children's Emergency even though the seizure has stopped and they are coming round. A doctor needs to confirm it was a febrile seizure and check the cause of the fever.
Should I put something in my child's mouth during a seizure?+
No. Never put fingers, spoons, or anything else in the mouth of a child having a seizure. They will not swallow their tongue. Objects in the mouth can break teeth, block the airway, or injure you. Keep the area clear and turn them gently onto their side as soon as you can do it safely.
Will a febrile seizure cause brain damage or epilepsy?+
Simple febrile seizures do not cause brain damage and do not mean your child has epilepsy. Most children grow out of febrile seizures by around age 6. Around 1 in 3 children who have one will have another during a future fever, which is why knowing what to do makes a real difference.